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This wise and practical book provides effective strategies for helping therapy clients with anxiety resolve ambivalence and increase their intrinsic motivation for change. The author shows how to infuse the spirit and methods of motivational interviewing (MI) into cognitive-behavioral therapy or any other anxiety-focused treatment. She describes specific ways to use MI as a pretreatment intervention or integrate it throughout the course of therapy whenever motivational impasses occur. Vivid clinical material—including a chapter-length case example of a client presenting with anxiety and depression—enhances the utility of this accessible guide.

KEY POINTS
> Great potential: MI offers powerful tools to effect change, and there is a high demand for titles in this area.
> The first MI book focusing on anxiety—one of the most common problems therapists see.
> MI can boost the effectiveness of cognitive therapy and other approaches.
> Designed for utility: includes specific clinical tips, pull-outs highlighting key points, and detailed case examples.

AUDIENCE
Mental health practitioners, including clinical psychologists, social workers, counselors, and psychiatrists.

COURSE USE
May serve as a supplemental text in graduate-level courses.

CONTENTS
I. Integrating Motivational Interviewing into the Treatment of Anxiety and Related Problems
1. Where and Why Motivational Interviewing Fits
2. The Spirit of Motivational Interviewing
II. Assessing Readiness for Change
3. Observing Resistance
4. Asking About Readiness
III. Understanding Ambivalence and Building Resolve
5. Introduction to Working with Ambivalence
6. Understanding and Reframing Resistance to Change
7. Evoking and Elaborating Change Talk
8. Developing Discrepancy
IV. Extending Motivational Interviewing into the Action Phase
9. Evoking and Elaborating Client Expertise
10. Sharing Your Expertise
11. Listening Reflectively
12. Rolling with Resistance
V. Putting It All Together
13. Integrated Case Illustration
Epilogue. Training and Future Directions
Appendix. Resources and Recommended Readings

"A practical, compassionate, and clinically wise guide to effective treatment for clients who present with anxiety and related clinical concerns. Compelling descriptions/m-/coupled with rich clinical illustrations/m-/show therapists how to flexibly apply motivational interviewing and access clients' full potential and wisdom. Westra's sensitive and skilled instruction in combining 'ways of being' with 'ways of doing' makes this book a much-needed, extremely valuable contribution to the therapy literature. It should be read by all beginning clinicians and their supervisors, as well as by experienced clinicians looking to refresh and improve their practice."/m-/Lizabeth Roemer, PhD, Department of Psychology, University of Massachusetts Boston

"Westra masterfully communicates the conceptual basis of MI and its application to anxiety. While maintaining a strong commitment to empirical evidence, the volume is steeped in clear, compelling clinical illustrations and explanations. It provides original insights into how MI can be used to address difficult treatment issues in anxiety, including resistance and noncompliance. This is one of those few clinical manuals that I consider 'must reads' for all practicing clinicians, regardless of level of experience or therapeutic orientation. It is a substantial and noteworthy contribution that will enhance the treatment of anxiety."/m-/David A. Clark, PhD, Department of Psychology, University of New Brunswick, Canada

"Simply a wonderful book. This is an invaluable guide to using the spirit of MI to engage and collaborate with clients with anxiety. Ambivalence about treatment is viewed not as a hindrance but as an opportunity to explore, validate, and understand the client's salient preferences, fears, values, and goals. Therapist/n-/client dialogues generously provided throughout the book illustrate the natural, flexible ways that MI can be incorporated into all stages of treatment."/m-/Nancy K. Grote, PhD, MSW, School of Social Work, University of Washington

"MI is one of the most promising approaches for helping anxiety sufferers resolve conflicting motivations and more fully immerse themselves in treatment. Yet having taught and supervised beginning therapists in a range of psychotherapy techniques for the past decade, I can attest that MI can be challenging to master. That is why we are fortunate to have this clear and accessible book, featuring vivid examples and thoughtful advice. Beginning student therapists and experienced clinicians alike will benefit from Westra's wealth of research and experience."/m-/Peter J. Norton, PhD, Director, University of Houston Anxiety Disorder Clinic

"Anxiety is not only a common problem in itself, it is a frequent concomitant of other problems encountered in fields where behavior change is an issue. This book brings together contemporary thinking on MI and anxiety. It provides an approachable framework for thinking about and addressing anxiety using MI approaches, and deserves to find a wide audience among MI practitioners and trainers."/m-/Guy Undrill, PhD, MRCPsych, Consultant Psychiatrist, 2gether NHS Foundation Trust, and Honorary Clinical Lecturer, Academic Unit of Psychiatry, University of Bristol, United Kingdom

"This is the essential guide for cognitive-behavioral and other therapists who want to learn how to integrate MI into the treatment of anxiety. A master clinician and an expert MI practitioner, Westra interweaves the relational aspects of MI with its more directional components. She shows therapists how to enhance their effectiveness by seamlessly integrating MI skills and strategies throughout the therapeutic process. A variety of clinical examples emphasize the centrality of empathic accuracy and highlight important nuances of timing and communicative style. Deeply humane and technically sophisticated, this book is integrative in the fullest sense of the term."/m-/Allan Zuckoff, PhD, Departments of Psychology and Psychiatry, University of Pittsburgh

Henny A. Westra, PhD, is Associate Professor of Psychology at York University in Toronto, Ontario, Canada. She has nearly two decades of clinical and research experience and has worked as a front-line clinician, clinical director, professor, and trainer. Her research on resistance, motivation, and interpersonal process in psychotherapy has been funded by the National Institute of Mental Health and the Canadian Institute of Health Research. She has presented and published widely on the treatment of anxiety and depression.