Motivational Interviewing Techniques….A behavioural change intervention that is growing in popularity within physiotherapy practice is Motivational Interviewing (MI). MI is a co-operative way of talking. MI empowers clients in their own motivation to change their behaviour. MI is suitable for treating the frequent problem of ambivalence against behaviour change of clients.
Motivational interviewing is a collaborative guide to elicit and is person- centered with strengthening motivation to change in a counselling setting and this is according to the founders William Miller and Stephen Rollnick.
A motivational interviewing process is built on mainly four foundational values. Most of the health care practitioners prefer integrative medicine ones, find that these are already part of their consultations or interactions:
- Accepting Client: This includes empathising with the client and recognising that the client is valuable and competent regardless of his or her circumstances. This also includes demonstrating support for the client’s ability to decide to change now, later, or not at all.
- Compassion: A Dedication to others’ welfare and well-being is often present in the health care provider’s life. They value long before formal training and working with clients. (Motivational Interviewing Techniques)
- Collaboration: This approach tells you to involve alongside the client, join them in the process, or looking at the client’s life or situation with the client and with his perspective, only then you will understand what he is going through; partnering with the client to consider a difficult situation.
- Curiosity: The health care provider helps the client access his desire and reasons for doing the health-promoting behaviour, Instead of trying to in still knowledge or motivation
The goal of motivational interviewing is to improve adherence with behavioural change recommendations. Motivational interviewing helps the patient to explore and resolve their ambivalence about change in accomplishing the goal. (Motivational Interviewing Techniques)
Motivational interviewing is a client-centered counselling style focused on developing motivation to change. The therapist’s role is to uncover and help build rapport, resolve ambivalence, provide normative feedback, and evoke commitment to change in an empathetic and collaborative manner. The principles of motivational interviewing are to express empathy, develop discrepancy, roll with resistance to change, and support self-efficacy to make changes.
Motivational Interviewing techniques helps a person to change. The counsellor knows how people work, and will try everything they can to get the client motivated.
This technique rests on the findings in clinical experience and research that simply show that clients who believe that they can change do so
Here is some Motivational interviewing techniques you should know:
- Battling Resistance: People are contradictory. They want to change and have the ability to do it, yet they have a resistance to do so. The therapist is always prepared to handle the resistance in many ways. The therapist should avoid telling the client that they are wrong or they are doing something wrong, due to this the client may lose his hope. Instead, the therapist should ask the client to think about new ways of solving a problem. It’s a friendly form of therapy that doesn’t want to be argumentative.
- Advice Offering: It’s a tricky rope to walk, yet MI therapists are good at what they do. They know that people don’t like being told to do something, but instead, they like to have a choice.
This can be performed in many ways, like:
- People don’t like the advice they didn’t ask for, and by asking, they are more open to listening. So the therapist always asks before giving the person advice.
- The advice is not given in the way that demands change. You will hear things like “you should consider this” “you can do this rather than this”. Telling someone they should consider their options makes the client feel like they’re not being rushed. A therapist may also say “It’s your choice,” to give the client more freedom of thought.
- They ask for the feedback of the advice they give. Then, they give confidence about their advice. They are confident about their advice given to clients and also about the chances of the client taking it.
- Therapeutic Paradox: Another technique for clients who have made little progress is the therapeutic paradox. They are statements made by the therapist that seem contradictory. If the client is trying to lose weight but is having hard time to do so. The therapist may say, “You’ve tried to do a lot of things, yet I see you’re still not working out. Maybe it’s not time for you to start right now.” By this the client can open up and tell things through which the therapist will come to know the actual reason for why the client is having a hard time. It’s a riskier technique, but it can be effective for clients who refuse to change.
- Self-Efficacy: The client needs the confidence and motivation to change their ways in the end. Having high self-esteem can make them self-sufficient, and the therapist knows very nicely how to motivate their clients.
- Empathy: The therapist can put themselves in the client’s perspective, and this can allow them to see it through their eyes. The therapist acknowledges that change is difficult and that they know how they feel. This the biggest Motivational interviewing techniques used by therapists.
- Columbo approach: The therapist may ask a question about the behaviour of the client that sounds like a curious question. It’s not meant to be judgmental, but instead, a question that wants more information. When they find information that is contradictory, the therapist will present it in a way that is not judgmental but instead makes the client think about how their mindset is. They will end their questioning with a call to reflect on their actions. For example: The therapist may ask the client, “How can your smoking make you live a long life,” and this lets the client think about their actions quite well.
- DEARS: Develop discrepancy, express empathy, amplify ambivalence, roll with resistance, and support self-efficacy. These are the 5 things that a therapist keeps in the process of Motivational interviewing techniques.
