My philosophy on motivating people to change

Many people want to change some aspect of their life, and for some it’s crucial for health reasons such as quitting smoking, reducing alcohol intake, losing weight or exercising more. Motivational Interviewing (MI) is a relatively new, yet growing, method used by professional therapists to enable clients make lifestyle changes. The emerging evidence is that MI works better than the traditional consultation and has long lasting results.

Evidence shows that just telling people what to do does not work well as a way of changing people’s behaviour. MI helps individuals overcome their negative views about changing by exploring the desire and ability to change that lies within them (it really is in most people!). In doing this it supports change in a manner that sits comfortably with a person’s own values and concerns.

What it MI?

MI works by tapping into your own goals, values, aspirations and dreams and draws them out. But it acknowledges your right to autonomy and your freedom not to change. Trying to force people to change usually drives them in the opposite direction!

MI evokes what is known as ‘change talk’ - the idea is that the more you hear yourself say something, the more likely you will be motivated to do it. MI is collaborative and allows for rapport and trust to develop between you and the practitioner; the practitioner does not take the role of knowing all or lording over you.

MI will focuses on the positive things you say about moving forward, however small, and this ‘change-talk’ will skilfully be used to help change your mind set and eventually lead to positive action.

How does an MI consultation differ to traditional one?

One of the biggest differences is that I will not be always trying to put right what I see as wrong in your life. Instead I will want to gain an understanding of your world through your eyes. You will not be marginalised or put in a box but receive positive regard and your autonomy respected.

I will do a lot of reflective listening and summarising/interpreting back to you what you’ve said; this should highlight the important elements of the discussion, especially talk that helps to move you along. This reflective listening is also a way of showing I amd listening and am interested in what you say and from my end it ensures I understanding things correctly. It also allows me to point out to you your existing strengths and abilities. It is the basis of MI

I ask mostly open questions, so that you can expand more. These questions help to gently draw out your motivation to change. Unsolicited advice won’t be given - but saying that, I may ask your permission to give you some advice or information on a range of options.

The four stages of an MI consultation

  1. Engaging involves gathering relevant background details and I can explain how the consultation will run. This will hopefully set us off on the right foot! If you at all feel you are being judged, not listened too or that I am not trying to walk in your shoes, then MI is not happening!
  2. Focusing clarifies the goal both you and I hope to achieve together; it’s the unravelling of whether, why, how and when you change. In this stage the focus is on purposeful conversation that has ‘change’ at its heart.
  3. Evoking involves drawing out the ‘change-talk’: when this happens when there is a strengthening of the reasons why you want to change and the motivation to change. This may include helping you to realise you have the skills within you to do the job!
  4. Planning is the last stage for when you are ready to take action; it’s usually when you begin talking more about when and how to change and less about whether and why. Your plan should be SMART: Specific, Measurable, Achievable, Relevant and Time specific. So rather than saying I want to lose weight, you would need to say if it relevant for you to lose weight, how much, how (choose a sensible approach), by when and set a realistic amount.

Your role in the process

MI is a partnership between you and me. Please air your viewpoint; you know most about yourself! Work with me understand your world. Remember, I won't be telling you what to do, but this doesn’t mean I wholeheartedly endorse your current behaviour, or your ideas about how to change it. It’s all about trust and reaching a mutual understanding about the way forward. Have a think about what you could realistically do to change; my role will be to draw out your motivations and skills for change and help you make some quite detailed plans

MI is a partnership between you and me

One of my case studies

Jane was overweight and it was putting a strain on her health and she was heading towards diabetes. She really didn’t want to become diabetic but weight loss was the only thing that would prevent this happening

She had been advised (she called it nagged) in the past by numerous health professionals, family and friends about what to do. None of it had helped

She came to see me and I listened to what had been going on in her life. She admitted to being very disorganised. After exploring the situation more, she mentioned that maybe trying to organise herself would help her with her diet. This was the start of ‘change talk’ and it gave us something we could work on together

Jane did go on to lose a significant amount of weight and avoided becoming diabetic. She said that she had found it really helpful that I did not ‘have a go’ at her for not losing weight, but just listened and advised only when she wanted it. She found that planning her shopping and meals were key to her following a sensible diet that lead to weight loss