Motivational Interviewing: Difference between revisions
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Motivational interviewing (MI) is a behavioural change intervention that is growing popularity within physiotherapy practice. Rollnick and Miller<ref>Rollnick S, Miller WR. What is Motivational interviewing? Behavioural and Cognitive Psychotherapy. 1995 Oct;23(04):325.</ref> describe MI as 'a directive, client-centred counseling style for eliciting behaviour change by helping clients explore and resolve abivalence'. MI has been used across various conditions such as diabetes, asthma, cardiac rehabilitation<ref>Chilton R, Pires-Yfantouda R, Wylie M. A systematic review of motivational interviewing within musculoskeletal health. Psychology, Health &amp;amp; Medicine. 2012 Aug;17(4):392–407.</ref>. Eighty per cent of studies have found that MI has superior outcomes when compared to tradition educational approaches<ref>Lauritzen T, Rubak S, Sandbæk A, Christensen B. Motivational interviewing: A systematic review and meta-analysis. Review Article. 2005 Apr 1 [cited 2016 Feb 2];55(513):305–312. Available from: http://bjgp.org/content/55/513/305.short.</ref>. | Motivational interviewing (MI) is a behavioural change intervention that is growing popularity within physiotherapy practice. Rollnick and Miller<ref>Rollnick S, Miller WR. What is Motivational interviewing? Behavioural and Cognitive Psychotherapy. 1995 Oct;23(04):325.</ref> describe MI as 'a directive, client-centred counseling style for eliciting behaviour change by helping clients explore and resolve abivalence'. MI has been used across various conditions such as diabetes, asthma, cardiac rehabilitation<ref>Chilton R, Pires-Yfantouda R, Wylie M. A systematic review of motivational interviewing within musculoskeletal health. Psychology, Health &amp;amp;amp; Medicine. 2012 Aug;17(4):392–407.</ref>. Eighty per cent of studies have found that MI has superior outcomes when compared to tradition educational approaches<ref>Lauritzen T, Rubak S, Sandbæk A, Christensen B. Motivational interviewing: A systematic review and meta-analysis. Review Article. 2005 Apr 1 [cited 2016 Feb 2];55(513):305–312. Available from: http://bjgp.org/content/55/513/305.short.</ref>. | ||
= Ambivalence = | = Key concepts<br> = | ||
== Ambivalence == | |||
A conflict between two courses of action each of which has perceived costs and benefits associated with it. An example might be going for a jog: the benefits would be all of the health gains, however, a cost might be the perceived risk of social embarassment. Unresolved ambivalence is often why clients are unable to commit to behavioural change. How a therapist handles a clients ambivalence may influence outcomes.<ref>Miller and Rollnick (2013) Motivational Interviewing: Preparing people for change. 3rd ed Guilford Press</ref> | A conflict between two courses of action each of which has perceived costs and benefits associated with it. An example might be going for a jog: the benefits would be all of the health gains, however, a cost might be the perceived risk of social embarassment. Unresolved ambivalence is often why clients are unable to commit to behavioural change. How a therapist handles a clients ambivalence may influence outcomes.<ref>Miller and Rollnick (2013) Motivational Interviewing: Preparing people for change. 3rd ed Guilford Press</ref> | ||
= Righting reflex = | == Righting reflex == | ||
Therapists have the desire to want to help the people under their care and this is often and unhelpfully expressed as the 'righting reflex'. Clinicians beliefs and aspirations for the patient determine the use of language and interventions used. When a therapist sees discrepancy between how things are and how they ought to be they want to fix it.<br> | |||
When patient ambivalence is confronted by the righting reflex of the therapist, outcomes tend to be poor. Patients can feel unvalidated, want to resist the clinician, or withdraw from the consultation. Ultimately, people want to be understood and accepted without judgement<ref>Rogers, C.R. (1951) Client-centred Therapy. Boston: Houghton-Mifflin</ref> | |||
