The role of the primary care provider in long-term counseling: Establishing a therapeutic alliance with the child and family

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.