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Does Motivational Interviewing Align with International Scope of Practice, Professional Competency Standards, and Best Practice Guidelines in Dietetics Practice?

Published:March 06, 2014DOI:https://doi.org/10.1016/j.jand.2013.12.023
      Facilitating change in client behavior is a key challenge for registered dietitian nutritionists (RDNs). RDN frustration occurs when clients do not adhere to the behavior change plans developed during consultations.
      • Rollnick S.
      • Miller W.
      • Butler C.
      Motivational Interviewing in Health Care: Helping Patients Change Behaviour.
      The client may return for future appointments having made minimal or no lifestyle changes, or showing a decline in diet and physical activity behaviors. Despite many clients having the knowledge, skills, and need to make nutritious dietary choices and to participate in regular physical activity, many still struggle to maintain behavior change in the long term.
      • Fjeldsoe B.
      • Neuhaus M.
      • Winkler E.
      • Eakin E.
      Systematic review of maintenance of behavior change following physical activity and dietary interventions.
      Clients may be ambivalent when it comes to the need to make behavior changes.
      • Miller W.R.
      • Rollnick S.
      Motivational Interviewing: Preparing People for Change.
      Ambivalence is a state of mixed feelings resulting in an inability to choose between two courses of action.
      • Miller W.R.
      • Rollnick S.
      Motivational Interviewing: Preparing People for Change.
      When confronted with feelings of ambivalence in clients, an RDN may take the role of arguing for change, hoping to convince a client of the benefits of changing behavior. In response, a client may feel judged and criticized, and may rationalize his or her current behavior by providing arguments to maintain the status quo, stop engaging with the RDN, or may silently resolve not to change.
      • Rollnick S.
      • Kinnersley P.
      • Stott N.
      Methods of helping patients with behaviour change.
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      References

        • Rollnick S.
        • Miller W.
        • Butler C.
        Motivational Interviewing in Health Care: Helping Patients Change Behaviour.
        Guilford Press, New York, NY2008
        • Fjeldsoe B.
        • Neuhaus M.
        • Winkler E.
        • Eakin E.
        Systematic review of maintenance of behavior change following physical activity and dietary interventions.
        Health Psychol. 2011; 30: 99-109
        • Miller W.R.
        • Rollnick S.
        Motivational Interviewing: Preparing People for Change.
        2nd ed. The Guilford Press, New York, NY2002
        • Rollnick S.
        • Kinnersley P.
        • Stott N.
        Methods of helping patients with behaviour change.
        Br Med J. 1993; 307: 188-190
        • Thomas B.
        Manual of Dietetic Practice.
        2nd ed. The University Press, Cambridge, UK1994
        • Rollnick S.
        • Butler C.C.
        • McCambridge J.
        • Kinnersley P.
        • Elwyn G.
        • Resnicow K.
        Consultations about changing behaviour.
        Br Med J. 2005; 331: 961
        • Hancock R.E.
        • Bonner G.
        • Hollingdale R.
        • Madden A.
        ‘If you listen to me properly, I feel good’: A qualitative examination of patient experiences of dietetic consultations.
        J Hum Nutr Diet. 2012; 25: 275-284
        • Spahn J.M.
        • Reeves R.S.
        • Keim K.S.
        • et al.
        State of the evidence regarding behavior change theories and strategies in nutrition counseling to facilitate health and food behavior change.
        J Am Diet Assoc. 2010; 110: 879-891
        • MacLellan D.
        • Berenbaum S.
        Canadian dietitians’ understanding of the client-centered approach to nutrition counseling.
        J Am Diet Assoc. 2007; 107: 1414-1417
        • Cant R.
        • Aroni R.
        Exploring dietitians’ verbal and nonverbal communication skills for effective dietitian–patient communication.
        J Hum Nutr Diet. 2008; 21: 502-511
        • Brug J.
        • Spikmans F.
        • Aartsen C.
        • Breedveld B.
        • Bes R.
        • Fereira I.
        Training dietitians in basic motivational interviewing skills results in changes in their counseling style and in lower saturated fat intakes in their patients.
        J Nutr Educ Behav. 2007; 39: 8-12
        • Dietitians Association of Australia
        DAA Best Practice Guidelines for the Treatment of Overweight and Obesity in Adults.
        Dietitians Association of Australia, Canberra, Australia2012
        • Armstrong M.
        • Mottershead T.
        • Ronksley P.
        • Sigal R.
        • Campbell T.
        • Hemmelgarn B.
        Motivational interviewing to improve weight loss in overweight and/or obese patients: A systematic review and meta-analysis of randomized controlled trials.
        Obes Rev. 2011; 12: 709-723
        • Rubak S.
        • Sandbaek A.
        • Lauritzen T.
        • Christensen B.
        Motivational interviewing: A systematic review and meta-analysis.
        Br J Gen Pract. 2005; 55: 305-312
        • Miller W.R.
        • Rollnick S.
        Motivational Interviewing: Helping People Change.
        3rd ed. Guilford Press, New York, NY2012
        • Carels R.A.
        • Darby L.
        • Cacciapaglia H.M.
        • et al.
        Using motivational interviewing as a supplement to obesity treatment: A stepped-care approach.
        Health Psychol. 2007; 26: 369-374
        • Bennett J.A.
        • Young H.M.
        • Nail L.M.
        • Winters-Stone K.
        • Hanson G.
        A telephone-only motivational intervention to increase physical activity in rural adults: A randomized controlled trial.
        Nurs Res. 2008; 57: 24-32
        • Heinrich E.
        • Candel M.
        • Schaper N.C.
        • de Vries N.K.
        Effect evaluation of a Motivational Interviewing based counselling strategy in diabetes care.
        Diabetes Res Clin Pract. 2010; 90: 270-278
        • Resnicow K.
        • Davis R.
        • Rollnick S.
        Motivational interviewing for pediatric obesity: conceptual issues and evidence review.
        J Am Diet Assoc. 2006; 106: 2024-2033
        • Bowen D.
        • Ehret C.
        • Pedersen M.
        • et al.
        Results of an adjunct dietary intervention program in the Women's Health Initiative.
        J Am Diet Assoc. 2002; 102: 1631-1637
        • Hollis J.L.
        • Williams L.T.
        • Collins C.E.
        • Morgan P.J.
        Effectiveness of interventions using Motivational Interviewing for dietary and physical activity modification in adults: A Systematic Review.
        Joanna Briggs Inst Database Syst Rev Implement Rep. 2013; 11: 1-27
        • The Academy Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee
        Academy of Nutrition and Dietetics: Scope of practice for the registered dietitian.
        J Acad Nutr Diet. 2013; 113: S17-S28
        • The Academy Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee
        Academy of Nutrition and Dietetics: Revised 2012 standards of practice in nutrition care and standards of professional performance for registered dietitians.
        J Acad Nutr Diet. 2013; 113: S29-S45
      1. Dietitians of Canada and College of Dietitians of Ontario. Professional standards for dietitians in Canada. 2000. http://www.cdo.on.ca/en/pdf/publications/ProfessionalStandardsforDietitians.pdf. Accessed August 16, 2013.

