How can we help patients to initiate change?

This paper presents guidelines to help patients initiate change in risk behaviours for coronary artery disease. Two questions are explored. These address the clinical method and session content, respectively. How might we best conduct the interview, so that the patient's motivation for changing risk behaviour is enhanced? What is the optimal focus for counselling, so that the patient can feel that the activity of exploring or modifying their risk behaviour is meaningfully connected with their personal goals and life priorities? Specific guidelines are presented to guide practitioners in fostering a patient-centred clinical method. Practitioner tasks for structuring session content are derived from motivational theory and the transtheoretical model of readiness for change.