If you find yourself in challenging conversations with clients around changing nutritional and lifestyle habits, then “Motivational Interviewing” (MI) can be a valuable tool to add to your skill set.
It has certainly served myself well in training VIP clients who want to retain an element of control (and personal significance) when working out or examining their diet! It’s also a good way to customise exercise, nutritional and lifestyle information to best fit the client and their unique circumstances versus the all too common “one-size fits all” approach.
The problem is that MI can appear quite complicated to apply. However, the principles are simple and knowing these alone can greatly enhance your effectiveness to influence and inspire clients to change.
Let’s first outline a few key pointers about MI:
It’s not just theory; it’s supported by research.
It’s a client-centered, directive approach geared towards enabling lasting change.
It involves a collaborative, conversational, coaching style.
“Conversational” means the client gets to speak as much as you do.
You see the client as the expert on themselves and their life (who knows best about what can work for them).
Whereas you are the expert on the process of change plus on exercise/nutrition/lifestyle etc
Hence about TWO experts coming together (eg collaborative versus confrontation); Not one person telling the other what to do!
It assumes the validity of the client’s subjective experiences/perspectives, allowing them to express their true motives and feelings.
The central purpose of the MI method is to strengthen the client’s own motivation, by focusing on and enhancing the intrinsic motivation the person already has (evoking and strengthening it).
Through a careful balance of inquiry and reflective listening, MI elicits and selectively reinforces pro-change talk (opens their minds to the possibility of change), explores ambivalence and responds to any resistance in a way that is intended to diminish it.
Any resistance means retreating one step; The goal is to stay with them wherever they are.
The MI Process
Start with their agenda for the session – to establish rapport and priorities.
Allow them to talk about their main concerns or preoccupations they hold right now.
Rather than putting your opinion forward, you wait for the other person to make their stand.
You work with this dynamic to gently lead the other person where you’d like them to go.
Encourage the client to explore their ambivalence (internal conflicts) and to express their reasons for concern and their arguments for change.
Listen to talk about “change” from the client and reinforce it when you do hear it.
Use “tell me more” to coax people to open up.
Re-use some of their own language around why it might happen for them.
Use a decisional balance worksheet to examine the pros and cons of the targeted behavior.
Provide personal feedback (based on testing and monitoring their results).
You – The Coach
It’s not just about the technique itself. You – the Coach – must possess certain qualities:
Acceptance = For who he or she is AND for where he or she is in the change process.
Autonomy = Allowing them full responsibility for making the change.
Compassion = For the difficulty of the struggle to change. That it’s not easy to change. It requires a lot of effort, but it pays off.
Affirm = A genuine appreciation of the person’s actions towards change genuine involvement and reflection on what they’re going through in their process.
Empathy = You should seek to understand the client, their lives, and feel with them what makes it difficult for them to change, how long it has been going on for and accepting that maybe there are many things that need to be changed.
Choice = You may need to start with maybe just one behavior of their choice (re: nutrition, exercise, sleep?) at a pace which suits them.
Strategic = The ability to strengthen their belief in change and to agree on the actual steps required for change.
MI helps clients explore and resolve ambivalence (internal conflicts) thus strengthening their inner motivation to act
In other words, it helps the client shift their perspective around making changes.
The client must believe they can change, plus believe it will lead to their desired outcome.
Don’t rush it. Accept that simply exploring ambivalence can often lead to making changes later on.
Note MI is particularly helpful for clients “stuck” in unhealthy, addictive behaviors or ruts!
Putting MI into Practice
Hopefully, you now have an idea of some of the key concepts behind MI and would like to learn more. In part two of this article, I’ll run through some specific examples of MI, so you can start practicing it yourself on your clients.
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