Shared decision making and motivational interviewing: achieving patient-centered care across the spectrum of health care problems.

Patient-centered care requires different approaches depending on the clinical situation.

Motivational interviewing and shared decision making provide practical and well-described methods to accomplish patient-centered care in the context of situations where medical evidence supports specific behavior changes and the most appropriate action is dependent on the patient's preferences.

Many clinical consultations may require elements of both approaches, however. This article describes these 2 approaches--one to address ambivalence to medically indicated behavior change and the other to support patients in making health care decisions in cases where there is more than one reasonable option--and discusses how clinicians can draw on these approaches alone and in combination to achieve patient-centered care across the range of health care problems.