Family Practice Vol. 19, No. 5, 573
© Oxford University Press 2002
Book review |
Beyond advice: 1. Becoming a motivational practitioner.
Richard J Botelho. (271 pages, US$30.) Motivate Healthy Habits, 2002. ISBN 0-9706738-2-5.Beyond advice: 2. Developing motivational skills.Richard Botelho. (222 pages, US$25.) Motivate Healthy Habits, 2002. ISBN 0-9706738-1-7.
GP, Chairman of Surrey Heath PCG and joint lead for Clinical Governance
These two books are a new and exciting experience in a variety of ways. First, they are ‘self-published’ by the author which means that you visit the author’s website (www.MotivateHealthyHabits.com) and he then uses a web-based company to print your copies on demand. In practical terms, this meant that the review copies were ring bound approximately A4-sized and looked more like academic reports than books. Perhaps this is the way of the future.
Secondly, the content is stunning if you are looking for new presentations of not always new concepts. The style is made for reflective practitioners who like a little structure to help them reflect. Suggestions for reflection at the end of each chapter include "how you have deepened your understanding about ...", "your emotional reaction to the content" as well as the more practical "how it might improve what you do with your patients".
Motivational interviewing is of course not new. It is at least 10 years since I made a video on the topic with Steve Rollnick who is referred to in the Introduction as a trail-blazer in the field. What these books do is to move from using a motivational approach as one of a variety of interventions to a position where this largely replaces the ‘fix-it’ role in the consultation.
Perhaps the author’s previous experience of teaching communication skills has led him down this route. The breadth and range of the text suggest a deep understanding of the area. This includes "How worldviews affect our approach" as well as the more traditional, clarifying roles and responsibilities, negotiating an agenda, assessing resistance and motivation and an interesting section on enhancing mutual understanding. All the sections are referenced almost to the point of exhaustion.
The second book is a mixture of straightforward practical educational methods followed by examples of implementation of motivational techniques in the key areas of smoking, alcohol misuse and, more surprisingly, diabetes. Perhaps the section in the first book on "Exploring different kinds of evidence" might sit more comfortably in the second book.
All in all, both books are an uplifting experience and brought to mind Roger Neighbour’s approach to learning. I couldn’t help feeling that they might be the work books for a masters degree, but it is a degree that any doctor interested in human interaction would relish.
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