62.4 MOTIVATIONAL INTERVIEWING AS A COMMUNICATION FRAMEWORK TO FACILITATE ADHERENCE TO PEDIATRIC TRANSPLANT CARE

Abstract

Behavior change is an innately human experience. We all know the feeling of being asked, pushed, cajoled, or even being forced into engaging in a behavior that we may not be invested in pursuing. The experience can be frustrating and result in a mix of responses. In many of these situations, the result is a state of ambivalence. Despite our awareness of this shared human experience, we often neglect this inherent understanding when conducting health behavior change counseling. Motivational interviewing is a framework to empower patients and families to enact behavior change to improve their health and quality of life in a way that is feasible to them. It takes the spotlight for health behavior change off of the clinician and refocuses that light onto the patient’s thoughts, understandings, emotions, and abilities. There has been an emergence of interest, research, and practice utilizing motivational interviewing to support youth receiving pretransplant and posttransplant care. In this presentation, we will describe the current evidence of the utility and practice of implementing motivational interviewing as a foundational language style in pediatric transplant care. We will highlight the spirit of motivational interviewing, the general principles and microskills, the 4 processes, and the practical applications for youth and families. We will highlight case-based examples relevant to transplantation and clinical pearls to support engagement, enhance reflective listening, and facilitate opportunity for behavior change. We will explore examples of successful models of implementing motivational interviewing systemically in the delivery of pediatric transplant care. As motivational interviewing grows in its evidence base, application, and dissemination, it can become a vehicle to fuel integrated care and interdisciplinary education. Child and adolescent psychiatry has the unique opportunity to foster and nurture the education and dissemination of motivational interviewing to enhance evidence-based, patient-centered health behavior change counseling within pediatric transplant care.