Motivational Interviewing Strategies to Promote Change Part 3

Motivational Interviewing: Strategies to Promote Change Part 3 – Application of M. I. Skills PREVENT Curriculum

Objectives • Identify common barriers to using MI • Describe strategies to address these common barriers

Communication Skills: Asking

What might you ask? Mom of a 2 year old: “I don’t know what’s wrong with Jayden. He never goes to sleep before midnight. He’s so spoiled. ” You might respond: • Tell me more about that. • What are his bedtime routines?

What might you ask? Mom says: “That’s a lot to ask me to do. Change the time he goes to bed while I’m trying to put the other kids to bed, stop watching TV, and read to him. I want him to go to sleep earlier but how do you expect me to do all that at once? ” You might ask: • This is pretty overwhelming for you. What seems like a reasonable first step for you? • If you were to make these changes, how might you go about doing them?

Communication Skills: Listening

Listening • When people feel heard, they will often say more – Focus on what the person is saying – Communicate your understanding of what the person has said – Reflect what they have communicated

What might you reflect? Dad says: “I know that Skye should eat healthier but she loves hates vegetables except for French fries. I’m just happy she’s eating something. ” You might reflect: • You would like for Skye to eat healthier and you’re not interested in changing her diet now. • You’re satisfied that Skye’s eating since she’s eating solid foods. Getting her to eat healthier isn’t something you want to change yet.

Communication Skills: Informing

Informing • Providing information to a caregiver/child about his/her condition, diagnosis, treatment options, and your recommendations • The manner in which we provide information influences how well it is heard/understood (Rollnick et al. , 2008)

Informing & Advice Giving • Ask permission first – Conveys respect – Information is more likely to be heard and considered • Explicitly acknowledges they have a choice – “You’ll know when you’re ready. ”

Informing & Advice Giving • 3 forms of permission: – Person asks for information or advice – You ask permission to give it – Offer permission to agree or disagree • “I don’t know if these ideas would be useful to you or not. Some things other families have tried are …”

Avoiding Information Overload • Provide small amounts of information at a time • Check understanding – Does this make sense? – Would you like me to go over something again? • Use Elicit-Provide-Elicit format – Ask open-ended question about topic (ex: agenda setting) – Provide information – Elicit understanding and reaction, picking up on change talk

Summary • Assess readiness, importance, and confidence • Focus on what the person is saying • Share small amount of information • Check understanding and reaction • Convey hope and optimism

Teach Back • Tell me one thing you learned from today’s talk • Tell me one thing you will apply to patient care