Monday, October 5, 2015

Motivational Interviewing Part IV

This is part four 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.

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 client action.  This link focuses on OARS (open ended questions, affirmations, and reflections) and DARN CAT (desire, ability, reason, need, commitment, activating step, taking steps).  Part Two focused on OARs while this post will look at “DARN CAT.”
“DARN CAT” can be split into two areas.
The “CAT” portion of the acronym focuses on the client’s action and will be the subject of this post. It stands for commitment, activation, and taking steps.
The following information is adapted from C. Delos Reyes.  This post will focus on seeing how interested the client is in lifestyle changes. 

Commitment—the client may make statements about their intentions to lose weight with a definitive date such as, “I’m starting my diet on Monday.” As a practitioner, you may want them to discuss what they intend to do.
Activation—What the client is willing to do, they may have the plan to start following a healthier diet or they may be willing to cut out sugary drinks.  Find out what they are ready or agreeable to do.
Taking steps—this last piece is where you ask the client what they’ve done, they might have started walking every evening for 30 minutes after dinner. 

The goals of this last segment is to have the client personalize and develop their own goals. 
So the big question is, can I really do this?  Or am I doing this “right”?
This link from the Center for Evidenced-Based Practices provides a cheat sheet for working with clients.  Consider this a road map for building trust and a rapport with your clients for more successful outcomes.