Promote Behavioral Change with Motivational Interviewing

| May 1, 2021

by Nicholas Pennings, DO, FOMA

Dr. Pennings is an executive director of clinical education for the and a fellow of the Obesity Medicine Association. He is an associate professor and chair of family medicine at Campbell University School of Osteopathic Medicine (CUSOM), where he serves as the director of the Campbell University Health Center.

Funding: No funding was provided.

Disclosures: The author has no conflicts of interest relevant to the content of this article.

Bariatric Times. 2021;18(5):20

Educating and encouraging patients to embark on a healthier lifestyle is challenging. This is especially true when you’re advising them to adopt new behaviors and cut back on others that might pose an imminent health risk. It’s common for your clinical recommendations to be met with resistance, ambivalence, and maybe even fear. However, research shows that patients’ behavior change can be influenced by a provider’s therapeutic approach.1

In the 1980s, healthcare providers began digging into the science of change and developed a model to treat people with addictions. The “stages of change” model has since been embraced by providers helping patients overcome obesity. This approach uses a technique known as “motivational interviewing,” where providers hone in on a patient’s true intentions and resolve inner conflicts to achieve a desired outcome. Motivational interviewing tunes into a patient’s unique circumstances and offers the necessary support to move from ambivalence to behavioral change.

What is Motivational Interviewing?

Motivational interviewing is a collaborative style of patient-centered engagement that focuses on identifying the patient’s own motivation for change. This approach empowers healthcare providers to develop specific treatment strategies for patients that are aligned with their individual goals and objectives. Not only does this set patients up for success, but it also provides an effective framework to facilitate behavior change.

  • The process of motivational interviewing can be broken down into four steps:
  • Identify a patient’s motivation for change
  • Reinforce that motivation
  • Develop specific patient-centered goals towards achieving change
  • Provide follow-up and support

How It Works

Changing any behavior is hard and can be scary. While many patients want to engage in behavioral change, they often have ambivalence toward putting it into action. A good way to combat this is with motivational interviewing because it puts the patient’s intentions and ideas for improving their health at the forefront. Additionally, it empowers patients to take ownership of their own weight loss and healthcare journey.

Here’s a clinical example of how motivational interviewing can work in your practice. While taking the dietary history of a patient with diabetes and obesity, you identify that they are consuming large amounts of soda each day. By identifying the patient’s goals and eliciting their own ideas for reducing their soda intake, you can work together to develop an actionable plan. This makes the patient an active participant in their treatment and also inspires them to make a lifestyle change.   

Motivational Interviewing in Action

As providers, we are accustomed to directing patients and offering our medical expertise. But motivational interviewing requires a communication paradigm shift that might seem out of the ordinary at first. While initiating procedures and prescribing medications are effective in acute-care situations, patients facing long-term care and lifestyle-change decisions benefit from a greater sense of involvement. The message providers give should never be, “I am the expert, you are the patient, and therefore do what I say.” Instead, we need to tap into our detective skills and uncover the patient’s own motivation for change. We can then use their aspirations as the blueprint to help them achieve their goals. 

In the end, motivational interviewing might flip the script on your typical patient interactions. But it has proven to be a successful strategy to elicit behavioral change in patients with overweight or obesity. By leveraging your patients’ motivations, you’ll develop a genuine connection while providing the necessary support for them to regain control and embrace change.

If you are interested in learning more about motivational interviewing and how you can incorporate it into your practice, visit the Obesity Medicine Association and view all of their available online courses.

References

  1. Motivational interviewing techniques. Facilitating behaviour change in the general practice setting. https://www.racgp.org.au/afp/2012/september/motivational-interviewing-techniques/#2. Accessed 5 April 2021.

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Category: Medical Methods in Obesity Treatment, Past Articles

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