Chapter 6

Motivational Interviewing

Imad Alsakaf, Subhash C. Bhatia and Shashi K. Bhatia

Abstract

Motivational interviewing (MI) is to motivate patients with addictive and non-addictive disorders like noncompliant patients, to help them develop skills to find intrinsic motivation for change through resolution of ambivalence . Ambivalence may lead to arguments against change referred to as sustain talk. Strategies to decrease sustain talk may promote change talk. These strategies include: straight reflection, amplified reflection, double sided reflection, emphasizing autonomy, agreeing with a twist, reframing, running head start, and coming along side. Five principles for creating condition for change are: expressing empathy, avoiding confrontation, supporting selfefficacy, rolling with resistance, and developing discrepancy between the patient’s behavior and his/her own goals and values. Key skills needed for MI include: open ended questioning, reflective listening, affirmations, periodic summarization of the content of the session, and informing and advising with permission of patient. The successful therapeutic process for MI involves: establishing rapport, setting the agenda, assessing readiness for change, sharpening the focus to what the patient truly wants to change, identifying ambivalence, eliciting self-motivating statements, handling resistance, and shifting focus of conversation to get around resistance. The stages of change model is distinct from MI but naturally fit together. MI helps patients move from one stage of change to another e.g. from pre-contemplation, contemplation, preparation, action, to maintenance.

Total Pages: 58-65 (8)

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