      2. European Federation of the Association of Dietitians. European Dietetic Competences and their Performance Indicators. 2009. http://www.efad.eu/everyone/1468/5/0/32. Accessed August 15, 2013.

      3. Dietitians Association of Australia. Scope of dietetic practice framework. 2006. http://dmsweb.daa.asn.au/files/DINER/DINER_Scope_of_Practice.pdf. Accessed August 16, 2013.

      4. Dietitians Association of Australia. National Competency Standards for entry level dietitians in Australia. 2008. http://daa.asn.au/universities-recognition/national-competency-standards/. Accessed August 16, 2013.

        • National Heart Blood and Lung Institute
        Clinical Guidelines for the Identification, Evaluation and Treatment of Overweight and Obesity in Adults.
        National Institutes of Health, Washington, DC1998
        • Seagle H.M.
        • Strain G.W.
        • Makris A.
        • Reeves R.S.
        Position of The American Dietetic Association: Weight management.
        J Am Diet Assoc. 2009; 109: 330-346
        • Lau D.C.
        • Douketis J.D.
        • Morrison K.M.
        • Hramiak I.M.
        • Sharma A.M.
        • Ur E.
        2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children.
        Can Med Assoc J. 2007; 176: 1-117
        • Tsigos C.
        • Hainer V.
        • Basdevant A.
        • et al.
        Management of obesity in adults: European clinical practice guidelines.
        Obesity Facts. 2008; 1: 106-116
      5. Obesity: Guidance on the Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. National Institute for Health and Clinical Excellence, London, UK2006
      6. Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. National Health and Medical Research Council, Canberra, Australia2013
        • Dietitians Association of Australia
        Best Practice Guidelines for the Treatment of Overweight and Obesity in Adults.
        Dietitians Association of Australia, Canberra, Australia2005
        • Miller W.R.
        • Rollnick S.
        Ten things that motivational interviewing is not.
        Behav Cogn Psychother. 2009; 37: 129-140
      7. International Dietetics & Nutrition Terminology (IDNT) Reference Manual. 4th ed. Academy of Nutrition and Dietetics, Chicago, IL2013
        • Miller W.R.
        • Yahne C.E.
        • Moyers T.B.
        • Martinez J.
        • Pirritano M.
        A randomized trial of methods to help clinicians learn motivational interviewing.
        J Consult Clin Psychol. 2004; 72: 1050-1062
        • Martino S.
        • Ball S.A.
        • Nich C.
        • Frankforter T.L.
        • Carroll K.M.
        Community program therapist adherence and competence in motivational enhancement therapy.
        Drug Alcohol Depend. 2008; 96: 37-48
        • Miller W.R.
        • Mount K.A.
        A small study of training in motivational interviewing: Does one workshop change clinician and client behavior?.
        Behav Cogn Psychother. 2001; 29: 457-471
        • Moyers T.
        • Martin T.
        • Manuel J.
        • Miller W.
        • Ernest D.
        Revised Global Scales: Motivation Interviewing Treatment Integrity 3.0 (MITI 3.0).
        University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque, NM2007
        • Moyers T.B.
        • Martin T.
        • Manuel J.K.
        • Hendrickson S.M.
        • Miller W.R.
        Assessing competence in the use of motivational interviewing.
        J Subst Abuse Treat. 2005; 28: 19-26
        • Miller W.R.
        • Moyers T.B.
        • Ernst D.
        • Amrhein P.
        Manual for the Motivational Interviewing Skill Code (MISC).
        (Version 2.0) University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque, NM2003
        • Rollnick S.
        • Butler C.C.
        • Kinnersley P.
        • Gregory J.
        • Mash B.
        Motivational interviewing.
        Br Med J. 2010; : 340(c1900)
        • Resnicow K.
        • McMaster F.
        Motivational Interviewing: Moving from why to how with autonomy support.
        Intl J Behav Nutr Phys Activity. 2012; 9: 1-9
      8. Motivational Interviewing Network of Trainers. Motivational interviewing. 2013. http://www.motivationalinterviewing.org/home. Accessed September 5, 2013.