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Motivational Interviewing: A Patient-Centered Approach to Elicit Positive Behavior Change

Delwyn Catley photo

Dental Care

Dental Care

Delwyn Catley, Ph.D.
Professor of Psychology
University of Missouri – Kansas City

E-mail: catleyd@umkc.edu

Although it is widely recognized that patients need to play a central role in maintaining their oral health, there has been increasing recognition in the field of dentistry and dental hygiene that current methods of encouraging patients to change their behaviors are ineffective.  Traditionally dental professionals have relied on educationally oriented methods that are often characterized by one-sided conversations in which the provider lectures the patient and provides recommendations for what the patient should do.  Providers commonly find patients to be unresponsive to such interventions and often become frustrated or dismissive of efforts to change patient behavior.

Consistent with this common clinical experience, a wealth of behavioral science research has now demonstrated that, while knowledge is an essential building block for behavior change, knowledge alone is insufficient. While there are a variety of models of health behavior change, one of the leading empirically supported clinical methods of intervention for fostering motivation for behavior change is Motivational Interviewing.  It has demonstrated efficacy across a wide range of behaviors including alcohol abuse, dietary change, smoking cessation, and treatment adherence.  Importantly, there is also emerging literature that indicates Motivational Interviewing offers great promise for addressing oral health behaviors in dental settings.

The focus of Motivational Interviewing is on working with patients to explore their own particular reasons for making behavior change.  Deemphasizing the importance of providing information and advice, the approach instead has practitioners focus on listening well to the patient’s perspective and encouraging elaboration of any statements oriented toward making a change.  The approach is supportive, interactive, and places ultimate responsibility for the decision to work toward change in the hands of the patient without practitioner disengagement.

While Motivational Interviewing is more involved than simply providing health education evidence indicates that it can be successfully mastered and implemented in brief sessions by health professionals who are not trained counselors.  Research and my experience as a trainer of Motivational Interviewing suggests that practitioners can benefit greatly from training and supervised practice in order to become proficient.  Most importantly, in my experience, practitioners also report far more satisfaction (even joy!) from engaging with their patients in this way once they have achieved some mastery.

Motivational Interviewing is now finding its way into dentistry and dental hygiene textbooks and leading dental schools are beginning to incorporate the approach into their educational curricula.  Hopefully this on-line course will encourage those interested dental professionals and students to begin on their path toward enjoying the rewards of incorporating Motivational Interviewing into their practice.

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