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Pediatric Obesity pp 685–693Cite as

The Role of the Primary Care Provider in Long-Term Counseling: Establishing a Therapeutic Alliance with the Child and Family

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Part of the book series: Contemporary Endocrinology ((COE))

Abstract

The primary care provider has a challenging yet important role in the prevention, screening, and management of childhood obesity. The therapeutic alliance describes a trusted relationship between the provider, patient, and family in which nonjudgmental and honest communication can help inform evidence-based and patient-centered healthcare decisions. Motivational interviewing (MI) is a key strategy that supports the development and sustenance of a successful therapeutic alliance. Providers can learn the core skills of MI and improve their use with repeated practice. Empathy is at the center of all MI skills and allows the provider to “meet the patient where they are,” normalizing the stages of change and guiding the patient toward healthier behaviors. Patient autonomy is critical to success, and MI provides a framework for facilitating meaningful shared decisions. MI has a growing evidence base to support its use by primary care providers in order to improve patient satisfaction, decrease provider burnout, and make healthy behavior choices more likely.

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References

  1. Wise PH. The future pediatrician: the challenge of chronic illness. J Pediatr. 2007;151(5 Suppl):S6–10.

    Article  PubMed  Google Scholar 

  2. Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120(Suppl 4):S164–92.

    Article  PubMed  Google Scholar 

  3. Lowenstein LM, Perrin EM, Campbell MK, Tate DF, Cai J, Ammerman AS. Primary care providers’ self-efficacy and outcome expectations for childhood obesity counseling. Child Obes (Print). 2013;9(3):208–15.

    Article  Google Scholar 

  4. Daniels SR, Hassink SG. The Role of the Pediatrician in Primary Prevention of Obesity. Pediatrics. 2015;136(1):e275–92.

    Article  PubMed  Google Scholar 

  5. Koole SL, Tschacher W. Synchrony in psychotherapy: a review and an integrative framework for the therapeutic alliance. Front Psychol. 2016;7:862.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Nienhuis JB, Owen J, Valentine JC, et al. Therapeutic alliance, empathy, and genuineness in individual adult psychotherapy: a meta-analytic review. Psychother Res. 2016;7:1–13.

    Google Scholar 

  7. Gudzune K. Dietary and behavioral approaches in the management of obesity. Gastroenterol Clin N Am. 2016;45(4):653–61.

    Article  Google Scholar 

  8. Dunn DS, Andrews EE. Person-first and identity-first language: developing psychologists’ cultural competence using disability language. Am Psychol. 2015;70(3):255–64.

    Article  PubMed  Google Scholar 

  9. Barry MJ, Edgman-Levitan S. Shared decision making--pinnacle of patient-centered care. The. N Engl J Med. 2012;366(9):780–1.

    Article  CAS  PubMed  Google Scholar 

  10. Aceves-Martins M, Llaurado E, Tarro L, Sola R, Giralt M. Obesity-promoting factors in Mexican children and adolescents: challenges and opportunities. Glob Health Action. 2016;9:29625.

    Article  PubMed  Google Scholar 

  11. Horvat L, Horey D, Romios P, Kis-Rigo J. Cultural competence education for health professionals. Cochrane Database Syst Rev. 2014(5):Cd009405.

    Google Scholar 

  12. Friel S, Chopra M, Satcher D. Unequal weight: equity oriented policy responses to the global obesity epidemic. BMJ (Clinical research ed). 2007;335(7632):1241–3.

    Article  Google Scholar 

  13. Neumark-Sztainer D. Preventing obesity and eating disorders in adolescents: what can health care providers do? J Adolescent Health. 2009;44(3):206–13.

    Article  Google Scholar 

  14. Rollnick S, Miller WR, Butler CC. Motivational interviewing in health care: helping patients change behavior. New York: Guilford Press; 2008.

    Google Scholar 

  15. Resnicow K, Davis R, Rollnick S. Motivational interviewing for pediatric obesity: conceptual issues and evidence review. J Am Diet Assoc. 2006;106(12):2024–33.

    Article  PubMed  Google Scholar 

  16. Accurso EC, Norman GJ, Crow SJ, Rock CL, Boutelle KN. The role of motivation in family-based guided self-help treatment for pediatric obesity. Child Obes (Print). 2014;10(5):392–9.

