Why is it so difficult to break bad habits — behaviors that negatively affect our health? That’s a question that behavioral health therapists regularly ponder.
We struggle with eating healthier, stopping abuse of alcohol or drugs, taking medicines regularly and following dietary recommendations. Even when we know behaviors could harm us or even result in death, many people continue engaging in risky behaviors.
Luckily, health care professionals have a communication technique that’s been proven to help patients increase their commitment to making life-saving behavioral changes. It’s a goal-oriented communication style called motivational interviewing.
When patients believe they can rely on their health care team to support them even if they are not yet ready to change, they’re less likely to hide their true thoughts due to fear of being judged.
The basics of this technique can be learned rather quickly so that medical professionals can incorporate it when talking with patients about all types of important behavior changes including:
With this style of communication, the therapist asks very few questions. And when questions are asked, they’re usually of the open-ended type. This approach motivates patients and gives them a sense of control over their problem.
Here’s an example of how a conversation might go, using the motivational interviewing technique:
Health care provider: What are your thoughts about successful strategies to manage your diabetes?
This results in the patient listing positive strategies, which helps her feel knowledgeable and provides a healthy sense of control over a situation that sometimes seems uncontrollable.
Patient: Well, I know that when I check my blood sugar levels regularly, I am able to adjust my insulin and what I eat without having huge swings in blood sugar. Those really scare me.
The clinician can then offer a reflective affirmation to the patient.
Health care provider: You are able to use insulin and food effectively when you check your sugar level regularly. That’s really great. You have figured out a way to avoid the scare of huge fluctuations!
Patient: Yeah! But sometimes it’s hard to check my sugar levels because I get busy taking care of the kids.
Health care provider: So it’s important to you to be a good mom.
Patient: Yeah, but when my sugar levels go haywire, it’s hard for me to be a good mom too, so I feel stuck.
Health care provider: I wonder if you have ideas about how you can take care of yourself and be a good mom at the same time.
Patient: Well, sometimes my sister comes over to help. Other times, I tell the kids they have to wait for my attention, but then I feel guilty.
Health care provider: So you feel guilty if you take care of yourself.
Patient: Sort of, but I know that doesn’t make much sense because I have to take care of myself in order to take care of my kids.
This interaction illustrates how the motivational interviewing approach helps the patient identify the root of his or her problem. In this case, she comes to the conclusion that she must make her own health a priority — checking her blood sugar level regularly — in order to achieve her goal of being a good mom.
From that point on, the patient and clinician can continue the motivational interviewing approach to make plans for how she can achieve her goal.
More and more medical practices are seeing excellent results by incorporating motivational interviewing. Research shows that collaborative communication styles help build supportive relationships between health care professionals and patients — and that these relationships are vital to patient success.
This openness paves the way for honest and frank conversations that promote healthy change.
For more information on how motivational interviewing drives behavior change, sometimes called “change talk,” click here.
About the authors:
Elissa Patterson, Ph.D., is a health psychologist with Michigan Medicine’s Consultation-Liaison Adult Psychiatry Services and Psychosomatic Medicine Program.
Michael J. Lucido, Ph.D., is a licensed psychologist with the Behavioral Health Program at Munson Healthcare Charlevoix Hospital.