Motivational Practice: Promoting Healthy Habits and Self-Care of Chronic Diseases

Rating:
Summary: Detailed and comprehensive guide to a new way to practice
Review: What do you do when patients do not change their unhealthy behaviors in response to your health information and advice? This is the question posed by author Rick Botelho at the start of MOTIVATIONAL PRACTICE. Botelho, a physician who has taught academic family medicine for over 20 years, answers his own question by inviting you to learn when and how to change from the usual "fix-it" role to a motivational role.

MOTIVATIONAL PRACTICE is structured as a self-directed professional development course for health care providers. It begins with the suggestion that you change yourself before helping others, both to serve as a model of self-change and to sharpen your experiential understanding of the processes at work. Subsequent sections provide a model of motivation and change and a practical six-step method for facilitating patients' behavior change. Ample case examples let you see how each step works in practice. Each chapter includes didactic information, prompts for reflection and experiential processing of the information presented, and guides for gradually incorporating a more motivational role into your practice. The general model is supplemented by chapters on specific behaviors (excessive alcohol use, smoking, and self-care of chronic diseases).

The author presents an extensive rationale for his approach, drawing on motivational interviewing, the stages of change model, self-efficacy theory, self-determination theory, relapse prevention, solution-focused therapy, and patient-centered approaches. If you're looking for a "quick-and-dirty" guide to increasing patient motivation to change, you won't find it here. Rather, this book is geared more toward those who want an in-depth understanding of the theory and evidence underlying the how-to advice. Reviewed by Deborah Van Horn for Amazon.com, November 1, 2004.