Motivating people to change is fundamentally different to helping them deliberate about tough decisions surely? Or is it? Depends we think on the fundamental respect a practitioner has for the agency and rights of the individual in question. If people make decisions in the face of avoidable ignorance then we are doing our work as health care professionals. But there is a fine balance when it comes to counseling individuals who have risky behavior, whether it be smoking, using drugs, taking part in risky sport - where is the line we might want to draw between respecting choice and motivating change. In this article, we consider how clinicians could use these two approaches, often in the same encounter, to deal with the complexity of day to day practice.
Shared Decision Making and Motivational Interviewing: Achieving Patient-Centered Care Across the Spectrum of Health Care Problems
AbstractPatient-centered care requires different approaches depending on the clinical situation. Motivational interviewing and shared decision making provide practical and well-described methods to accomplish patient-centered care in the context of situations where medical evidence supports specific behavior changes and the most appropriate action is dependent on the patient’s preferences. Many clinical consultations may require elements of both approaches, however. This article describes these 2 approaches—one to address ambivalence to medically indicated behavior change and the other to support patients in making health care decisions in cases where there is more than one reasonable option—and discusses how clinicians can draw on these approaches alone and in combination to achieve patient-centered care across the range of health care problems.