Effective Motivational Communication Inspiring Client Change Jennifer D. Irwin, PhD Financial Interest Disclosure (over the past 24 months) Becel Centre for Heart Health Unilever Canada Inc. Effective Motivational Communication / Interviewing Background on who am I and what is my fit for this talk Plan for our time (1.5 hrs): What is Motivational Communication/Interviewing (MI)? How MI can help support people s healthy eating behaviours? Some basic tools (that you can use right away) Examples and applications integrated throughout 1
That said If, at the end of this talk, you left thinking this was worthwhile attending, what would have happened? What is Motivational Interviewing? Lots of definitions very common one is: a client-centered counseling style that helps people to explore and resolve their ambivalence regarding [behaviour] change. (Miller & Rollnick) What is Motivational Interviewing? That is, MI is about... arranging conversations so people talk themselves into change based on their own values and interests (Miller & Rollnick, 2013, p. 4) 2
If health promotion is... The process of enabling people to increase control over, and improve their health [WHO] MI is very much a process of intervention that enables and empowers people to enhance their health and lives Evidence, Expertise, Client Components Motivational Interviewing Definitions: a directive, patient-centered counselling style that enhances motivation for change by helping patients clarify and resolve ambivalence about behaviour change a client-centered, yet goal-directed counselling method for helping people to resolve ambivalence about health behaviour change by building intrinsic motivation and strengthening commitment Goal: To identify and resolve discrepancies between current behaviour and broader values and goals ~ closing the behaviour gap 3
What gets in the way? Please Partner up Please make eye contact with someone to be partnered with NO talking, no writing to each other, no gestures, charades In the next 60 seconds, decide (and write down), what is this person s: Favorite hobby Favorite meal (as if you are ordering off a menu for them) Favorite style of music First rule/tool for MI (1) Drop assumptions (2) Get curious! [ their pear ] Why do most of us do what we do professionally? Previous research indicates that practitioners want to help others How do we do this? Learn and tell, passionately We want them to eat well/attend cardiac rehab Sometimes frustrating if our advice isn t followed(?) 4
Advice: What we know about receiving advice But isn t that what we re paid to do? Next slide an example of an adviceexchange What s it all about The Nail Have you been there? What did you observe? What s the pear lesson here? 5
Tools to handle the advice challenge (3) avoid giving unsolicited advice; (5) ask permission to give information/suggestions/advice and wait for the answer! (4) ask powerful questions ; Powerful or Open-ended Questions What are you afraid What are your What are you passionate of? assumptions about? about? What do you want? Where do you hold What do you need to give back? yourself permission for? What do you need to What do you want What is important about adm to congratulate? yourself for? What will you do? What s your first What s another way to look at When? step? How will I know? Who do you need to What would be a What s the bigger game for be to? metaphor for this? What s the impact What rule have you What rule do you need to you want? created about change for yourself?? What are you saying What are you What are some other choices? yes to? saying no to? What do you know What s exciting What s fun about What about it now? about makes your heart sing? What s hard about What s scary about If you knew you d succeed, what would you do? What are you What lie are you How do you want it to be? avoiding? telling yourself? What else? What are the What would give Is there more? possibilities? What does this cost What will you How will you measure your commit to? success? How does this serve What aren t you What do you value What is calling to saying? about? What are you What is the gift in What s neat about this? tolerating? this? Powerful or Open-ended Questions What are you afraid What are your What are you passionate of? assumptions about? about? What do you want? Where do you hold What do you need to give back? yourself permission for? What do you need to What do you want What is important about adm to congratulate? yourself for? What will you do? What s your first What s another way to look at When? step? How will I know? Who do you need to What would be a What s the bigger game for be to? metaphor for this? What s the impact What rule have you What rule do you need to you want? created about change for yourself?? What are you saying What are you What are some other choices? yes to? saying no to? What do you know What s exciting What s fun about What about it now? about makes your heart sing? What s hard about What s scary about If you knew you d succeed, what would you do? What are you What lie are you How do you want it to be? avoiding? telling yourself? What else? What are the What would give Is there more? possibilities? What does this cost What will you How will you measure your commit to? success? How does this serve What aren t you What do you value What is calling to saying? about? What are you What is the gift in What s neat about this? tolerating? this? 6
What s important about asking What s important Taps into client values: Why WE want them to change behavior is irrelevant If we can find their desire to change, they are more likely to do it, and have it be longer lasting Shifts the balance of responsibility from practitioner to client More effective for client, less stress/pressure for practitioner everybody wins E.g., What s important to you about having a healthy heart? Asking and Listening Essential that questions asked get heard really heard Forms clients fill out, need to be read Make sure clients know you are listening Increases trust, and the strength of the relationship is where change is really possible Reflective Listening, with empathy, echoes and mirrors your client So you feel It sounds like you You re wondering if It seems to you that You want to strengthen So you are challenged by 7
The Power of Empathy Fundamental MI Concept re being with Clients ~ they are... Naturally Creative, Resourceful, & Whole The Michelangelo Belief > * The capacity and potential for change and adherence is within every person! * Inherent release of assumptions; competent world view { vs deficit world view } 8
NCRW or Michelangelo Belief Core MI Strategies: Moving from Status to Change Talk Core MI Strategies; OARS Open Ended Questions Affirming/Acknowledging Reflective Listening Summarizing [ advising with permission ] MI control, choice, permission Control and choice: People are more motivated to make change when it s based on their own decisions and choices, rather than an authority figure telling them what to do E.g., There s two things we re to focus on today, fibre and cholesterol, which one do you want to start with? [opportunities for choice] E.g., I have some information on heart healthy eating tips, would you like me to share it with you? [Permission] 9
Tools shared today: 1) Drop Assumptions 2) Get curious 3) Avoid unsolicited advice 4) Ask permission 5) Use Powerful Questions 6) Find out expectations Revisiting. Wants from session.. Thank you! Questions, or want to learn more? Email me: dr.jenirwin@monarchsystem.com or jenirwin@uwo.ca Resources on website: www.monarchsystem.com take/use anything from website that you like 10