motivational interview helps support patients reporting depressive symptoms H e a l t h M e d i c a l

Motivation is believed to be a “key to change, multidimensional, dynamic and fluctuating, influenced by social interactions, modifiable, clinician’s style, elicit and enhancement. (US Department of Health and Human Services, 2019)” Due to this, motivation can increase the enthusiasm for change (US Department of Health and Human Services, 2019). Being direct can cause someone to be more argumentative and resist the need the change (Rueve & Maphis, 2016). Motivational interviewing was developed assist the clients in determining their own need to change (US Department of Health and Human Services, 2019; Rueve & Maphis, 2016).

In order to elicit change, there are 4 pillars that the client-counsellor relationship should which are collaboration, acceptance, compassion and evocation (Muth, 2019). There are different approaches to motivational interviewing such as the FRAMES approach, delusional balance exercises, discrepancies between goals and behaviors, flexible pacing and contact with clients during treatment (US Department of Health and Human Services, 2019). Frames method is based on the concept that there are feedback, responsibility, advice, menus, emphatic counseling and self-efficacy (US Department of Health and Human Services, 2019). For the change that is being procured, motivation should not be based on the needs of society but for the individual’s personal needs for change (US Department of Health and Human Services, 2019). Motivational Interviewing goes through 4 phases which is engaging, focusing, evoking and planning (Muth, 2019).

One should also understand the basis of change is through the stages of change (US Department of Health and Human Services, 2019). There is precontemplation, contemplation, preparation, action and maintenance (US Department of Health and Human Services, 2019). In each component of an individual’s change, there is ambivalence in the minds (US Department of Health and Human Services, 2019). It is the role of the counsellor to assist the client in their indecisive decision in change (US Department of Health and Human Services, 2019). Clients will argue, interrupt, deny and ignore the needed change (US Department of Health and Human Services, 2019). However, a counsellor can “reflect” on the statements on integrating change (US Department of Health and Human Services, 2019). Contemplation stage assist in recognizing the problem, acknowledging the concern, intention for change, optimism, feedback conveyance and the purpose of showing appreciation to the significant other (US Department of Health and Human Services, 2019). Once contemplation is over, the next step is preparation (US Department of Health and Human Services, 2019). Through preparation, the client needs to negotiate a plan, offering options, developing a contract, identifying barriers and asking for social support (US Department of Health and Human Services, 2019). At this point, client can be assessed through their readiness by noting their ambivalence (US Department of Health and Human Services, 2019). There can be barriers on the way or the client tends to back track on his development (US Department of Health and Human Services, 2019). However, the counsellor can use the motivation to put the client on track (US Department of Health and Human Services, 2019). The next phase is the action phase wherein the client engages on the plan which can be terminated prematurely (US Department of Health and Human Services, 2019). It is the counsellors job to put the client on track by resetting the expectations, resolving the barriers and padding against difficulties (US Department of Health and Human Services, 2019). Lastly, the last stage is maintenance wherein the client understands the triggers of his actions and oppose it with reinforcements (US Department of Health and Human Services, 2019). The key skills while undergoing the change are through the use of open-end questions, affirmations, reflective statements and summarizing statement (Muth, 2019; US Department of Health and Human Services, 2019).

There are considerations to note such as time, quality of the engagement. Even though, there is only one session due to time constraints or situational issues (US Department of Health and Human Services, 2019). Research states that even one session can make an impact to an individual (US Department of Health and Human Services, 2019). Another advantage of motivational interviewing is it does not only apply to substance abuse but also to other conditions such as diet, exercise, risky behavior (Rueve & Maphis, 2016). However, motivational interviewing takes time and practice to develop yet the results is beneficial (Muth, 2019).

References:

Muth, N. D. (2019, June). Talking their Way to Health. Fitness Journal, 30-37.