Harvard Mental Health Letter

Motivating behavior change

Motivational interviewing is a therapeutic technique many clinicians use to help a patient identify personal reasons for undertaking the hard work of behavior change. Although originally developed for the treatment of alcohol dependence, motivational interviewing is now used to help patients overcome other types of substance abuse, stop smoking, lose weight, increase physical activity, and improve adherence to medical treatment. Motivational interviewing shares much in common with the transtheoretical or "stages of change" model of behavior change. Although not universally endorsed, the transtheoretical model holds that at any given time, a person is at a particular stage in relation to behavior change: precontemplation, contemplation, preparation, action, or maintenance. At the precontemplation stage, people do not acknowledge how serious the problem is, or even refuse to admit that they have a problem. At the contemplation stage, they are aware of the problem but have not yet decided to act. Especially for people addicted to alcohol or drugs, the first steps are often the most difficult, and many of them languish too long in the precontemplation and contemplation stages. Motivational interviewing is often best suited for these early stages of change.
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