This well-organized text provides a concise overview of the spirit and fundamental strategy inherent in motivational interviewing (MI), followed by a more detailed look at its utility in a number of special circumstances. The authors do a masterful job of explaining why this approach is particularly relevant to social and emotional development in adolescence and emerging adulthood, often revisiting this theme. Early chapters written by the authors give us a sense of the history and evolution of this approach, showing particular respect to the seminal work of W.R. Miller.
Chapters on person-centered guiding skills, responding to resistance, change talk and commitment clarify key concepts and skills, often illustrated by case examples. They provide a convincing argument as to how this approach makes particular sense with young people who are reluctant clients or ambivalent about identifying or making changes in dysfunctional behaviours. The authors’ approach considers resistance to be an interpersonal process consistent with normal development in this age group. Their concepts of resistance talk (“negative comments about treatment”), sustain talk (“statements about sustaining a behavior and not engaging in change”) and hesitancy about behaviour change represented by limited conversation are all very familiar to those of us who work with such clients. Their recommended responses, from “stop, drop and roll,” to various types of reflection, to an array of strategic responses deserve consideration, even by those of us who might not see ourselves as fully trained in this set of techniques.
Special topics, addressed by a wide range of guest contributors, include alcohol and drug treatment (in individual and group formats), work within the juvenile justice system, sexual risk reduction and approaches to those with psychiatric and eating disorders, obesity and problematic self-care in chronic medical conditions. The authors also look at application of this approach in schools and in family-based intervention. The extent of research done in each of these areas is reviewed, with many areas having an impressive, or in some cases at least promising, evidence base. The authors return to tackle the ethical considerations in a thoughtful and pragmatic way, suggesting a set of key guidelines for ethical practice utilizing MI.
MI approaches are seen as having wide application from therapy and medical offices to schools, probation and custody and a range of intensive treatment settings. The authors are clear that there is no substitute for observed and supervised development of these skills under an experienced practitioner. They identify a range of resources from introductory workshops to coaching and supervised coaching and feedback, even describing a couple of behavioural coding systems developed for the analysis of the MI method for skill development and research purposes. The text itself is well-referenced throughout.
This book fully delivers on all fronts. The review of key concepts and intervention skills is easily grasped and convincingly presented, a nice review for those with some familiarity. Case examples are presented in brief exposition that clearly illustrates the clinical or conceptual point. Chapter summaries, often in simple “do’s and don’ts” format and side-line quotes allow easy review of core chapters. The chapters addressing special topics provide a strong argument for the MI approach and should be invaluable to those working in these areas. Contributors, mostly clinical psychologists and MSW’s, have solid credibility. The amount of research related to MI is impressive, although of course there is more to be done, especially in more specialized applications.
I have little critique to offer. It would have been encouraging to see more contribution from physicians and psychiatrists amongst the authors. I also am of the impression that many of these strategies would be helpful to those of us in consulting and clinical practices even if we do not have the opportunity or perceived need to proceed through the full MI training and supervision process. Perhaps a chapter addressing this level of utilization of MI concepts and strategies would have been appropriate. However, these are limited concerns regarding a book I would highly recommend.