Welcome to the training on Motivational Interviewing provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).
The goal of this module is to equip Texas Health Steps providers and others to begin using motivational interviewing techniques as part of routine clinical practice to support children, adolescents and families in making positive health changes and maintaining optimum self-care for chronic conditions.
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Assess how motivational interviewing (MI) differs from traditional provider-patient communication and why it can effectively motivate positive behavior changes.
- Integrate MI best practices into routine clinical encounters to promote healthy habits and optimum self-care.
Please note this module expires on 7/31/2023.
This module was released on 7/31/2020.
Continuing Medical Education (Ethics Accredited)
The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians.
The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This course has been designated by The Texas Department of State Health Services, Continuing Education Service for 1.00 credit(s) of education in medical ethics and/or professional responsibility.
Continuing Nursing Education
The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Nursing Education.
Social Workers (Ethics Accredited)
The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Social Work Education.
This course has been designated by The Texas Department of State Health Services for 1.00 contact hours of education in professional ethics and social work values.
Certified Health Education Specialists
Sponsored by The Texas Department of State Health Services, Continuing Education Service, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to receive up to 1.00 total entry-level Category I contact education contact hours.
Licensed Professional Counselors (Ethics Accredited)
The Texas Department of State Health Services, Continuing Education Service is an approved provider (#690) by the Texas State Board of Examiners of Professional Counselors to offer continuing education contact hours to Licensed Professional Counselors. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) for Licensed Professional Counselors and 1.00 contact hour(s) in professional ethics for Licensed Professional Counselors.
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support.
- Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
- Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
- Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
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- American Academy of Pediatrics. (n.d.). Healthy Active Living for Families Implementation Guide: Motivational Interviewing.
- Center for Evidence-Based Practices at Case Western Reserve University MI Resources, including a workbook for practitioners on building MI skills and “Motivational Interviewing: Helping People Change” (Miller & Rollnick, 2013). Also serves as a homepage for Motivational Interviewing Network of Trainers (MINT).
- Center for Evidence-Based Practices at Case Western Reserve University. Audio training.
- Center for Evidence-Based Practices at Case Western Reserve University. Video training.
- Gold, M. A., & Kokotailo, P.K. (2007). Motivational Interviewing Strategies to Facilitate Adolescent Behavior Change. Adolescent Health Update, American Academy of Pediatricians, 20(1).
- Motivational Interviewing Network of Trainers. MINT. Training and events.
- Psychotherapy.net. Motivational Interviewing Step by Step: 4-Video Series.
- The Rudd Center for Food Policy and Obesity. Handouts on MI strategies and scripts for clinical practices, specifically for weight-related issues, with Motivational Interviewing Strategies and Motivational Interviewing Example Scripts.
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. SAMHSA-HRSA Center for Integrated Health Solutions. Webinars.
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. SAMHSA TIP 35: Enhancing Motivation for Change in Substance Abuse Treatment.
- Zimmerman, G., Olsen, C., & Bosworth, M. (2000). “A ‘Stages of Change’ Approach to Helping Patients Change Behavior.” American Family Physician, 61(5), 1409-16.
- American Academy of Pediatrics. (n.d.). Healthy Active Living for Families Implementation Guide: Motivational Interviewing.
- American Academy of Pediatrics. (2011). Policy Statement: Substance Use Screening, Brief Intervention, and Referral to Treatment for Pediatricians.
- Auburn University. (2007). Patient Compliance Improves Through 'Motivational Interviewing.' ScienceDaily, 26 July.
- Bahafzallah, L., Hayden, K. A., Raffin Bouchal, S., Singh, P., & King-Shier, K. M. (2019). Motivational Interviewing in Ethnic Populations. Journal of Immigrant and Minority Health.
- Bocian, A., Slora, E., Harris, D., Drehmer, J., McMaster, F., Woolford, S. . . . Resnicow, K. (2012). Pediatric Office-Based Brief Motivational Interviewing: Diet, Activity and Media Use. Presented at the April 2012 Pediatric Academic Societies Annual Meeting.
- Centers for Disease Control and Prevention. (2019). Youth and Tobacco Use.
