Motivational interviewing is a technique used by counselors to get their clients to change their behaviors. The various exercises are effective because the counselor can observe clients making changes with little or no persuasion. Counselors grasp on to the clients’ desire to change and play off that motivation to build momentum. It’s almost like rolling a rock down a hill -- once it starts, it keeps going all by itself.
Ask Open-Ended Questions
To get the client to open up and not be guided in any particular direction, motivational interviewers rely on open-ended questions. This exercise allows you to find out where your client’s head is at, how she views her problems and whom, if anyone, she blames. This approach is especially effective in the early stages of treatment, when you’re gathering information and getting to know your client. By continuing the dialogue with a series of open-ended questions, you show that you care and you’re listening, inviting the client to continue opening up to you.
While clients may need to change, it helps if they have goals that they can strive for while they’re undergoing a transformation. Develop an exercise that helps clients figure out positive goals that are attainable. Set up a chart or use a whiteboard to write down these goals. For example, if you’re counseling someone who wants to lose weight, ask her what she might do once she loses the extra pounds. If she sees herself on the beach in a new bikini, put that down on a chart. Add other examples of her new life, such as fitting comfortably into an airplane seat or giving away her plus-size wardrobe.
After a few sessions that you’ve used to get to know your client, you can begin applying feedback exercises to elicit suggestions for change and to clarify how your patient is dealing with the revelations she has made to you. Try asking questions to pull out feedback that gets at the feelings behind various statements, such as, “You told me that you hated the way you were dismissed because of your weight; how does that make you feel?” Or, “Your weight falls in the category of morbid obesity; what do you think about that?”
Once you’ve broken through the barriers the client may have put up and identified the core issues she’s dealing with, you can begin to work toward solutions. Motivational interviewing requires that you let clients find the solutions with your help. Pull out the chart again and make a page labeled “solutions.” Write down ideas your client comes up with to change. Encourage her to break it down into small, doable actions and behaviors. For example, instead of just “lose 50 pounds,” get her to start with what she’ll eat for breakfast, who she’ll call when she feels like bingeing and how many miles she’ll walk each week. The small, simple steps she comes up with will ultimately lead her to the changes she desires. It’s your job to point that out to her, not design the journey for her.
- University of Arizona: Use of Motivational Interviewing
- Substance Abuse and Mental Health Services Administration: Motivational Interviewing Training and Techniques
- Journal of the Royal Society of Medicine: Changing Behaviour
- American College of Obstetricians and Gynecologists: Motivational Interviewing
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