Motivational Interviewing

Dr. Miller's Podcast: Motivational Interviewing - NSHC

Motivational Interviewing

Angels Unaware...  Creating Patient Resistance Without Realizing It....

little girl dressed as angels unaware motivational interviewing

Clinicians who Motivational Interviewing (MI) can avoid or lessen patient resistance resulting in a more favorable patient / family outcome. 

As a clinician, have you ever thought about what causes the patient's/family's "push back" or resistance to the treatment plan? Could we be creating some or all of this without even realizing it? The answer is yes....

Consider what happened in this true story of an angel unaware.....

My elderly father (status post vertebral fracture, with an inpatient fall complicated by pneumonia) was in the process of being discharged from an inpatient rehab facility with home health and DME (oxygen). My mother and and I were there to take him home. The clinician was quite busy that day and was quickly reading the discharge instructions to my mother and I when she mentioned that he would be going home with oxygen. 

A Prime Opportunity Missed...
My mother quickly interrupted the nurse and said, "Oh no, I don't want that big tank in my house!" to which the nurse replied, "You want him to breathe don't you?" My heart sunk as I thought how this clinician missed a prime opportunity to engage my mother differently, had she learned the conversational skills to do so.

Basic Motivational Interviewing (MI) in Action

I quickly turned to my mother as the nurse continued to read...
Showing concern I said, "Mother, what's causing you to feel this way?" She replied, "My father was on oxygen at home, and we were always afraid the house would catch on fire. We never rested one moment at night until we got that tank out of there." 

I briefly explained how oxygen is managed differently now... Too late... Damage done...The nurse nicely continued, "Do you want the oxygen?" My mother replied, "No, not now."

The nurse mentioned this no further, and my father was discharged without it. 

I called a local Respiratory DME company before leaving the hospital and arranged for the oxygen setup to arrive at their home within the hour, while explaining more about it to my mother who remained hesitant.

Better Results Using MI

Clinicians who use Motivational Interviewing within a health coaching context draw upon their learned listening and conversational skills to avoid creating patient resistance from the outset. You can learn how resistance is created and how to lessen it or better yet, avoid it altogether, achieving a better patient / family outcome in the end!

Over 25 years of research and over 300 studies have shown that when MI is used, people most often have significant improvements in achieving desired outcomes in less time and at less cost!