Motivational enhancement therapy for smoking cessation in primary care: A case study

(from the chapter) Motivational interviewing has been practised in the UK primary care setting over many years; a popular intervention because it enables the primary care doctor to address questions of behaviour change in a nonconfrontational manner, exploring the reasons for change, eliciting and exploring concerns with the aim of creating a desire to change based upon confidence and optimism in its results. It departs from the practice of persuading the patient of the benefits of and need to change and has been applied to problems that require behavioural change in order to bring about improvements in health. Smoking cessation interventions in the primary care and specialist setting in the UK have been based primarily upon motivational interviewing and behavioural interventions. Effects found in two studies (Butler et al. 1999; Colby et al. 1998) have been described as 'small but significant' and 'encouraging' (Dunn et al. 2001). In this chapter we document a single session, part of a three session structured Motivational Enhancement Therapy (MET) delivered by a primary care doctor to a patient for smoking cessation. This session follows the protocol for MET as delivered in the UK Alcohol Treatment Trial and described in Chapter 10. The transcript is a verbatim account derived from a video-recorded session and the patient gave written informed consent for use of the video content as a contribution to this book. In the transcript, T denotes the therapist, in this case a primary care physician and P is the patient. The doctor begins with a summary of the current situation and the patient's previously completed decisional balance (describing the pros and cons of smoking). The commentary and description is provided at the end of the transcript of the dialogue, in order to avoid breaking up the flow. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (chapter)