Motivational Interviewing Beyond the Clinical Setting: The AiM App

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April 6, 2015 by Nicholas Spence


For many people, there is no doubt that mobile devices play a major role in their day-to-day existence. From keeping one organized to maintaining contact with friends, family, and co-workers, these devices just seem to be getting harder and harder to get away from. Given the number of hours these devices spend attached to their owners, there is much potential to use them to facilitate behavior change. This is the rationale behind the “AiM App to Improve Motivation.”

Recently, this app came to my attention. I found the idea of attempting to bring the clinical practice of motivational interviewing to a mobile device, for people seeking to make changes in their lives, quite fascinating. Here is an overview for those who may be interested in trying it out:

What? The “AiM App to Improve Motivation” was designed to help people change those things in their lives that are of importance to them. Not only is the app relevant for lifestyle behavior changes associated with health, such as exercise, there are options for users targeting non-health related goals, such as studying.

Who? The app was developed by Dr. Daniel Bressington and Harvey Wells, two clinicians and professors with substantial experience related to motivation and health behavior change.

When? AiM became available in late 2014.

Where? The app can be downloaded from links on the company website at a cost of $3.49.

Why? Based on the success of motivational interviewing in the clinical setting, this app was designed to bring this counseling approach to the “masses” using mobile technology. A noble attempt for sure, but be warned as the evidence of its effectiveness relative to the traditional clinical context has not been established. I do, however, credit the creators for the clear disclaimer on the infancy of work in this area and the main point that the app is not a quick fix, as changing lifestyle behaviors is far from a simple task.

How? AIM is rooted in motivational interviewing; therefore, a crucial aspect of the app is the emphasis on exploring and building the motivation of the user to foster behavior change, as opposed to the traditional education approach coupled with an emphasis on telling people what to do. There are four elements of motivational interviewing that are explicitly incorporated into the app: open questions; affirmation; reflection; and summary. Of course, since it is not an actual clinician interacting with the client, there are obvious limitations associated with attempting to conduct true motivational interviewing through this medium. That being said, one of the strengths of the app is that it is readily available and actively facilitates the day-to-day behaviors necessary for long term, sustainable change.

The actual process is quite simple: select a lifestyle behavior to be changed, such as drinking, studying, smoking, or exercise; consider the reasons for changing; examine and score three areas of motivation (importance, confidence and readiness); review progress over time.

A few unique features of the app are the “emergency button,” “reminders,” and “online forum.”

The “Emergency Button” is available for those moments when motivation begins to wane. This feature provides reminders to the user, particularly the initial desire to change, in the form of text, pictures, and videos, as well as triggers to contact networks of social support (e.g., friend, health care professional), via telephone or text.

I think the app does a good job of keeping the long term goal in mind, while reducing it to a series of smaller weekly activities through the “reminders” feature. For example, the grand goal may be to eat healthier by increasing fruit and vegetable intake from zero servings per day to four servings per day. However, in the short term, the aim for the current week may be to increase fruit and vegetable intake from zero servings per day to one serving per day. Not only does this simplify what may be perceived as an enormous and difficult goal into a series of little attainable goals, but in conjunction with the reminders function, which sets out weekly activities/milestones and reviews progress, momentum builds over time. Another neat item is the “locations reminder” that links behaviors with specific contexts when the user is in close proximity to them. This reminder indicates to the user to engage (e.g., buy fruits and vegetables at the supermarket) or not engage (e.g., do not buy soda at the cafeteria with lunch) in a specific behavior at a specific site.

Finally, the online forum provides a support network to converse with app users and expert authors in an anonymous manner. This dimension of the app is quite useful for many reasons, such as troubleshooting technical issues and developing links with other people possessing similar goals. At the moment, this online forum does not have much activity, but this may reflect the short time frame the app has been on the market.

Overall, the app allows the user to engage with the numerous tools available in a very personalized manner. The central goal, using motivational interviewing principles in a mobile format for behavior change for the masses at a small cost, is no easy feat and only rigorous evaluation will reveal whether it lives up to expectations. Please, feel free to share your thoughts and experiences with me!

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