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Motivational Interviewing

This resource provides an overview of Motivational Interviewing (MI) and its integration with the Stages of Change theory, designed for healthcare providers aiming to support patients in making behavioral changes. It highlights the significance of understanding the patient's perspective on change, the balance of giving advice, and the importance of timing. Key stages include precontemplation, contemplation, preparation, action, and maintenance. This guide also offers strategies for effective communication, addressing patient and provider blocks, and fostering a partnership that enhances motivation and commitment to change.

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Motivational Interviewing

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  1. Motivational Interviewing The Process of Change Gloria Sayler, Seattle, U.S. Communication Skills Teacher

  2. Change • Think about a pt who is trying to make a change • Consider a change you tried to make • What helped, what didn’t?

  3. Goals • Integrating Motivational Interviewing with Stages of Change theory • Understanding the process of behavior changes • Decreasing frustration for both pt and provider • Increasing effectiveness

  4. Advice Giving • Works about 25% of the time • The key is timing – using it in a pt centered approach

  5. The Nature of Change • Change is rarely a discrete, single event • Sometimes, after a crisis, a person will readily change

  6. Stages of Change • Precontemplation – Pt is not interested or is deeply ambivalent • Contemplation – patient is considering a change • Change usually involves loss – in spite of the perceived gain

  7. What is your role • Elicit, understand the behavior’s meaning • How are they thinking about the benefits and difficulties of changing X

  8. Preparation • Preparing to make a change • Experiment with small steps • Elicit and provide information

  9. Action • Pt starts making the changes in behavior more consistently • Encourage • Anything else ?

  10. Maintenance • Keeping the change in behavior in place • Occasional “slips” • Discouragement • Encourage • Provide information

  11. Dancing vs. Wrestling • Eliminates persecutor /victim roles • Enhances provider and pt empowerment/partnership

  12. Elicit – Provide - Elicit • What do they know/Want to know? • What additional information can you provide? • Generate options • What do they /family/friends think about that? • Goals – what do you think will work?

  13. Provider Blocks • Anxious for change we end up: • Lecturing – • Ask questions • Cheerleading • Acknowledging/eliciting

  14. Patient Blocks • What is going to happen when you leave? • Resistance - argument: • quick summary// Identify and use discrepancies • Helplessness : • Acknowledging challenges/empathy; • Eliciting previous successes

  15. Resources: • Miller WR and Rollnick: articles and books • “Stages of Change and 12 Problem Behaviors…” article • Motivational Interviewing (book) – preparing people to change Prochaska, et al: articles and books Changing for Good

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