Why is motivational interviewing good

Patients benefit from this relationship the most when the practitioner also embodies hope that change is possible. If a practitioner has more time, four additional principles Table 5 can be applied within a longer therapeutic intervention.

Barriers to implementing MI in general practice include time pressures, the professional development required in order to master MI, difficulty in adopting the spirit of MI when practitioners embody an expert role, patients' overwhelming desire for 'quick fix' options to health issues and the brevity of consultation times.

These barriers to implementing MI in primary care represent significant cons on a decisional balance. On the other hand, the pros for adopting an MI approach with patients who are resistant to change are compelling.

While we are not advocating MI for all patient interactions in general practice, we invite practitioners to explore their own ambivalence toward adopting MI within their practice, and consider whether they are 'willing, ready and able'. Practitioners who undertake MI training will have an additional therapeutic tool to draw upon when encountering patient resistance to change and a proven method for dealing with a number of common presentations within general practice.

For further information and online motivational interviewing training opportunities visit www. Motivational interviewing techniques updated PDF 1.

Australian Family Physician. Search for: Search AFP. Filter Relevance Date. Issues by year. Volume 41, Issue 9, September Motivational interviewing techniques Facilitating behaviour change in the general practice setting.

Background One of the biggest challenges that primary care practitioners face is helping people change longstanding behaviours that pose significant health risks. Objective To explore current understanding regarding how and why people change, and the potential role of motivational interviewing in facilitating behaviour change in the general practice setting.

Discussion Research into health related behaviour change highlights the importance of motivation, ambivalence and resistance. Recent meta-analyses show that motivational interviewing is effective for decreasing alcohol and drug use in adults and adolescents and evidence is accumulating in others areas of health including smoking cessation, reducing sexual risk behaviours, improving adherence to treatment and medication and diabetes management.

The Stages of Change model and motivational interviewing Prochaska and DiClemente 2 proposed readiness for change as a vital mediator of behavioural change. These were: 1 the importance of change for the patient willingness the confidence to change ability whether change is an immediate priority readiness.

The spirit of motivational interviewing Motivational interviewing is underpinned by a series of principles that emphasise a collaborative therapeutic relationship in which the autonomy of the patient is respected and the patient's intrinsic resources for change are elicited by the therapist. Case study — using the spirit of motivational interviewing A male patient, 52 years of age, who drinks heavily and has expressed the desire to reduce drinking, but continues to drink heavily.

Table 2. The spirit of motivational interviewing vs an authoritative or paternalistic therapeutic style The spirit of motivational interviewing Authoritative or paternalistic therapeutic style Collaboration: a partnership between the patient and practitioner is formed.

Joint decision making occurs. The practitioner connects health behaviour change to the things the patient cares about Education: the patient is presumed to lack the insight, knowledge or skills required to change. Table 3. Can you tell me about them? Versus Are you concerned about your drinking? But you are beginning to worry about the impact drinking is having on your health.

How am I doing? Examples of key questions to build a 'change plan' include: It sounds like things can't stay the same as they are. What do you think you might do? What changes were you thinking about making? Where do we go from here? What do you want to do at this point? How would you like things to turn out? After reviewing all of this, what's the next step for you?

Table 4. What difficulties have resulted from your drinking? In what way does your weight concern you? What are the advantages of reducing your drinking? What would be different in your life if you lost weight? How did you do it? What strengths do you have that would help you make a change? Forget how you would get there for a moment. If you could do anything, what would you change? Miller and Rollnick 17 have attempted to simplify the practice of MI for health care settings by developing four guiding principles, represented by the acronym RULE: Resist the righting reflex Understand the patient's own motivations Listen with empathy Empower the patient.

Resist the righting reflex The righting reflex describes the tendency of health professionals to advise patients about the right path for good health. Understand your patient's motivations It is the patient's own reasons for change, rather than the practitioner's, that will ultimately result in behaviour change.

Listen with empathy Effective listening skills are essential to understand what will motivate the patient, as well as the pros and cons of their situation. Empower your patient Patient outcomes improve when they are an active collaborator in their treatment. Table 5. Building empathy and understanding does not mean the practitioner condones the problematic behaviour. Evocative questions guide the client to reflect on how change may be meaningful or possible.

Reflections are based on careful listening and trying to understand what the person is saying, by repeating, rephrasing or offering a deeper guess about what the person is trying to communicate. This is a foundational skill of MI and how we express empathy. Summarizing ensures shared understanding and reinforces key points made by the client. Attending to the language of change identifies what is being said against change sustain talk and in favor of change change talk and, where appropriate, encouraging a movement away from sustain talk toward change talk.

Exchange of information respects that both the clinician and client have expertise. Sharing information is considered a two way street and needs to be responsive to what the client is saying. MI has four fundamental processes. Focusing : In this process an agenda is negotiated that draws on both the client and practitioner expertise to agree on a shared purpose, which gives the clinician permission to move into a directional conversation about change.

Ambivalence is normalized, explored without judgement and, as a result, may be resolved. This process is optional and may not be required, but if it is the timing and readiness of the client for planning is important. Although motivational interviewing has helped many people find the motivation to make both small and major behavior changes, it's not the ideal course of treatment for everyone.

Motivational interviewing works best for people who have mixed feelings about changing their behavior. If you have absolutely no desire to change your behavior, or are already highly motivated to change, you may not reap the benefits of this approach. If you feel that you or someone you love might benefit from this counseling approach, consider the following first steps:.

Learn the best ways to manage stress and negativity in your life. Miller WR, Rollnick S. Motivational interviewing: Helping people change. Guilford Press; Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. Motivational interviewing as an adjunct to cognitive behavior therapy for anxiety disorders: A critical review of the literature. Cogn Behav Pract. Effect of psychotherapy on reduction of fear of childbirth and pregnancy stress: A randomized controlled trial.

Front Psychol. Motivational interviewing: A systematic review and meta-analysis. Br J Gen Pract. Motivational interviewing for adolescent substance use: A review of the literature. Addict Behav. Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews.

PLoS One. Rollnick S, Miller WR. What is motivational interviewing? Behav Cogn Psychother. Your Privacy Rights. To change or withdraw your consent choices for VerywellMind.

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