One of the biggest challenges healthcare professionals face is helping people change longstanding behaviours. Motivational interviewing is an effective, evidence-based counselling method that enhances motivation through resolution of ambivalence or doubt. It is underpinned by a series of principles that emphasise a collaborative relationship between the member and the therapist. Motivational interviewing maintains and respects member autonomy. The therapist plays the role of a facilitator rather than an expert who adopts a non-confrontational approach to help guide the member towards change.

The approach includes learnable techniques which assist in allowing the patient to speak about the advantages of behavioural change and treatment. Thus, motivational interviewing helps patients adopt a healthier lifestyle while contributing to the professionalism of healthcare professionals and their sense of satisfaction from work.

Fundamental Principles

• Motivational Interviewing is underpinned by a mutual understanding and respect between the client and the therapist. 
• Motivational Interviewing is most effective when the desire to change comes from the members themselves.
• Motivational Interviewing can be used by anyone to help facilitate change.

Benefits of Motivational Interviewing

• It can be used in brief meetings with people.
• It positively affects both patients and healthcare professionals.
• It constitutes a good form of communication for healthcare professionals that provides self-confidence, professionalism and protects against burnout.
• Motivational interviewing skills help you to connect quickly with all people, not just patients which can benefit a healthcare professional across many areas of the role.

Understanding the Motivational Interviewing technique

Motivational interviewing is based on three key elements: collaboration between the therapist and the client, evoking the client’s ideas about change and emphasising the autonomy of the client.

Collaboration

‍Collaboration is based on the therapeutic alliance built between the therapist and the client. The therapist does not take the stance of an expert but instead acknowledges the client’s expertise about themselves. Although there may be differing views, there is a focus on collaboration and mutual understanding and respect. 

Evocation

Evocation lies in the ability of the therapist to motivate the client to change and commit. The determination for change is based upon the client’s own thoughts and beliefs opposed to the therapist imposing their own beliefs, and opinions of why the client should change. Motivation and commitment to change is at its strongest when it comes from the client. The therapist connects the benefits of changing with things the client cares about. ‍

Autonomy

Autonomy refers to the idea that it is the client’s right and freedom to not change despite the information and advice provided by the therapist. Motivational interviewing acknowledges that the determination and drive to want to change lies with the client. This empowers them, but also gives them the responsibility for their actions.

Basic Skills of Motivational Interviewing

Ask open-ended questions

• The member does most of the talking and allows you to learn more about the member and their values

Examples:

• “I understand you have some concerns regarding your drinking. Can you tell me about them?”

Make Affirmations

• Can take the form of compliments, statements of appreciation to validate and support the member during process of change
• Most effective when member’s efforts are noted and affirmed

Examples:

• "I appreciate that it took a lot of courage for you to discuss your drinking with me today."
• "Thank you for hanging in there with me today, I understand this is not easy for you to hear."

Use Reflections

• Involves rephrasing a statement to capture the implicit meaning and feeling of a member’s statement
• Encourages personal exploration and helps people understand their motivations more fully
• Can be used to amplify or reinforce desire for change

Examples:

• "You enjoy the effects of alcohol as it helps you interact with friends without being too self-conscious. But you are beginning to worry about the impact drinking is having on your health. Until recently you weren’t too worried about how much you drank because you thought you had it under control. Then you found out your health has been affected and your partner said a few things that have made you doubt that alcohol is helping you at all."

Use Summarising

• Links discussions and ‘check in’ with the member
• Ensures mutual understanding of the discussion so far
• Point out discrepancies between person’s current situation and future goals

Examples:

• "If it is okay with you, let me check that I understand everything that we’ve been discussing so far. You have been worrying about how much you’ve been drinking in recent months because you recognise that you have experienced some health issues associated with your alcohol intake, and you’ve had some feedback from your partner that she isn’t happy with how much you’re drinking. But the few times you’ve tried to stop drinking have not been easy, and you are worried that you can’t stop. How am I doing?"

Motivational Interviewing Workshop

You are invited to attend our motivational interviewing workshop with Psychologist and Researcher Dr Trevor Simper. This is a 4 hour workshop hosted by Ascend Health located in Perth CBD on Friday 11th of November. These workshops will be intended to expand the knowledge of health professionals. This could include 4th-year university students as well as new and established healthcare professionals in the health sector looking to deliver the highest quality care.

To learn more about the event or purchase your ticket to attend visit this link HERE

‍