This is part two in a series regarding Motivational
Interviewing. The goal of Motivational
Interviewing (MI) is to increase client awareness and decrease ambivalence or
resistance towards change. For those in
private practice, you may already be aware of how important your relationship
is with a client.
Please note that a lot of this information comes from
chemical dependency and substance abuse counselors and researchers but can be
effectively applied to many areas of practice.
These are examples and considerations for dietetic practitioners.
Case
Western Reserve University’s Center for Evidenced-Based Practices (CEBP) is
a resource for MI and focuses on practitioner’s changing their service approach
and culture towards MI. These benefits
include positive outcomes and client engagement/ retention.
The focus of this post builds on avoiding and dealing with
client resistance. This
link focuses on OARS (open ended questions, affirmations, and reflections)
and the other acronym DARN CAT (which will be the subject of part three).
OARS
·
Open ended questions allow your client to
reflect on why they’re seeing you or allows them to open up.
o
You may want to ask, “What food or part of your
diet holds you back?” to a client that isn’t showing weight loss.
o
“What do you want to do next?” if a client seems
ambivalent.
·
Affirmations show the client that you care and
take notice.
o
“I’m glad you shared your struggles with the
meal plan we developed, what changes are doable for your schedule right now?”
·
Reflections can repeat what a client says or
reflect feelings to help put them in perspective.
o
Client statement: “That box of candy I keep in
my desk helps me deal with my boss when she’s in a bad mood.”
o
Simple reflection: “You eat to cope with work
stress.”
·
Summary Statements link themes and client
comments together.
o
“You have expressed concern with work and have a
demanding boss, these are stressful situations.”
These are basic steps to reframe a client’s situation, it
combined environmental stressors that contribute to a habit that we may seem as
unhealthy but the client may seem as a coping mechanism. OARs questions and MI is challenging to
implement initially but having a few open ended questions to sprinkle into a
session with a client is a first step to improving your practice.
What challenges have you seen on a daily or weekly basis? Have you used Motivational Interviewing? What struggles do you have with implementing
it?
