Introduction to the principal elements of Motivational Interviewing

The purpose of this activity is to gain an introduction to the elements and skills of Motivational Interviewing (MI) and initiate practice of these skills. Motivational Interviewing is a guiding skill that builds on the foundation of therapeutic communication, hence the mnemonic OARS. The skills include asking Open-ended questions, providing Affirmations, Reflective listening, and Summarizing. Those practicing these skills indicate a depth of skill and practice that is necessary beyond their use of therapeutic communication skills. Some comments on these skills reflect this: • “I'm no longer going to say that my patients are noncompliant. It just may be that they are not ready to make a change yet. As nurses and doctors we get so caught up in thinking that all we need to do is tell our patient what they need to do and when they don't, we say its their fault they are noncompliant. Instead we need to take it further and find out the whys.” • “I have found that open ended questions are a great way to begin discharge teaching. For example, once a patient is past the initial post-operative period and is beginning to look ahead to discharge a simple question like “What concerns you the most right now?” can give the patient the opportunity to discuss a wide array of topics that will affect their recovery after they leave.” • “I have been modifying my care in ways that incorporate use of MI techniques into every bedside encounter. Results have already proved positive….Careful questions at the correct time have left my patients with ‘food for thought' so to speak :) and the next time I come into the room I find a lot of them tend to pick up where we left off without me starting the conversation..” • “I have always thought of myself as more of a listener than a talker, but realized there is a difference between just listening and actively listening. Having to perform frequent reflections increased my active listening and made me realize that in the past I have not been the best active listener.” • “During frequent interactions with [older immigrants with chronic illness] I learned a lot about their health conditions by just listening to what they had to say. I used reflection, affirmation, summarizing, and, of course, advice giving. I knew that they have heard my information many times before, but I felt that it was my professional duty to "educate" them again and again. If I [had MI then], I would've tried to elicit solutions from the clients themselves.”