Motivational interviewing and clinical psychiatry.
OBJECTIVE
Our objectives were as follows: (1) to survey the literature on motivational interviewing (MI), "a client-centered yet directive method for enhancing intrinsic motivation to change by exploring and resolving client ambivalence" and a well-established method of brief intervention, especially in the field of addictions treatment; (2) to review hypotheses about its mode of action; and (3) to discuss its possible impact on clinical psychiatry, in particular, on teaching communications skills.


METHODS
Literature reviews and metaanalyses of numerous clinical trials of MI for addictions treatment have already been published and are briefly summarized. So far, no literature survey exists for MI applied to psychiatric patients. This review is limited to a synthesis of the articles relevant to psychiatry and to comments based on our team's experiences with MI.


RESULTS
There is no evidence that MI achieves better results than other established techniques for treating addictions; it may simply work faster. The explanation for the method's rapid effectiveness remains speculative. Outcomes concerning the application of MI to psychiatric patients, although preliminary, are promising. Methods of assessing the integrity of MI treatment are more developed than in most psychotherapies, which permits the learning progress of trainees to be measured.


CONCLUSIONS
MI offers a complement to usual psychiatric procedures. It may be worthwhile to teach it, not only for addictions but also for other broad treatment issues, such as enhancing patients' medication compliance and professionals' communication skills. Questions remain concerning MI's feasibility in psychiatry settings.
Chanut
Florence
F
Addiction Research Program, Douglas Hospital, McGill University, Montreal, Quebec. f.chanut@videotron.ca
Brown
Thomas G
TG
Dongier
Maurice
M
D015928:Cognitive Behavioral Therapy; D006801:Humans; D007406:Interview, Psychological; D001523:Mental Disorders / Q000628:therapy; D009042:Motivation; D011570:Psychiatry / Q000379:methods*