Motivational interviewing from the pediatricians' perspective: assessments after a 2-day training for physicians caring for adolescents with chronic medical conditions (CMCs)

Abstract

Background: Counseling adolescents with chronic medical conditions (CMCs) can be challenging regarding suitable interviewing skills and clinicians' attitudes toward the patient. Successful communication can be a key element of treatment. Motivational Interviewing (MI) is broadly applicable in managing behavioural problems and diseases by increasing patient motivation for lifestyle changes. However, data concerning the applicability, feasibility, and implementation of MI sessions in everyday practice are missing from the physicians' point of view. Purpose: Our aim was to explore clinicians' experiences of MI training and subsequent use of MI in the routine care of adolescents with CMCs. Therefore, we wanted to find out if and how MI can be integrated into clinical practice and how training in MI should be designed. Method:The present study has a descriptive and qualitative design. Twenty pediatricians were randomized to a 2-day MI course followed by MI consultations in a cluster-randomized controlled trial (COACH-MI). Data were collected one year after MI training using a questionnaire. Factors for effective training and possible barriers to successful use of MI were examined. Results: Completed questionnaires were returned by 19 of 20 pediatricians. The pediatricians' experiences with MI demonstrate that MI is regarded as a valuable tool when working with adolescents with CMCs. 95 % of all respondents reported that they found MI education necessary for their clinical work and were using it also outside the COACH-MI study context. 73.7 % percent saw potential to strengthen the connection to their patients by using MI. The doctors were already using more MI conversation techniques after a 2-day MI course. Obstacles were seen in the short training, the lack of time, and missing undisturbed environment (interruptions by telephone, staff, etc.) during clinical flow. Conclusions: MI techniques are not yet a regular part of medical training. However, a 2-day MI course was rated effective and providing a lasting impact by physicians caring for children and adolescents with chronic medical conditions (CMCs), although booster sessions should be offered regularly.