EXPH 3500 - Lec 17: Motivational Interviewing and Brief Action Planning

motivational interviewing

a collaborative, goal-oriented style of communication with particular attention to the language of change

controlled motivation

external source

‘should’, ‘must’, ‘need to’, ‘have to’

long term behavior change rarely results from facts, force, or fear

autonomous motivation

full sense of volition, interest, and choice; control of choices

compassion

caring about patient’s experiences and struggles —> express empathy

acceptance

1. Absolute worth

2. Autonomy support

3. Affirmation

Partnership

• importance of collaboration

• you = exercise expert

• patient = expert of their experience

• professional humility

• patient has ultimate decision-making power

evocation

• invite patient’s knowledge and opinions

• support self-efficacy

engaging process

• establish connection and productive working relationship

• build rapport

• more necessary the more ‘stuck’ a patient is

• view risky or ‘illogical’ behaviors as an expression of patient’s unmet needs

focusing process

• clarify patient’s priorities

• collaboratively move into directional conversation about change

• develop discrepancy

evoking process

• help patient build own “why” of change

• the role of MEANING in motivation

• assessing readiness + motivation

planning process

• explore “how” of change

• consolidate commitment to change

• develop goals and plan

• roll with resistance

open-ended questions

• evoke thoughtful response vs yes/no answer

• draw out and explore patient’s experiences, perspectives, and ideas

affirmations

• verbalize support and understanding

• confirm strengths, efforts, and past successes

reflections

• based on careful listening

• repeat, rephrase, or offer deeper guess on what patient is communicating

summarizing

• ensures shared understanding to allow clarification

• allows patient to hear own ambivalence and motivations

Brief Action Planning (BAP)

self-management support tool based on principles of MI and action planning

SMART Behavioral Plan

• specific, measurable, achievable, relevant, and timed

• variety of ideas

• importance of patient saying the plan

• might use other scales or analogies

• importance of problem solving

• increase self-efficacy