Motivational Interviewing

The idea behind motivational interviewing is that giving people direct advice is not a good idea for a number of reasons:

• they may not have given you all the relevant information for whatever reason
• what would work for you may not work for them
• offering advice can seem condescending and judgemental
  

therefore motivational interviewers work from the premise that the person with the problem is actually in the best position to find the most ideal solution that would work for them and that the interviewer's role is to assist them to come up with their own solution.

Motivational interviewing has 4 principles: express empathy, develop patient's discrepancy, manage patient's resistance, and support patient's self-efficacy.

1. Express empathy - Listen to the patient and use your reflective listening skills so they feel listened to.
2. Develop patient's discrepancy - help the patient see the gap between what they want and how they're acting. For example, "you've told me you really want to stop smoking, but two months later you're still smoking a pack a day". The point here is to highlight the discrepancy between the patient's goals and their behaviour, not to tell them off or make them feel judged. Try to discover what it might be that is causing this discrepancy. For example, perhaps they have a partner who smokes around them? Once barriers are discovered, work with the patient to find ways around them.
   
3. Manage patient's resistance - the patient is in control. If they don't want to talk about something, don't insist - you will only piss them off.
   
4. Support patient's self-efficacy - encourage patient to come up with their own solutions. Praise any progress they make.