Congratulations on the publication of the second edition of your bestselling book, Motivational Interviewing in Health Care! For those who are uninitiated, can you briefly explain what Motivational Interviewing (MI) is, and why it is so effective in helping patients change behavior when it comes to things like medication adherence, smoking, diet, and exercise?

That’s actually two questions, not one! What is MI? The answer to this question seems to have become simpler over time. When the subject comes up of change in a patient’s life, MI involves using compassion and curiosity to help the person clarify why and how this might come about, aided, not dominated, by your best advice. Even if this is for literally a minute or two. It is a very normal sounding conversation, free of prejudice, in which you speak with a person first; someone who has strengths and dreams that provide a powerful channel for leading a healthier, more balanced life. How you hold this conversation is what the book is about. It is like learning to dance in a particular way. We can all dance. With MI, it’s just a matter of using familiar communication skills in a particular way, all designed to bring the best out of the patient.

Why is it so effective? I am flabbergasted by the number of controlled trials of MI—over 2,000 at the present time. I can’t possibly keep up with all this research but I think a certain truth emerges that corresponds with my clinical experience: it is a powerful and “motivating” experience to be asked how you feel by a practitioner, and to be listened to as you say how you might move ahead in life and make this or that change. This is also my experience as a patient myself. You hear yourself think aloud in the presence of someone who is genuinely interested and not trying to persuade you to do something. That’s where the magic is, I think.

The first edition of Motivational Interviewing in Health Care was published in 2007. A lot has changed since then—especially in the last three years. Can you speak to the relevance of the book in today's new health care landscape, and its importance to the challenges people are facing with the pandemic?

This recent pandemic raises challenges that go way beyond vaccination. People face isolation, distress, fear, and the breakdown of continuity in the treatment of existing medical conditions. The poorer the neighborhood, the worse are the challenges. Then there’s hesitancy around taking a vaccine itself, distrust and misinformation that practitioners need to address for the benefit of all. How to work in an MI style with patients who are hesitant about taking a vaccine is highlighted and illustrated in many places in this new second edition. There’s also a chapter devoted to this topic.

Health care is a very broad field! Who do you see as the primary audience for your book?

Motivational Interviewing in Health Care, Second Edition is helpful to any practitioner seeking to discuss change with their patients. This includes nurses, physicians, physician assistants, medical social workers, physical and occupational therapists, health educators, dentists, dietitians, behavioral health consultants, and health care administrators and managers; as well as graduate students and trainees in these fields.

New to this edition is a chapter on making telehealth consultations more effective—this is especially relevant now, because virtual doctor’s visits have become part of the norm. What are some other new additions to the book?

Yes, remote consulting is much more frequent these days. It doesn’t suit everyone. The virtual consultation provides a great opportunity to sharpen listening skills and MI can fit seamlessly into the consultation, especially if you start with an open heart and mind and not allow assessment to dominate the early exchanges. Other new additions in this book are chapters on how to merge advice-giving with MI, using MI in groups, using MI in very brief consultations, and a deep dive into what an MI-consistent consultation looks and feels like.

Lastly, we would love to learn a little bit more about you on a personal level! When you are not working, what do you do for fun? Now that your book is out, is there a project that you are excited to work on next (a presentation, a workshop, writing another book, etc.)?

I retired from my job ten years back, so now I do what I love: after visiting schools and writing a book on MI for teachers, I went into the world of sports. I wrote a book on MI for coaches, and now I mentor coaches and athletes and I’m having the time of my life. Using MI at home is a topic I am tempted to do my next book on, but ask my four kids about it and they will throw their heads back and laugh. They know from experience that parenting is a tough topic and they will probably advise me to look after my little woodland instead. They may be right but on the other hand....

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