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Objectives: To examine whether motivational interviewing is used by GPs in consultations with patients living with mental-physical multimorbidity., Methods: Secondary analysis of selected videos from an existing database of routine general practice consultations with adult patients in Glasgow, Scotland. Consultations involving patients with mental-physical multimorbidity were selected and coded using the Motivational Interviewing Treatment Integrity (MITI) coding system., Results: Sixty consultations were coded involving 32 GPs across 16 practices. Mean consultation length was 9.9 min. On average GPs asked 1.7 questions per minute and offered 1.2 pieces of information per minute. Using the MITI, five GPs met beginner proficiency for the relational global qualities of partnership and empathy; however, none of the GPs met beginner proficiency for the technical global rating of efforts made to encourage patients to discuss behaviour change. Simple reflections were observed in 67% of consultations and complex reflections in 28% of consultations. Confrontation, a technique inconsistent with motivational interviewing, was observed in 18% of consultations., Discussion: MI was not evident in these consultations with patients living with mental-physical multimorbidity. This study provides information about the baseline motivational interviewing-consistent skills of GPs working with multimorbid patients and may be helpful in informing motivational interviewing training efforts and future research.

Internationally, health systems face an increasing demand for services from people living with multimorbidity. Multimorbidity is often associated with high levels of treatment burden. Targeting lifestyle factors that impact across multiple conditions may promote quality of life and better health outcomes for people with multimorbidity. Motivational interviewing (MI) has been studied as one approach to supporting lifestyle behaviour change. A systematic review was conducted to assess the effectiveness of MI in healthcare settings and to consider its relevance for multimorbidity. Twelve meta-analyses pertinent to multimorbidity lifestyle factors were identified. As an intervention, MI has been found to have a small-to-medium statistically significant effect across a wide variety of single diseases and for a range of behavioural outcomes. This review highlights the need for specific research into the application of MI to determine if the benefits of MI seen with single diseases are also present in the context of multimorbidity., Competing Interests: K.J.M. is a member of the Motivational Interviewing Network of Trainers. There are no other conflicts of interest to declare.

The last decade has witnessed an exponential growth in user-generated online content featuring Non-Suicidal Self-Injury (NSSI), including photography, digital video, poems, blogging, and drawings. Although the increasing visibility of NSSI content has evoked public concern over potential health risks, little research has investigated why people are drawn to create and publish such content. This article reports the findings from a qualitative analysis of online interviews with 17 individuals who produce NSSI content. A thematic analysis of participants' narratives identified two prominent motives: self-oriented motivation (to express self and creativity, to reflect on NSSI experience, to mitigate self-destructive urges) and social motivation (to support similar others, to seek out peers, to raise social awareness). Participants also reported a double-edged impact of NSSI content both as a trigger and a deterrent to NSSI., (© The Author(s) 2015.)