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Catalyst for change

Motivational interviewing can help parents to help their kids

Key iconKey Points

  • People are more likely to change a behavior if they view the alternative behavior as being positive.
  • Motivational interviewing can facilitate positive behavioral changes.
  • Plant "seeds of change" by raising the patient's level of awareness and assess readiness for change.
  • The clinician can explore how the patient views his or her current behavior.

Assess readiness for change

The clinician can then ask the patient about how ready she is to take the next step. For example, the clinician can ask, "How ready are you to . . . ?" As in the precontemplation stage, a numeric rating scale can be used to gauge the patient's degree of readiness. In addition, asking the patient "How will you know when you are ready?" may assist the patient in working through his ambivalent feelings and serve to facilitate change by encouraging the patient to continue to wrestle with the behavior under discussion.

Establish a time frame

For the patient who expresses a desire for change, the clinician can establish a time frame for change by asking, "What is your time frame?" or "How much time do you think you need before beginning to lose weight? . . . beginning to vaccinate your child? . . . quitting cigarette smoking?"

Conclude the discussion

The clinician can wrap up the discussion by allowing the patient to summarize the salient pros and cons of the discussion and giving the patient an opportunity to let his thoughts percolate. If the patient indicates readiness for change, the clinician can help move the patient toward the stages of preparation and action by asking the patient if he would like to schedule a follow-up visit to work on a plan. Otherwise, the clinician can conclude with a statement such as, "It sounds like you have got a lot to think about. Take some time to consider our discussion and perhaps we can talk about this again at our next visit." Again, this is the time for the clinician to remain flexible and back off, leaving the door open for future discussion.

Getting to yes and beyond

Motivational interviewing techniques can often be successfully used to help patients move through the stages of healthy change. Clinicians can plant seeds of change for patients in the "no" precontemplation stage and process ambivalence with patients in the "maybe" contemplation stage. Part 2 will examine how to help patients who are in the "yes" preparation stage to move toward the action stage.


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