We all put a little more effort into things when we’ve got a personal investment in the outcome.
That basic principle is at the heart of motivational interviewing (MI), a collaborative way of talking to — and even more, listening to — others in order to draw out, and strengthen, their personal motivations for change. A goal-oriented, evidence-based approach, MI has proven exceptionally effective as a tool in patient care, to empower and educate individuals to change behaviors that can improve their management of their own health. It often works to affect change when nothing else seems to.
The MI model itself is simple:
- Motivation is the key to successfully engaging a patient – and we all are motivated by something.
- Engagement is the key to a patient being more receptive to education.
- Education is the key to empowering the patient to actually change behaviors.
How Does MI Work?
In practice, a real-life scenario might go something like this:
A social worker on a home visit learns, through attentive conversation, that the patient is continuing to have symptoms that could be expected to have lessened through the patient’s taking a particular medication as prescribed. By encouraging the patient to discuss how his illness is affecting him daily, the social worker also determines that the man does seem motivated to work on improving his health, but by contrast, is not motivated to take his medication as prescribed, due to its pronounced side-effects, some of which he is clearly embarrassed to discuss. By repeatedly enlisting the patient’s desire to be able to take part in other activities his illness is currently preventing, the social worker is able to get the patient himself to arrive at the decision to make a follow-up visit with his medical home, where he can at least learn about other medication options that might lead to the same desired clinical outcome, but would maybe not present the same set of side-effects the man finds so off-putting.
The MI model gives healthcare professionals like our hypothetical social worker the tools and training to generate such positive outcomes, to support patients in making decisions for themselves that enhance their own care, and health improvement.
Our MI Training
Beginning in 2011, our state partners at Community Care of North Carolina (CCNC) made MI a key organizational focus; engaging, educating, and empowering the consumers we serve has become a core CCNC value.
As a result, care managers at Community Care Plan of Eastern Carolina (CCPEC), and at all the CCNC networks, now receive extensive training, coaching, and technical assistance in MI techniques. In addition, a full day of MI training is now part of all CCNC networks’ New-Hire Orientation, with each network also identifying staff members who can serve as “MI Champions” able to provide mentoring in this wonderfully effective interviewing style.
The long-term goal of all this training is not simply to enhance our own care-management efforts on a patient-by-patient basis, but also to support MI at the individual practice level, for both physicians and staff, as a means of enhancing communication with the patients we all serve, and of improving the overall functioning of our healthcare system.
- For the CCNC resource guide on MI that we employ as part of this training, go here.
- View this set of independently produced videos, which we often employ in our staff training, for a dramatized contrast between conventional interview techniques in a clinical setting, and using MI instead: