Motivational interviewing is a way for the clinician and client to talk about the clients reasons for change. The clinician helps the client understand reasons for change and helps elicit the clients desire for change. It has been effectively used for addiction behaviors, tobacco treatment, weight loss interventions, and other situations where an individual wants to change their negative health behaviors. The approach expresses empathy, avoids arguing, develops discrepancy, and supports self-efficacy. It is useful in clinical situations where ambivalence is high, desire is low, motivation is low, and confidence is low. The main takeaway of motivational interviewing is to understand that there is no information that is new to the client (I.e. they know the substance is harmful) and the doctor gently helps the client understand that they are an expert in their own health and any previous experience trying to quit. The approach is a team effort of both the clinician and client.
Chloe: Hi and welcome to the BH WELL video blog. I'm Chloe Robertson, your host. BH WELL stands for Behavioral Health Wellness Environments for Living and Learning. Today on the vlog we have with us Dr. Lovoria Williams he is an associate professor at the University of Kentucky College of Nursing. She's here with us to discuss motivational interviewing. Hi Dr. Williams.
Dr. Williams: Hi, how are you today?
Chloe: Good how're you?
Dr. Williams: Good.
Dr. Williams: Wow, that's a big question for such a complex style of conversation. But simply, motivational interviewing is a way for the clinician and the client communicate to one another in a way where the clinician helps the client explore their reasons for change. The client is the expert and the clinician is also the expert, but it's where the clinician helps the client understand reasons for change and helps elicit from the client reasons why they should be motivated to change.
Dr. Williams: Motivational interviewing has been used effectively in many areas. It's been used in addiction behaviors for tobacco treatment. It's been used in weight loss interventions. It's been used in any situation where an individual wants to change their behaviors or the clinician believes that what the individuals doing may affect their health in a negative way and they want to guide the individual to change their behaviors.
Dr. Williams: Any clinical situation where ambivalence is high, desire is low, motivation is low, and confidence is low. So that could be in the case of tobacco, the individual uses tobacco and the clinician is trying to have a conversation with the individual about changing their tobacco use behaviors. The individual may be ambivalent because tobacco helps them, and helps them when they’re stressed, or it helps them calm down and so their ambivalent. They know the information about the ill health effects, but they still are ambivalent about changing their behavior. Or, again in the case of tobacco, they may have tried before so their confidence is low because they perhaps have tried unsuccessfully before; And their motivation could also be low because again they desire it; And then their desire may be low because they have some pleasure from using tobacco. So it’s most effective in the clinical situation where those four factors exist.
For more in depth information on Motivational Interviewing, check out the book Motivational Interviewing: Helping People Change by Miller & Rollnick. ISBN 9781609182274