We agree with the author that promoting collaboration between the adolescent, family, and nurse through the use of motivational interviewing can empower behavior change and lead to a healthier lifestyle. We'd like to add that this method of treatment has the potential to be most effective if performed in the home. Research has shown that a home-based intervention using motivational interviewing can be successful in reducing service attrition and maladaptive behaviors compared with a more traditional intervention.1

Working with the patient in the home allows the nurse to gather objective information about the environment, witness the family dynamic, identify barriers to change, and evaluate progress. This approach is more time consuming and potentially expensive, but it enables the nurse to work with the patient and family in the optimal setting, discovering the source of the problem and suggesting changes and improvements that support self-efficacy.

Christine Gillen-McKay

Michael Grocki

Holly Leahy

Milton, MA

For more letters from AJN readers, go to http://links.lww.com/AJN/A47.

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