This text from Schumacher and Madson contributes tremendously to the growing knowledge base regarding motivational interviewing (MI). It provides an update on MI practices, principles and processes. Particular attention is paid to defining MI concepts and terms, methods for applying MI concepts and skills, and demonstrating how MI can be used to improve clinical practice and outcomes across diverse domains and situations. The authors go beyond theoretical explanations, providing practical applications through the use of case histories with examples to demonstrate the positive effects it can have. In addition, they report evidence-based research, hence providing a sense of credibility for the positive effects of MI. The authors effectively distinguish many common MI-inconsistent approaches from MI-consistent approaches by providing examples of each. For instance, the authors provide case histories that are followed by MI and non-MI examples. This text considers a variety of settings, such as health care, substance abuse treatment, criminal justice and mental health, and focuses on a wide variety of audiences, ranging from experts to lay persons. It therefore would have appeal to the seasoned professional, novice and lay person alike.
The book is organized into two sections, with eight chapters: Part One: Motivational interviewing overview (the first three chapters) and Part Two: Motivational interviewing for clinical challenges (the remaining five chapters). Part One focuses on fundamental principles and practices. The introduction (Chapter 1), is followed by definitions of key MI concepts and examples of the use of the concepts in MI (Chapter 2), and a discussion on the four processes of MI (Chapter 3).
The authors commence the introduction with the big question, ‘Does MI intervention work’ before discussing how to effectively learn and use MI. The authors are able to provide strong credibility for MI effectiveness with meta-analysis findings as well as descriptions of decades of experience in performing and training others to perform MI. With regards to the effectiveness of MI, they make it clear that MI is not a panacea, and outcomes are unknown for many cases. The caution MI should be ‘. . . applied where it is useful and avoided where it is not’ (p. 5). In the how to learn MI section, the authors start by indicating preparation through formal training and coaching is key to mastering MI. They also indicate that the usual advice giving and confrontation approach are contrary to the MI philosophy and approach. For many who use advice and confrontation in their practices this method may be thought provoking and perhaps ignite reflective learning and practice.
Chapter 2 starts with an explanation of what MI is and what it is not, followed by a comparison of MI with common psychotherapies. Following the definition and explanations of key MI concepts, the chapter provides examples of MI and non-MI communication approaches. The authors compare and link MI to common psychotherapy. For example, they compare MI to person-centred, cognitive and behavioural therapies, while linking it to Carl Roger's person centred therapy and social-psychology principles. In addition, the authors note the current broader base of applications of MI to a wide range of populations and disciplines.
Chapter 3 covers the four-phase process of MI, namely ‘engaging’, ‘focusing’, ‘evocating’, and ‘planning’. It clarifies the role of ‘engaging’ and ‘focusing’ in the MI process. This chapter concludes with examples for health professionals and those who work with alcohol prevention.
Part Two focuses on clinical applications of MI to working with difficult clients and also those with psychiatric conditions. Chapter 4 commences by pairing up MI with an effective model, namely the transactional model, and explains how the model stages of readiness to change can be used as a frame to empower a person to change by including the client in the planning process. Those working with clients resisting treatment or change of behaviours, including clients who do not show up or clients forced to be in treatment (e.g., court-ordered cases), will find this chapter both helpful and informative, as the authors provide strategies with examples for particular cases.
Chapter 5 explores an important and difficult road block in behaviour change that is often neglected – that is, loss of momentum, which can lead to setbacks and even reengagement of previous maladaptive behaviour. As is the case through the text, the authors go beyond theoretical explanations, providing strategies for particular cases and examples for each case.
In Chapter 6 the authors apply MI to challenges faced when working with persons with psychiatric disorders such as depression, posttraumatic stress, anxiety, schizophrenia and obsessive–compulsive disorders. Chapter 7 addresses crucial issues in settings comprised of multiple individuals, in particular, parent and group settings. However, the focus is on challenges faced in these contexts, not on MI-based intervention for parents and groups. The book ends with a chapter in which the authors return to a topic addressed in the introduction and throughout the book: Learning and implementing MI.
In summary, the authors have provided a book that is not only informative, but practical in nature. The book is a valuable resource for MI skill building. This text is notable for its updated information on MI, clear and easy to read content, and broad appeal to multiple audiences, including experts, novices and other readers at all levels of professional development. Authors of future editions could consider incorporating content on working with multicultural individuals or groups, given the complex multicultural society that exists today. In addition, authors of future editions could consider focusing on group MI treatment, especially those groups with close ties, such as family members, given the unique nature of behaviour in this context.
