Your patients are always trying to make sense of their illnesses. This includes their treatment and their relationship with you. Some take their medications as prescribed; others push back. They don’t want to take their medications because they’re resistant to change. Their ideas become corrupt by misinformation.
Motivational interviewing is listening to and understanding patients’ reasoning for their partial adherence. Don’t leave them stuck with conflict. This results in feelings of discomfort (known as cognitive dissonance). Allow them to balance their thoughts about what they should do and what they’re actually doing.
- Uses opportunities to discuss patients’ health-related behaviors
- Moves them to adopt and maintain treatment recommendations
- Encourages patients to share their own reasons for concerns with their lifestyle behaviors or prescribed treatment regimens
- Helps resolve patients’ doubt about behavioral change and helps them take responsibility
- Guides the discussion to a patient-centered interaction
- Methodically explores the hesitancy associated with a behavior
Three steps to motivational interviewing:
- The first step is to begin a conversation. Talking in a supportive environment promises a possibility of change.
- The second step is to talk about discrepancies between your patient’s thoughts and goals, along with their current behaviors. A non-judgmental discussion is vital.
- Step three is to resist arguing or giving advice, and stay away from confrontation. If your patient is resistant to change, your response should be of basic reflective and clear-cut statements. Speak simply.
Here are more tips for your motivational interviews:
Use open-ended questions:
You cannot answer an open-ended question with a single word or phrase. Don’t ask your patient, “Do you take your medications?” Ask, “How do you go about taking your medications?” This initiates conversation and develops focus. Here are some more examples:
- How important is it to you to take the medicine?
- What does having (diabetes/high blood pressure/etc.) mean to you?
- What’s your understanding of the purpose of this medication?
- What gets in the way of you taking the medicine?
- What would have to change for you to decide to take your medication?
Practice reflective listening:
Use reflective statements to deepen a conversation and show that you hear and understand the patient. Paraphrase what the patient said.
Periodically summarize what the patient said, and provide some direction for what’s to come next in the conversation.
A patient who decides to make a change in behavior needs to feel confident. Help increase morale by referring to strengths, motivations, intentions, progress, and past successes.
Want to get a better understanding of how your patients process information and make their decisions? Listen to them. Everything starts with a listening ear. By doing this, you become a partner willing to understand what your patients are thinking. Motivational interviewing is a path toward improved self-management. It can help improve adherence and lead to better long-term outcomes for patients.
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