= Case studies = | = Case studies = | ||
*[[Management of Obesity|Obesity]] | *[[Management of Obesity|Obesity]] | ||
*[[ | *[[Tackling Physical Inactivity: A Resource for Raising Awareness in Physiotherapists|Physical inactivity (i)]] [http://www.physio-pedia.com/Physiotherapists%E2%80%99_role_as_a_health_coach:_encouraging_the_use_of_technology_to_enhance_patient_self-management (ii)] | ||
*[http://www.physio-pedia.com/Manual_Therapy_and_Exercise_Intervention_in_the_Treatment_of_Shoulder_and_Neck_Pain_in_a_Patient_with_Mental_Health_Comorbidities:_A_Case_Report Shoulder and neck pain] | *[http://www.physio-pedia.com/Manual_Therapy_and_Exercise_Intervention_in_the_Treatment_of_Shoulder_and_Neck_Pain_in_a_Patient_with_Mental_Health_Comorbidities:_A_Case_Report Shoulder and neck pain] | ||
*[[ | *[[Health and wellbeing needs of the homeless, the physiotherapist's role|Homelessness]]<br> | ||
*[[ | *[[Physiotherapy management strategies in people with schizophrenia|Schizophrenia]]<br> | ||
*[[ | *[[Promoting the role of Physiotherapy in Palliative care: Information for allied health professionals|Palliative care]] | ||
*[[ | *[[Intraveneous Drug Abuse|Intraveneous drug abuse]] | ||
= References = | = References = | ||
<references /> | <references /> | ||
Revision as of 18:59, 2 February 2016
Motivational interviewing (MI) is a behavioural change intervention that is growing popularity within physiotherapy practice. Rollnick and Miller[1] describe MI as 'a directive, client-centred counseling style for eliciting behaviour change by helping clients explore and resolve abivalence'. MI has been used across various conditions such as diabetes, asthma, cardiac rehabilitation[2]. Eighty per cent of studies have found that MI has superior outcomes when compared to tradition educational approaches[3].
Key concepts
[edit | edit source]
Ambivalence[edit | edit source]
A conflict between two courses of action each of which has perceived costs and benefits associated with it. An example might be going for a jog: the benefits would be all of the health gains, however, a cost might be the perceived risk of social embarassment. Unresolved ambivalence is often why clients are unable to commit to behavioural change. How a therapist handles a clients ambivalence may influence outcomes.[4]
Righting reflex[edit | edit source]
Therapists have the desire to want to help the people under their care and this is often and unhelpfully expressed as the 'righting reflex'. Clinicians beliefs and aspirations for the patient determine the use of language and interventions used. When a therapist sees discrepancy between how things are and how they ought to be they want to fix it.
When patient ambivalence is confronted by the righting reflex of the therapist, outcomes tend to be poor. Patients can feel unvalidated, want to resist the clinician, or withdraw from the consultation. Ultimately, people want to be understood and accepted without judgement[5]
Case studies[edit | edit source]
- Obesity
- Physical inactivity (i) (ii)
- Shoulder and neck pain
- Homelessness
- Schizophrenia
- Palliative care
- Intraveneous drug abuse
References[edit | edit source]
- ↑ Rollnick S, Miller WR. What is Motivational interviewing? Behavioural and Cognitive Psychotherapy. 1995 Oct;23(04):325.
- ↑ Chilton R, Pires-Yfantouda R, Wylie M. A systematic review of motivational interviewing within musculoskeletal health. Psychology, Health &amp;amp; Medicine. 2012 Aug;17(4):392–407.
- ↑ Lauritzen T, Rubak S, Sandbæk A, Christensen B. Motivational interviewing: A systematic review and meta-analysis. Review Article. 2005 Apr 1 [cited 2016 Feb 2];55(513):305–312. Available from: http://bjgp.org/content/55/513/305.short.
- ↑ Miller and Rollnick (2013) Motivational Interviewing: Preparing people for change. 3rd ed Guilford Press
- ↑ Rogers, C.R. (1951) Client-centred Therapy. Boston: Houghton-Mifflin
