Motivational Interviewing

Getting Motivation Started

We do many things because our motivation is feeling bad; when we work hard, we start to feel good, and when our motivation thusly disappears, we drop the behaviour.

Keeping it Going

We need to keep behaviour going; if negative feelings are short-term motivators, positive feelings are long-term motivators:

health, control, and self-esteem

Assessing Motivation

"Do you want to take care of yourself?" is a superficial question; also need to ask

"why do you want to take care of yourself?" and

"how hard are you willing to work to take care of yourself?"

give patients 3 chances

"how willing are you to make choices that might increase the burden temporarily in order to improveyour health in the long run?"

Assessing Behavioural Intention

Do you know this is a problem?

Are you distressed by this problem?

Are you interested in change?

Are you ready to change now?

Ask questions; minimize statements

We've got about 3 miutes here.. what can you tell me about...?"
"do you know what I would recommend?"
"have you ever thought about..."
"research shows that... Are you interested in this?"
I've heard what you're thinking; do you want to hear what I'm thinking?

Express empathy

let them know you understand their choices and behaviours
- "know I understand why you..."

Take a curious, non-judgmental stance

"help me understand what went wrong"

Avoid arguing

"yes, but" means "no, because" - you are in a motivational argument. stay away
"remind me of why you want to change"

Roll with Resistance

as things don't work out, see them as challenges to overcome

Support self-efficacy

the best predictor of change is confidence
find things the person knows they can do