    Article  PubMed Central  Google Scholar 

  17. Pollak KI, Nagy P, Bigger J, et al. Effect of teaching motivational interviewing via communication coaching on clinician and patient satisfaction in primary care and pediatric obesity-focused offices. Patient Educ Couns. 2016;99(2):300–3.

    Article  PubMed  Google Scholar 

  18. Skelton JA, Beech BM. Attrition in paediatric weight management: a review of the literature and new directions. Obes Rev. 2011;12(5):e273–81.

    Article  CAS  PubMed  Google Scholar 

  19. Skelton JA, Irby MB, Geiger AM. A systematic review of satisfaction and pediatric obesity treatment: new avenues for addressing attrition. J Healthc Qual. 2014;36(4):5–22.

    Article  PubMed  Google Scholar 

  20. Woo Baidal JA, Price SN, Gonzalez-Suarez E, et al. Parental perceptions of a motivational interviewing-based pediatric obesity prevention intervention. Clin Pediatr. 2013;52(6):540–8.

    Article  Google Scholar 

  21. Gunnarsdottir T, Njardvik U, Olafsdottir AS, Craighead LW, Bjarnason R. The role of parental motivation in family-based treatment for childhood obesity. Obesity (Silver Spring, Md.). 2011;19(8):1654–62.

    Article  Google Scholar 

  22. Bean MK, Powell P, Quinoy A, Ingersoll K, Wickham EP III, Mazzeo SE. Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI Values randomized controlled trial. Pediatr Obes. 2015;10(2):118–25.

    Article  CAS  PubMed  Google Scholar 

  23. Christie D, Channon S. The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. Diabetes Obes Metab. 2014;16:7.

    Article  Google Scholar 

  24. Borrello M, Pietrabissa G, Ceccarini M, Manzoni GM, Castelnuovo G. Motivational interviewing in childhood obesity treatment. Front Psychol. 2015;6:1732.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Haeseler F, Fortin Vi AH, Pfeiffer C, Walters C, Martino S. Assessment of a motivational interviewing curriculum for year 3 medical students using a standardized patient case. Patient Educ Couns. 2011;84(1):27–30.

    Article  PubMed  Google Scholar 

  26. Burton AM, Agne AA, Lehr SM, Davis NJ, Willett LL, Cherrington AL. Training residents in obesity counseling: incorporating principles of motivational interviewing to enhance patient centeredness. J Grad Med Educ. 2011;3(3):408–11.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Söderlund LL, Madson MB, Rubak S, Nilsen P. A systematic review of motivational interviewing training for general health care practitioners. Patient Educ Couns. 2011;84(1):16–26.

    Article  PubMed  Google Scholar 

  28. Welsh JA, Nelson JM, Walsh S, Sealer H, Palmer W, Vos MB. Brief training in patient-centered counseling for healthy weight management increases counseling self-efficacy and goal setting among pediatric primary care providers: results of a pilot program. Clin Pediatr. 2015;54(5):425–9.

    Article  Google Scholar 

  29. Carpenter KM, Cheng WY, Smith JL, et al. “Old dogs” and new skills: how clinician characteristics relate to motivational interviewing skills before, during, and after training. J Consult Clin Psychol. 2012;80(4):560–73.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Resnicow K, McMaster F, Bocian A, et al. Motivational interviewing and dietary counseling for obesity in primary care: an RCT. Pediatrics. 2015;135(4):649–57.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Duke University, Durham, NC, USA

    Sarah Armstrong MD & Joseph A. Jackson Jr. M.D.

  2. Department of Pediatrics, Duke Children’s Hospital and Health Center, Duke University School of Medicine, Durham, NC, USA

    Sarah Armstrong MD & Jessica Lyden Hoffman BS

Authors
  1. Sarah Armstrong MD
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  2. Joseph A. Jackson Jr. M.D.
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  3. Jessica Lyden Hoffman BS
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Corresponding author

Correspondence to Sarah Armstrong MD .

Editor information

Editors and Affiliations

  1. Duke University School of Medicine , Durham, North Carolina, USA

    Michael S. Freemark

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Armstrong, S., Jackson, J.A., Hoffman, J.L. (2018). The Role of the Primary Care Provider in Long-Term Counseling: Establishing a Therapeutic Alliance with the Child and Family. In: Freemark, M. (eds) Pediatric Obesity. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-68192-4_39

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  • DOI: https://doi.org/10.1007/978-3-319-68192-4_39

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-68191-7

  • Online ISBN: 978-3-319-68192-4

  • eBook Packages: MedicineMedicine (R0)

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