Motivational interviewing, developed by Miller and Rollnick,
provides a useful framework to improve the depth of data collected
by the provider and can provide deeper insight into patient behavior.
Motivational interviewing follows the patient centeredness of Rogerian
theory, but unlike stricter interpretations of Rogerian practice,
motivational interviewing is a directive technique. Providers may
have identified harmful behaviors, but they hypothesized that consistent
and repeated advice giving may actually engender patient resistance
to behavior change.9 Current research by Resnicow10 goes
further in describing the role of the provider as that of facilitator
who helps set the stage for behavior change. The provider can increase
the likelihood of behavior change by various actions and statements,
but ultimate responsibility lies with patient and caregiver. Motivational
interviewing suggests that the path to behavior adoption is not linear,
as proposed by Prochaska and DiClemente, but rather is chaotic,
progresses forward and back in readiness, and is fraught with expected
relapses, failures, and false starts.