A Practical Guide to Motivational Interviewing for Behavioral Health
By Angela Walther, LCSW
Sometimes we see patients who are resistant to trying new services and have some stigma/fears that get in the way of referrals for behavioral health services. Motivation interviewing (MI) is a tool used in mental health, health care, and substance abuse treatment to reduce resistance to interventions for change. By eliciting and exploring the person's resistance to change, we can help patients move toward interventions that can help reduce suffering. Here is a brief introduction to MI techniques that could help address the resistance and move patients toward motivation for change.
Tips from motivational interviewing (MI) to help with referrals to behavioral health services:
Motivational interviewing’s foundation is the belief that there is a partnership between provider and patient. This involves active collaboration, evoking or drawing out the client's ideas about change, and emphasizing the autonomy of the client. It’s helpful to remember the Acronym PACE:
● Partnership- The role of collaboration between provider and client. Patients are more willing to be vulnerable and share concerns when providers approach barriers to care with empathy and curiosity about their perspective. The provider gently influences the patient, but the patient drives the conversation.
Ex. “You have told me that depression is really causing you distress right now. I’m curious what you think would make a difference in increasing your overall mood.”
● Acceptance- Showing respect and approval of the patient. This will show the intent to understand and value that patient regardless of choice. MI’s four components of acceptance include absolute worth, accurate empathy, autonomy support, and affirmation.
Ex. “I have some ideas of things that could help, such as medications or therapy. Ultimately, it’s your decision on what you would like to try. We will keep working together on options to get you some relief.”
● Compassion- Actively promoting the client’s well-being and prioritizing the client’s needs according to their experience.
Ex. “I really want to see you have some relief from suffering. I understand you have some fears about medications and seeing a therapist. This is a normal fear many people experience when trying something new.”
● Evocation- This is how providers work to elicit and explore a client’s existing motivations, values, strengths, and resources. This is how we move toward a patient-centered treatment plan.
Ex. “What are you willing to try to reduce your depression symptoms?”
“We have talked about several options, is there one you think would be helpful?”
Taking time to use these techniques will help form a meaningful partnership with patients, leading to decreased resistance when offering options to reduce suffering. Feel free to reach out to our behavioral health team if you have a patient who is struggling and may need some support moving toward positive change.
