Motivational interviewing is a research-based strategy that has proven effective in facilitating change (Hettema et al., 2005; Miller et al., 1994; Rubak et al., 2005). Interviews are structured in a way that makes clients confront themselves.
Many health care practitioners report feeling frustrated with clients who sway between the early stages of change. Prochaska and DiClimente (1983) developed a change model that describes common stages clients go through in the process of change. Practioners may see clients who are at different stages. For example, clients at the precontemplative stage may have a substance use problem that does not concern them. Smokers at the contemplative stage may recognize the drawbacks of smoking but also feel helpless to change because their previous attempts to quit have failed.
Health care practitioners often provide facts and figures to clients in the early stages of change in an effort to motivate them. However, logic is not always effective in promoting change. Practitioners are often left wondering how to motivate clients and how to build confidence in their ability to make changes to improve their lives.
When to Use Motivational Interviewing
Motivational interviewing can create a spirit of collaboration, elicit the reasons for change from clients and empower them to want to change for their own reasons. One of the assumptions of motivational interviewing is that resistance to change is a normal part of the process. When clients are in the early stages of change, it is vital to roll with resistance, offer options and deal with the discrepancy between maintaining the status quo and change, while promoting self-efficacy. Resistance is a key indicator that a strategy is not working. By remaining flexible and maintaining the spirit of motivational interviewing, primary care practitioners can make strides toward client-centred goals.
Examples of Motivational Interviewing
The effective pharmacist: Motivational interviewing demonstration
The effective physician: Motivational interviewing demonstration
The ineffective pharmacist: Non-motivational approach
The ineffective physician: Non-motivational approach