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Motivational Interviewing training
Clinicians involved in home based pulmonary rehabilitation programs can learn the technique of Motivational Interviewing online or by attending a course, preferably designed for health professionals.
An example of an online course can be found at the Pacific Centre for Motivation & Change – MI in Healthcare Online is an introductory level course suitable for medical and allied health practitioners working in healthcare settings with patients who have chronic conditions.
To become skilled at this technique, practice and feedback is very important. Interview a colleague and discuss the process afterwards.
Motivational Interviewing method
Once a course is completed, the following guidelines will assist with the weekly telephone calls with the patients.
Structured telephone modules are used, with written prompts for the interviewer to explore and build motivation for change, then move towards commitment and action.
Core Communication Skills
Ask open ended questions and try not to ask two questions in a row.
allow more room to respond
perceived as showing interest and caring
allows patient more active involvement in and influence over the course of the consult
See Interview Examples for “asking” questions.
By listening a clinician is more likely to be be present with the patient and understand their perspectives and experiences.
Allow time for silence.
See Interview Examples for “Listening”.
A period of listening is followed by reflection:
a short summary of what you think is happening at that moment
patient confirms or disagrees with your hypothesis
statements (not questions) so that patient feels more comfortable and keeps talking
The aim of informing is to improve information exchange with the patient.
It is important that:
The clinician asks the patient’s permission to be informed
Messages are phrased in a positive fashion
The patient isn’t overloaded with information
Management options are provided
See Interview Examples for “Informing”
Aim to elicit change talk from the patient.
When you hear change talk, you are doing it correctly. When you find yourself arguing for change and the patient defending the status quo, you know you’re off course.
The first four statements below (DARN) are pre-commitment forms of change talk.
Six kinds of Change Talk
- Desire – statements about preference for change; wish / want /like
- Ability – statements about capability; can / could / able
- Reasons – specific arguments for change
- Need – statements about feeling obliged to change; ought to / have to./should
- Commitment – statements about likelihood of change; will / intend /am going to
- Taking steps – statements about action taken; I started / I went out and
See Interview Examples for:
Using a Ruler