Evidence in healthcare indicates the importance of holistic care for patients. Psychological interventions involve therapies that are outside the pharmacological ones to aid the patient to wellbeing. It addresses the social, interpersonal, relational, psychological, and vocational needs of a person whose imbalance often leads to illness. Motivational Interviewing is one of the psychosocial intervention approaches that was developed by Stephen Rollnick and William Miller. The approach unlike traditional one's models of helping patients gain psychological wellbeing is goal-directed. It does not engage the client in a nondirect way but seeks to directly influence the patient to make cognitive and behavioral changes ( Lindson‐Hawley, Thompson, and Begh, 2015 p62). The approach is useful in helping clients realize their personal goals. Nonetheless, the nursing practitioner ought to exercise various in the helping process.
Motivational interviewing is based on assumptions, which have to be understood by the practitioner. MI’s basic assumptions include; practicing empathy, unconditional acceptance, and support for the patient while directing the patient on how to think and what to do to influence behavior change ( Bundy, 2004 p.43). Secondly, ambivalence is normal in the process of recovery. However, this can be resolved by finding out what motivates the patient and their values which can, therefore, be used to fuel their motivation ( Burke, B. L. (2011, p74). Additionally, it is important for practitioners to note that in this model, the patient and the practitioner work in a collaborative process.
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MI uses the techniques of evoking change by using various tools. The first strategy is to ask for permission to engage with the client. This communicates respect for the client’s feelings and beliefs as well as a way of striking a rapport ( Rollnick, Miller, Butler, & Aloia, 2008 pg.8). For instance, a nurse can ask “ I have read from the doctor’s record that you have insomnia, do you mind talking about how it affects your daily life?. Similarly, evoking change techniques has been found to have positive outcomes (Patterson, 2008, p23). Here the practitioner brings forth and illustrates the reasons for effecting change. However, the therapist does not lecture the patient but responds to the concerns of the patient. It is during the responses that the practitioner can get the things that matter to the client, which can be used to motivate them. Similarly, the strategy of exploring the importance of implementing a change for the client enables the practitioner to find the priorities of the patient.
The nurse needs to have excellent communication skills which are useful in asking questions and reflective listening. The therapist should ask open-ended questions which allow for varied responses. This is aimed at opening the conversation to more possibilities and genuinely understanding the client’s needs. (DiClemente, & Velasquez, 2002 p.201). Consequently, listening becomes a valuable strategy that should be paired with asking questions. It involves deeper listening, understanding of the issues raised by the patient from their perspective and making a hypothesis ( Shinitzky & Kub, 2001 p.182). The therapists should rephrase the statements of the patient to reinforce the arguments on the need for change basing on the words of the client. Notably, normalizing is essential in completing the communication. This involves making the patient aware that what they are going through is normal and that they can overcome ( Moyers, Miller, & Hendrickson, 2005, p.43). The normalizing strategy is not used to make patients comfortable with their condition without effecting changing. On the other hand, the patients should be able to achieve self-efficacy whereby they can communicate confidence in their ability to change.
Although patients decide wanting change at different levels, assessing readiness is vital. This can be evaluated by using the readiness to change ruler. Knowing the stage of readiness helps in planning for motivation ( Apodaca, T. R., & Longabaugh, R. (2009 p.705). Similarly, the therapist has to use affirmation statements which help the patient recognize that they are making progress. Notably, feedback is an important part of any relationship. The practitioner should not communicate in a way that makes the client feel that they are being confronted.
References
Apodaca, T. R., & Longabaugh, R. (2009). Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidence. Addiction , 104 (5), 705-715.
Bundy, C. (2004). Changing behavior: using motivational interviewing techniques. Journal of the Royal Society of Medicine , 97 (Suppl 44), 43.
Burke, B. L. (2011). What can motivational interviewing do for you?. Cognitive and Behavioral Practice , 18 (1), 74-81.
DiClemente, C. C., & Velasquez, M. M. (2002). Motivational interviewing and the stages of change. Motivational interviewing: Preparing people for change, 2, 201-216.
Lindson‐Hawley, N., Thompson, T.P. and Begh, R., 2015. Motivational interviewing for smoking cessation. Cochrane Database of Systematic Reviews , (3).
Moyers, T. B., Miller, W. R., & Hendrickson, S. M. (2005). How does motivational interviewing work? Therapist interpersonal skill predicts client involvement within motivational interviewing sessions. Journal of consulting and clinical psychology , 73 (4), 590.
Patterson, D. A. (2008). Motivational interviewing: Does it increase retention in outpatient treatment? Substance Abuse, 29(1), 17-23.
Rollnick, S., Miller, W. R., Butler, C. C., & Aloia, M. S. (2008). Motivational interviewing in health care: helping patients change behavior.
Shinitzky, H. E., & Kub, J. (2001). The art of motivating behavior change: the use of motivational interviewing to promote health. Public Health Nursing , 18 (3), 178-185.
