Models

Motivational Interviewing

Motivational interviewing is a directive, client-centred counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence[i]. The health professional’s task is to better understand the factors that contribute to a person’s motivation to making changes in a health-related behaviour.

Motivational interviewing is based on a number of principles that help the patient understand and challenge their thought patterns and processes and their associated feelings, related to a particular behaviour. It involves systematically exploring the ambivalence to change and seeking to elicit and amplify the patient’s discrepancies about their health related behaviour to enhance motivation to change. 

This can be done by:

  • using a decision balance. Patients will be more likely to make changes if they believe there are benefits to changing AND the costs of remaining the same are high. However, if patients believe there are few benefits arising from the specific behaviour, and significant costs associated with making a change, they are unlikely to change
  • offering advice and feedback when appropriate selectively using empathetic reflection to reinforce certain processes e.g. patient concerns

The goal of motivational interviewing is to assist the client/patient to work through ambivalence and commit to change. Motivational interviewing is an important skill for assessing patients’ willingness to change their lifestyle.

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[i] Hettema, J., I. Steele, and W. Miller, Motivational Interviewing. Ann Rev Clin Psych, 2005. 1: p. 91-111.

[ii] Royal Australian College of General Practitioners. Putting Prevention into Practice. Guidelines for the implementation of prevention in the general practice setting (2nd ed). RACGP; Melbourne: 2006.