Motivational Interviewing in Diabetes Care

Marc P. Steinberg, MD, FAAP (1952–2022), developed a focus on diabetes care during his 32 years of practice as a physician. He became increasingly interested in working more effectively with people struggling with the self-care of chronic conditions. After ending his medical practice in 2013, he focused on training health care providers in MI. Dr. Steinberg published articles on MI in Diabetes Spectrum and was a member of the Motivational Interviewing Network of Trainers. He belonged to the national medical honor society, Alpha Omega Alpha, and was a Fellow of the American Academy of Pediatrics. For more than 40 years, he maintained an active lifestyle with type 1 diabetes.William R. Miller, PhD, is Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico. He introduced motivational interviewing in a 1983 article and in the first edition of Motivational Interviewing (1991), coauthored with Stephen Rollnick. Dr. Miller’s research has focused particularly on the treatment and prevention of addictions and more broadly on the psychology of change. He is a recipient of two career achievement awards from the American Psychological Association, the international Jellinek Memorial Award, and an Innovators Award from the Robert Wood Johnson Foundation, among many other honors. His publications include 65 books and over 400 articles and chapters. His website is https://williamrmiller.net.

"An incredible resource for those who care for people with diabetes. Starting with the understanding that patients are often ambivalent about behavior change, the authors help readers practice a guiding style and adopt the right 'mindset and heartset' for helping patients improve their health. Real-life examples and sample dialogues demonstrate key strategies and drill down into specific diabetes scenarios. The book is full of practical examples of how to guide patients to make changes."--Robert A. Gabbay, MD, PhD, FACP, Chief Medical Officer, Joslin Diabetes Center; Associate Professor of Medicine, Harvard Medical School"Steinberg and Miller elegantly show how to infuse diabetes counseling with listening and talking skills known to enhance difficult conversations about change. Patients’ lifestyle habits are the most important factor in how well they will live with diabetes; providers of all training backgrounds can use this book to become more effective when talking to their patients about healthier habits. Beautifully written, the book is loaded with empirically supported conversational tips to maximize the chances that your patients will change. This is the consummate book on diabetes behavioral counseling."--Chris Dunn, PhD, Department of Psychiatry and Behavioral Sciences, University of Washington"Provides a concise and relevant explanation of what MI is about, plus invaluable examples of clinical conversations on the critical topics of diabetes care. This is the best resource I've seen for building skills that can make the work of busy diabetes practitioners both more successful and more satisfying--and it's a quick and easy read for our tight schedules! I strongly recommend it to any clinician hoping to build effective partnerships with people with diabetes. I wish I'd had this book when I was starting out in the field."--Nancy R. Eyler, MD, FACP, former 20-year Medical Director for Diabetes and Endocrinology, Community Medical Center, Missoula, Montana"Behavior change is the cornerstone of diabetes self-management. This thoughtful book helps diabetes educators tackle the challenges of the status quo, providing tools and resources to help us maximize our impact. The authors place the person with diabetes at the center of every interaction and remind us of the need to respect that person's autonomy. Carefully laid-out scenarios will allow us to sharpen our MI skills and navigate the nuances of conversations with patients. It is easy to apply the examples and suggestions to real-world situations to make us more effective communicators and educators."--Joan K. Bardsley, RN, CDE, FAADE, past president, American Association of Diabetes Educators"Marvelous. The book addresses many of the types of conversations and behaviors that we encounter every day in people with diabetes or pre-diabetes, and common flaws in our interactions with patients are highlighted. The authors emphasize that MI is not a series of ‘magic words,’ but a skill. Easy to read, the book offers keys to helping patients harness their internal motivation, make positive changes in their lifestyle, and enhance their responsiveness to all the members of the health care team. Having been an educator for many years, I would make this mandatory reading for anyone working in the field of diabetes."--Kim L. Kelly, PharmD, Kelly Diabetes Associates, LLC"Unlike many medical guides that are best suited to putting tired minds to sleep, this little gem is hard to put down! The book is full of realistic and challenging clinical scenarios. Steinberg and Miller provide superb suggestions for how to integrate MI into diabetes care, with a unique focus on the words, phrases, questions, and statements to use with patients to facilitate health behavior change. MI can help improve the overall quality of the clinical relationship--to the benefit of patients and providers alike."--Melanie A. Gold, DO, DABMA, Department of Pediatrics, Columbia University Medical Center"This book offers research-supported techniques for overcoming common challenges associated with caring for patients with diabetes. The authors include practical tips and numerous case examples that bring MI to life. Incorporating these ideas into everyday medical practice can help achieve a most important goal in diabetes care--actively engaging the patient."--Ann E. Goebel-Fabbri, PhD, Department of Psychiatry, Harvard Medical School

• I. Motivational Interviewing as a Clinical Style1. Why Don't People Do What We Tell Them to Do?2. Mindset and Heartset3. Four Processes of Motivational Interviewing4. OARS: Four Foundational Practice Skills5. Hearing, Evoking, and Responding to Change Talk6. Offering Information and AdviceII. Motivational Interviewing and Common Challenges in Diabetes Care7. A New Diagnosis of Diabetes8. Physical Activity and Healthy Eating9. Medication Use10. Insulin Use in Type 2 Diabetes11. Addressing Self-Care during Follow-Up Visits12. Substance Use13. Psychological Stress and Depression14. Talking with the Family15. Adolescents and Diabetes Self-Care16. Managing Diabetes-Related ComplicationsIII. Learning and Applying Motivational Interviewing17. Learning Motivational Interviewing18. Motivational Interviewing in Groups19. Motivational Interviewing, Diabetes Prevention, and the Global Epidemic of DiabetesAppendix. Systematic and Meta-Analytic Reviews of Motivational InterviewingReferencesIndex