37
Volume1 Issue2
|
S
upporting
Y
our
P
ractice
I hope that I have demonstrated howMI can be an effective
approach tobring about positive lifestyle changes inpatients.
MI is a collaborativeperson-centered formof guidance, which
elicitsand strengthensone’smotivation tochange.
Do you think that youcoulduse theMI approach inyour prac-
tice?Whyorwhynot?Haveyou tried itbefore? I look forward to
hearingabout your experiencesusing theMI techniqueor any
another successful approachyouhavebeenusing.
a
Motivational Interviewing (MI) inAction:
TheNewYear`sResolution
Edward is a 50-year-oldmalepatientwith ahistoryof smoking apack
a day for the past 30 years. He does not have a family physician. The
poor conditions of his gum and his teethmean that Edwardwill be
frequently returning for appointments. He presented for a new
patientexaminationwhere the followingconversationunfolded:
✹
Wouldyoumind tellingmeaboutyour tobaccouse?
✹
People often smoke because there is a something that has
benefited them in some way. How has smoking benefited
you?
✹
Whataresomeaspectsofsmokingyouarenothappyabout?
✹
I’d like to let youknowabout someof the risks in smoking
that you might not already be aware of, but I want to
emphasize that it is your choicealone todecide tomake
achange.
✹
Could you rate, on a scale of 0-10, the importance of
making this change relative toother priorities in your
life?
✹
Whatwould it take foryou togo froma ‘5’ toa ‘7’?
✹
Ifthingsworkedout inthebestpossibleway foryou,
whatwouldyoubedoing inayear fromnow?
✹
After this discussion, are you clearer aboutwhat you
would like todo?Whatwillbeyournext step?
✹
Whatelsedoyou thinkyouwill need tosupportyou
in thisplan forchange?
Edward proceeded to set an intention to live
a smoke-free life as his New Year’s resolution.
Supplemental information and helpful resources
weresupplied.Nicotine replacement therapyand
smoking cessationmedications were prescribed.
I arranged for follow-upappointments (either in-personor in the form
ofaphonecall)beginningwith thefirstweekafter thequit/changedate.
This initial conversation, grounded in MI techniques, may dramatically
changeEdward’s lifeandgivehima lifetimeofoptimaloralhealth.
Visit
tocomment on thearticle.
TheMIApproach
There is more to the practice of
MI than simply understanding
its
intention. I personally like to use MI
techniques inaparticularway:
•
I usenon-judgmental, open-ended
questions which allow for further
conversation, rather thanabrief ‘yes
orno’ answer.
•
I affirm the patient’s skills and
strengthswhichbuilds rapport and
helps thepatient see themselves in
anewandpositive light.
•
I listen carefully and give reflective
responses
which
demonstrate
empathy and guide the patient
towards talkof change.
•
I summarize the key points of
the conversation which allow for
structured, organized thinking, and
summaries
that promote some
ideasandminimizeother ideas.
