Curriculum · Counselling
Motivational interviewing
What it is
Motivational interviewing is a technique for the patient who is resistant to change, and patients who are resistant to change require skillful management. It has been shown to improve the therapeutic physician-patient alliance and to help engage patients in their own care, and it can aid in the management of difficult patient encounters.
What it explores is the patient's own stand: the level of desire to change, and with that the ability, reason, and need to make a change.
The patient it is for
The case is a 45-year-old male seen for follow-up of several chronic medical problems including hypertension, diabetes mellitus and obesity. He is a truck driver, smokes one pack of cigarettes per day, and does not exercise. His blood pressure is 166/94 mm Hg and his hemoglobin A1c is 9.7%. His medical conditions have been difficult to control with medications and he has been resistant to making lifestyle changes.
Nothing in that list is a gap in what the patient knows. He already knows, and that is why the answer is not to tell him more.