From Resistance to Change: How Motivational Interviewing Can Help Patients Overcome Obstacles and Achieve Goals

3/10/2023

Author: Kirstin Sellers, Director, Office of the Patient Experience & Employee Health

Motivational Interviewing (MI) might not be a new concept to you, but if you’re like me, it could be something you’ve misunderstood or are struggling to put into practice. When I’ve practiced MI, I’ve often felt like I’m trying to manipulate the other person toward my desired outcome, toward whatever I see as being the best change for them. Recently, I was able to participate in an event around MI that really shifted my perception of this skill. I started to see MI for what it is – truly being curious about the person you’re interacting with, what’s important to them, and what might be getting in their way of their goals.

Let’s back up a bit for those of you who might be newer to MI. MI is a guided style of communication, allowing us to respectfully explore what motivates others. In healthcare, this is so important for us to learn more about, as our patients’ motivation is going to be different from ours. If we don’t explore motivation, we risk missed opportunities to celebrate their progress toward their goals, address concerns or misunderstandings, and ultimately to partner with our patients on what matters most to them.

Sounds like a lot for an office visit or consult in the hospital, right? It doesn’t have to be! The event that shifted my mindset on MI recently was aptly titled “When Time is Short”, hosted by The PX Community (PX being a common abbreviation for Patient Experience). Bruce Berger, the featured presenter, guided us through several real case studies with examples of how MI could be used, noting that MI is “not about motivating patients to change. It’s about exploring their motivation and identifying what’s keeping them from changing their behavior.” I even got to borrow parts of his examples about cholesterol management with a family member, which led to learning not only that I have a family history of high cholesterol, but also that this person was reluctant to start Lipitor because of potential side effects and instead wanted to focus on lifestyle changes. Knowing this family member already was eating healthfully and physically active, I congratulated them for all that they were doing to be and feel healthy, and ultimately, through our conversation, they decided that with our family history and their desire to lower their cholesterol level, it would be most helpful to give the medication a try while continuing their healthy habits. I think this may have been the first time I engaged in MI that didn’t feel like it led to a circuitous conversation without any outcome, and it felt amazing!

Want to dive deeper?

Watch the 1-hour event, “When Time is Short”.
Register for Bruce Berger’s 8-hour e-learning course and use code “PXC2002” for $40 off through 3/31/2023. The training provides 8 accredited CE hours for nurses, pharmacists, physicians, social workers, pharmacy technicians, and patient experience professionals. The standard price is $125; with the discount code it is just $85.
Register for Harvard’s on-demand course Shared Decision Making: Skills for Clinical Practice. Shared decision making is a wonderful companion to MI, as it’s an approach to involve patients in making medical decisions. This course, costing $149, is designed for nurses, nurse practitioners, physician assistants, primary care physicians, and specialty care physicians.