Promoting Healthy Behaviors in Pediatrics

Abstract

1. Andrew J. Barnes, MD, MPH* 2. Melanie A. Gold, DO† 1. *Assistant Professor, Developmental-Behavioral Pediatrics, University of Minnesota, Minneapolis, MN. 2. †Clinical Professor of Pediatrics, Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh Student Health Service, Pittsburgh, PA. * Abbreviations: MI: : motivational interviewing MINT: : Motivational Interviewing Network Trainers After completing this article, readers should be able to: 1. Describe the spirit and principles of motivational interviewing (MI). 2. Know indications for using MI in the pediatric setting. 3. Apply MI to support behavioral change in pediatric patients at all stages of development. Please read the following and watch the video clip (Fig 1). Figure 1. Most pediatric clinicians realize that well-intentioned clinical plans can sometimes fall flat or backfire. Everyday practice is rife with times when one might wonder about which prescriptions go unfilled, whether home safety advice is being “tuned out,” or whether families will return for recommended follow-up visits. In pediatrics, in which “the family is the patient,” ensuring positive changes in health behaviors is daunting, especially in the face of perceived barriers such as lack of time and reimbursement for counseling. The true obstacles to high-quality care often are interpersonal and can include how practitioners deal (or fail to deal) with their feelings of discouragement or discomfort when faced with particularly “resistant” patients. Integrating motivational interviewing (MI) into one’s practice can be a very satisfying way to overcome some of these barriers. MI allows the clinician to stay more connected in a therapeutic relationship with patients by helping them identify how, when, and what behaviors they can change to improve their own health. MI is a supportive counseling style that guides patients toward positive health-related behaviors by helping them resolve ambivalence toward changing. (1) MI seeks to enhance the self-efficacy of patients to facilitate these changes, helping patients move through the continuum of change proposed in the Transtheoretical Model of James Prochaska and Carlo DiClemente, progressing from not yet …