Motivational Interviewing Questions
The aim of motivational interviewing is to encourage the patient to become an active participant in the change process by evoking their intrinsic motivations for change.
So here are some motivational interviewing questions that can be helpful for you if you are doing the process.
Motivational interviewing requires four key communication skills that support and strengthen the process of eliciting change talk, also known as OARS:
- Open Ended Questions: Open questions invite others to “tell their story” in their own words without leading them in a specific direction. This allows us to find out more about the client’s perspective and ideas about change. Open questions should not be used exclusively in conversation. (Motivational Interviewing Techniques)
Examples of open questions:
- How can I help you in….?
- What do you want to do next?
- What is your perspective on this?
And many other questions like this.
- Affirming: This can be done through recognizing and commenting on the patient’s strengths and abilities. Through affirmations the statements and gestures are recognized and the strengths and acknowledge behaviours that lead in the direction of positive change, no matter how big or small of the client is studied. Affirmations build confidence in one’s ability to change. Give a response that sounds affirmative and the client is happy to hear it and is convinced by your thoughts.
- Reflective listening: Reflective listening can sound easy but it takes hard work and skills to do. Engaging others in relationships, building trust, and fostering motivation to change is the pathway of reflective listening. It closes the loop in the communication so that breakdowns don’t occur. At the end of a reflective listening statement the voice of listener’s turns down
In motivational interviewing, reflective listening is used purposefully to help the patient consider a change. This is one of the strongest characteristics of the evoking process.
- Summarizing: Summarizing helps to ensure that there is clear communication between the speaker and listener. The clients find themselves hearing themselves talk about change, when we employ reflective listening and combine it with effective summarizing.
These four types of motivational interviewing questions are employed toward eliciting change talk. The client making statements that are in favour of the change is called the Change talk.
It signals he or she is more willing, able, or ready to make the change. Change talk can occur in several forms and is exemplified by a statement that indicates the desire for, the ability to, the reasons for, and the need to change.
The most important aspect of motivational interviewing is for the practitioner to recognise and then emphasise change talk and pay particular attention to commitment language. (Motivational Interviewing Techniques)
Motivational Interviewing Training
There are so many courses and workshops available for motivational interviewing training. This is the most important part of the MI that you get better training so it is helpful for your clients as well and remember that clients trust you and they come to you in search of help so training is very important.
So before taking up clients and helping those up you should have proper motivational interviewing training.
There are different stages in MI. The MI technique was designed to help clinicians to identify where individuals with substance abuse issues stood regarding their understanding of their substance abuse.
- Stage 1: Earliest stage where an individual can fall into is the Pre-contemplation Stage. The person may be experiencing some negative issues associated with their substance use in this stage. You may see that the client has little or no motivation to change their behaviour as they do not view themselves as having a problem.
- Stage 2: This stage is known as the Contemplation stage. Here, the individual may realise that their behaviour is problematic for them, but they are ambivalent about making any changes. The person may desire to change their behaviour but may not be willing to put any effort in changing it.
- Stage 3: The Preparation stage. In this stage the person makes some efforts and tries to change their behaviour. Most individuals in this stage weigh the positive versus negative ramifications of their behaviour. They can prepare a plan to change in this stage but are not taking any formal action towards it.
- Stage 4: Action stage, the person is actively involved in changing their behaviour. He is actively putting efforts on changing the behaviour. Most individuals in this stage understand that they are responsible for changing their behaviour, and they often require some form of outside assistance to help them reach their goal. (Motivational Interviewing Techniques)
- Stage 5: In the Maintenance Stage, the individual has developed some aspect of efficiency that has allowed them to change their behaviour. As a general rule, individuals must have made changes that have been in place for a minimum of six months in order to qualify for this stage.
- Stage 6: This stage is referred to as the Termination stage. The person has made all of the changes that are necessary for them to face new issues and continue in a productive manner. In this stage, the person has been able to make positive changes, overcome their issues, maintain new habits, and continue to improve.
The overall model is quite consistent with the experiences of mental health clinicians who treat all types of different mental health disorders, including substance abuse issues. The model assumes that different people start at different points in the process; some may experience setbacks and drop back, whereas others may move forward without setbacks.
Motivational Interviewing Techniques…When clients are resistant to change, therapists need to be directive but not forceful. The therapist should be direct and help the client to examine any ambivalence they have regarding change, the change should not be forceful, it should come out of willingness from the client only then it will work. Discuss the clients concerns, issues and goals by developing a therapeutic alliance with the client. Assist the client to plan the steps they wish to take to make desired changes in their behaviour. Guide them, help them throughout the process and it will be really helpful for your client and he will get some motivation looking at you who is trying so hard for them.