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Psychology

 

Review Essays of Academic, Professional & Technical Books in the Humanities & Sciences

 

Motivation

Handbook of Motivation and Change: A Practical Guide for Clinicians by Petros Levounis, Bachaar Arnaout (American Psychiatric Publishing) is a busy clinician s guide to motivational interviewing. With a special focus on substance use disorders and addiction, this unique handbook equips readers with a full understanding of the Motivational Interviewing approach an understanding that readers can flexibly apply to address patients issues of motivation and change even beyond substance use. The handbook is written by more than 20 practitioners of different psychotherapies who employ motivational work. This volume features a collection of case studies punctuated by movie references that illustrate discussed concepts, practical suggestions for treatment and trainee supervision, and summary key points and multiple-choice questions for readers. Authors focus on interventions ranging from psychopharmacology to support groups, zero in on the unique challenges of treating patients at various stages of their lives, examine how motivational work can change a culture, and discuss the evidence base of this effective and compelling therapy. The practical reach of this handbook will appeal not only to the general psychiatrist but to family practitioners, internists, pediatricians, medical students, and allied professionals. More than a how-to, this book provides clinicians with expert insight and information that will help them meet their patients in the midst of the very real challenges of motivation and lasting change.

Excerpt: The idea for writing Handbook of Motivation and Change: A Practical Guide for Clinicians came primarily from our clinical experience as psychiatrists working with patients who have substance use and other psychiatric disorders. Although there are several books that address motivation and change in our population of patients, we felt that a book based on case studies, practical suggestions, and movie ideas to enrich the clinical material—and written by busy clinicians for busy clinicians—was much needed. We hope that you will find this volume to be informative, useful, easy to read, and fun.

Our audience is primarily the general psychiatrist. However, we expect that this volume will also be helpful to family practitioners, internists, pediatricians, medical students, allied professionals, and anyone else who may be interested in issues of motivation and change—including physicians and other personnel of hospital emergency departments, where Motivational Interviewing can be particularly important in catalyzing behavior change. The book is written at a level that can be understood by clinicians who have an interest in this area but who do not have specialized knowledge or expertise in addiction treatment.

The main theoretical platforms for our book are two ground-breaking innovations in addiction treatment: Prochaska and DiClemente's (1984) Trans-theoretical Model of Change, also known as the Stages of Change model, and Miller and Rollnick's (1991, 2002) Motivational Interviewing. We have based our clinical discussions on their ideas and are deeply grateful for the opportunity to expand on their seminal body of work. However, we have also opened the theoretic framework to include other ideas and techniques that the chapter authors have found helpful in their scholarship and clinical experience.

This book is organized into 16 chapters that discuss the clinical aspects of working with patients on issues of motivation and change, especially as these concepts relate to substance use disorders. In the opening chapter of this book, Edward V. Nunes, M.D., helps us place our work in the general context of addiction treatment. In the following seven chapters, we then present the fundamentals of motivation and change before detailing the stages of change as well as relapse—and how to treat our patients who struggle through those stages. The next four chapters outline the intersection of motivational work with other interventions from psychopharmacology to Alcoholics Anonymous. In the following two chapters, we turn to the unique challenges of treating patients throughout the life cycle: adolescents and older adults. Next, the chapter on changing the culture illustrates an application of clinical principles to the "outside world." The book concludes with a systematic review of the research on Motivational Interviewing. Although the reader may decide to follow the flow of the book and read it sequentially, we have given each chapter enough autonomy to be easily studied out of order.

In order to create a somewhat uniform and as-readable-as-possible book, each chapter (except for the first two chapters and the last) follows the following format:

Introduction: We begin each chapter by setting up the specific subject in the context of the overall framework of motivation and change.

Clinical Case: The cases in this book are composites of several clinical (and sometimes nonclinical) experiences of the authors; the settings have been changed, all names are fictional, and every effort has been made to conceal any identifying information.

Discussion of the Clinical Case: Here we discuss the specifics of the case as they pertain to the educational objectives of each chapter.

Suggestions for Treatment: This section is the focus and centerpiece of each chapter; it provides practical information about helping people change. Suggestions for Teaching and Supervision: This is a short list of suggestions for supervisors and other educators to facilitate teaching and learning. Movie/Television Series: We present scenes from a popular movie or television series that illustrate a clinical point for discussion and briefly explain how each scene relates to the chapter material.

Key Clinical Points: Bulleted points summarize the most essential take-home messages of each chapter.

Multiple-Choice Questions: We provide five multiple-choice questions at the end of each chapter, with explanations of the correct answers in the Answer Guide at the end of the book. We fully appreciate, expect, and welcome that sometimes the reader will disagree with the wisdom, clinical judgment, and idiosyncrasies of the authors.

References: Except for the first two chapters and the last, which review in detail the context and evidence base of Motivational Interviewing, chapters are not intended to provide extensive literature reviews; we have tried to keep the number of references at the end of each chapter to a minimum. At the end of the book, we have included some helpful appendixes for readers. Appendix 1 contains a list of movies that could be used in the teaching of

a wide range of addiction-related topics. And with the explosion of information over the Internet (readily available to both clinicians and patients), we have suggested helpful Internet sites in Appendix 2.

We are deeply indebted to our colleagues who contributed to this volume for their wonderful clinical insights and imaginative approach to treatment. We are also grateful to our teachers, who have shaped our understanding and compassion throughout the years. Finally, we couldn't have completed this book without the support of our families and friends who, at times, were really hoping to motivate us to change our attitude and go to the movies instead of write about them.

 

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