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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
People with insomnia — the inability to sleep — may be plagued by
trouble falling asleep, unwelcome awakenings during the night,
and fitful sleep. They may experience daytime drowsiness yet
still be unable to nap, and are often anxious, irritable, and
unable to concentrate.
Millions of people suffer from insomnia, and it often accompanies
a psychiatric disorder. Sleep problems are particularly common in
patients with anxiety, depression, bipolar disorder, and
attention deficit hyperactivity disorder (ADHD).
One of the most common ways to classify insomnia is in terms of
duration of symptoms. Insomnia is considered transient if it
lasts less than a month, short-term if it continues for one to
six months, and chronic if the problem persists longer than six
Treatment becomes necessary once insomnia impairs sleep quality
to the degree that it adversely affects a person's health or
ability to function during the day. Cognitive behavioral therapy
is recommended over medication for treating chronic
Alzheimer's disease and other types of dementia are the biological
equivalents of slow-motion train wrecks. These degenerative brain
disorders take years to develop. Some factors that predispose
people to develop dementia — such as advanced age and genetic
profile — cannot be changed. Scientists are therefore searching for
modifiable risk factors that would help people reduce their risk of
One area of focus is cigarette smoking. The research so far is
preliminary, but it suggests that smoking increases risk of
developing Alzheimer's disease and other types of dementia.
A study of adolescents with anorexia found that those who
participated in therapy that involves other family members had
higher rates of remission than those who received individual
An analysis of dozens of longitudinal studies bolsters the belief
that strong social relationships contribute to longevity.
Dr. Michael Miller, editor in chief of the Harvard Mental Health
Letter, discusses research into traumatic brain injury, which has
similarities to amyotrophic lateral sclerosis but is distinct