- Centers for Disease Control and Prevention. (2018). Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students — United States, 2011–2018. Morbidity and Mortality Weekly Report (MMWR), 67, 1276–1277.
- Desai, N. (2019) The Role of Motivational Interviewing in Children and Adolescents in Pediatric Care. Pediatric Annals, 48(9), e376-e379.
- Erickson, S. J., Gerstie, B. A., & Feldstein, S. W. (2005). Brief Interventions and Motivational Interviewing With Children, Adolescents, and Their Parents in Pediatric Health Care Settings. Archives of Pediatrics & Adolescent Medicine, 159(12), 1173–1180.
- Gayes, L. A., & Steele, R. G. (2014). A meta-analysis of motivational interviewing interventions for pediatric health behavior change. Journal of Consulting and Clinical Psychology, 82(3), 5215-5235.
- Gold, M. A., & Kokotailo, P. K. (2007). Motivational Interviewing Strategies to Facilitate Adolescent Behavior Change.
- Howell, L. B. (2012). Motivational Interviewing and Continuing Medical Education: Facilitating Clinician and Patient Change. Alliance for Continuing Education in the Health Professions, Almanac, 34(8).
- Kien, T. L., Yee, C. K., Wan, N. A., Youngho, K., & Garry, K. (2018). Application of Transtheoretical Model on Behavioral Changes, and Amount of Physical Activity Among University’s Students. Frontiers in Psychology, 17.
- Miller, W., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change. Third Edition. Guilford Press: New York.
- Orchard Place/Child Guidance Center. (n.d.). Trauma Informed Care Project.
- O’Reilly, K. (2013). Motivating patients to make wise choices. American Medical News. Amednews.com, Feb. 13.
- Passmore, J. (2013). Motivational Interviewing: Reflecting on ethical decisions in MI. The Coaching Psychologist, 9(2), 112-116.
- Pont, S. (n.d.). Motivational Interviewing. Texas Pediatric Society.
- Powell, P., Hilliard, M., & Anderson, B. (2014). Motivational Interviewing to Promote Adherence Behaviors in Pediatric Type 1 Diabetes. Current Diabetes Report, 14(10), 531.
- Rubak, S., Sandbaek, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: a systematic review and meta-analysis. The British Journal of General Practice, 55(513), 305–312.
- Transtheoretical Model papers (various dates). Science Direct.
- Zimmerman, G., Olsen, C., & Bosworth, M. (2000). A ‘Stages of Change’ Approach to Helping Patients Change Behavior. American Family Physician, 61(5),1409-1416.
Adolescent Substance Use
Learn the tools to integrate substance use screening and intervention into practice, employ current evidence-based models to manage patients who use substances or are in recovery, and refer patients.
Building a Comprehensive and Effective Medical Home
Learn how and why to create and sustain a medical home in your primary care practice.
Identifying and Treating Children with Asthma
Equip Texas Health Steps providers and other health-care professionals to identify asthma, apply a stepwise treatment approach as part of managing asthma patients in a primary care setting and make appropriate referrals for specialty care.
Diabetes Screening, Diagnosis and Management
Recognize the symptoms of diabetes and distinguish among the various types that affect children and adolescents. Includes best practices for effectively managing diabetes through medication and lifestyle changes.
High-Risk Behaviors In Young People: Screening and Intervention
Learn about the prevalence, signs, symptoms and interventions for substance use and other risky adolescent behaviors.
Implementing Universal SBIRT in Primary Care: Tools and Resources for Your Practice
Learn about this evidence-based practice to identify, reduce or prevent alcohol substance use and misuse. Texas Medicaid supports universal SBIRT for adolescent and adult patients in primary care and other settings. This tutorial provides and overview of SBIRT, guidelines for implementation and access to resources to help you get started.
Promoting Adolescent Health
Adopt best practices for adolescent screening, including recommended schedules, effective communication and enhanced clinical procedures. Includes video examples of effective screening techniques.
Preconception Health: Screening and Intervention
Integrate best practices for preconception health care and counseling into preventive medical checkups.