Motivational interviewing or “Something I’d like to change but I’m finding it difficult to do.”

It's rare to meet someone who doesn't think they should have a healthier lifestyle, be it cutting down on drinking, going on a diet, smoking less or exercising more. It's a very human trait to do things we shouldn't. It's how we express ourselves - how we demonstrate our independence and our ability to rebel against ourselves, against other people and against the systems that constrain us. 

Motivational interviewing allows us to look at what prevents us from doing what we should be doing, and uses people's internal motivation to bring about change.

 

What is Motivational Interviewing (MI)?

Motivational interviewing emerged in the 1980s within the setting of alcohol addiction treatment, where it was noted that encouraging patients to think and talk about their own reasons to change minimised their resistance and strengthened their motivation and commitment to change.

MI accepts that ambivalence about change is part of the normal human experience, and often a necessary step in the process of change. MI allows the clinician to work with patients' ambivalence rather than viewing it as a problem. It also aims to encourage the patient's autonomy in decision-making. The clinician acts as a guide, clarifying the patient's strengths and aspirations, listening to their concerns, boosting their confidence in their own ability to change, and eventually collaborating with them on a plan for change.

I helps people look at why they are ambivalent about making a change they know they should make. The technique specifically allows patients to explore the pros and cons of changing, allowing them to reach the decision to change themselves rather than being told to change. After all, if we just needed to be told to change we would have done it by now!

By embracing a 'spirit of MI' people are freed to explore whether they want to change, and they ultimately become the expert in telling you why they might change.

 

My experience with Motivational Interviewing  

 

My introduction to MI came in 2007 when I worked with the Society of Sexual Health Advisers (SSHA) NICE sub committee to help them develop a training package for sexual health workers in Primary Care/Sexual Medicine and HIV clinics. We ran study days using MI techniques to better equip sexual health/ HIV practitioners in their work with patients to reduce sexual health/HIV risk.

Since then I have been regularly running training days for healthcare workers and voluntary sector employees, and developing my own experience of MI within the NHS, and through private practice work.  

 

I like working with people who are resistant to doing what they know they 'should' be doing. In particular, I have had a lot of success using MI techniques with people who feel stuck as they are concerned about how much they drink, smoke, or use recreational drugs, as well as those who gamble or are unable to control their eating. These techniques often help people voice their struggle which may enable them to make the change they seek to make.  

Here's a sample of the questios for looikng at whtehr someone wants to change the way theydrik alcohol.  

http://www.dorindathirlby.com/Alcohol MI sheet.pdf

 

The study days I run are a mixture of therapy and practical group work that allow participants to experience the 'Spirit of MI' and learn some of the techniques. 

http://www.dorindathirlby.com/MI presentation 2 hours .pdf

 http://www.dorindathirlby.com/practice you own behaviour_MI_Risk_Reduction_Proforma with promptd from talk.pdf

 

References / Further Reading

www.motivationalinterviewing.org

Rollnick, Mason and Butler (1999) Health Behaviour Change: A Guide for Practitioners.

Rollnick, Miller and Butler (2008) Motivational Interviewing in Health Care.

Miller & Rollnick (1991) Motivational Interviewing.

Bell G et al (2004) The Manual for Sexual Health Advisers.