The Benefits of Motivational Interviewing in Healthcare

The Unfortunate Perception

If you are anything like me, you dread and even avoid scheduling an annual physical with your physician.  This is because my skewed perception of a general doctor’s visit is an inconvenient and uncomfortable interrogation rather than a helpful and educational health care session.  As a health coach for a wellness provider, I strongly believe in the importance of seeing your doctor at least once a year as a vital part of preventative health care, so my perception is a very unfortunate one. The truth is doctors are not insensitive and actually do care about their patients well-being.  They simply have several patients to see in a small amount of time; therefore; speed and efficiency sometimes outweigh patient satisfaction. This approach, more often than not, leaves patients feeling discouraged and confused about what they need to do next to see desired changes in their health.

Is there an Alternative?

Motivational Interviewing (MI) has become a growing method for promoting change. MI is a relatively new idea developed by clinical psychologists Professor William R Miller, Ph.D. and Professor Stephen Rollnick, Ph.D.  This method uses the patient’s own motivators and values to make realistic and healthy lifestyle changes.  The use of MI has been proven to have more positive outcomes than other more coercive expert-to-student based techniques, which are similar to many physician-patient relationships.  In expert-to-student scenarios, the health professional is simply telling the patient exactly what to do based off the expert’s knowledge.   With MI, the patient is the expert of their own life putting both parties at an even playing field.  In MI, there is a collaboration and trust that establishes a more cohesive, non-confrontational partnership. This unique rapport works to create a plan for change resulting in higher success and patient satisfaction rates.

How does MI Work?

There are four key processes to motivational interviewing that create structure and order.

  • Engagement – Establishing partnership
  • Focus – Develop specific direction
  • Evoking – Elicit motivators and feelings about change
  • Planning – Making a commitment to change and developing a plan

In my experience, the most important process is engagement.   Engagement is where both the interviewer and the interviewee get to know each other and start developing a trusting and respectful relationship that grows and lasts throughout the entire change process.  This eliminates the discomfort of having to talk about your health to a complete stranger and creates an empathetic, judge free zone.  Engagement sparks enthusiasm and commitment allowing the interviewer to better develop a clear focus.  Continued engagement allows the interviewer to evoke feelings of motivation, helping to overcome barriers and to create a realistic and customized plan for the interviewee to follow.

Studies have shown that knowledge alone is not enough to evoke change.  Knowledge along with motivation, however, reduces resistance, ultimately increasing one’s ability to change.  This is the secret to the success of MI.

The Future of Healthcare

Perhaps, if more physicians took a few extra minutes engaging patients and practicing MI skills, vital annual exams would be far less uncomfortable.  Patients might even look forward to them each year as they continue to feel encouraged and inspired to make changes. As healthcare continues to transition into becoming more proactive in its treatments, MI will increase in its value to both physicians and patients.

As a health coach, the use of motivational interviewing not only increases the likelihood of change in the lives I work with, but makes my job far more enjoyable and rewarding as well.

By Ashlee Shondell
Health Coach

Sources:
www.motivationalinterviewing.org
http://faculty.fortlewis.edu/burke_b/CriticalThinking/Readings/MI-Burke.pdf