In this episode of the Move to Value Podcast, we have a conversation about Motivational Interviewing with Sebastian Kaplan, PhD, a clinical psychologist at Atrium Health Wake Forest Baptist and Associate Professor of Psychiatry and Behavioral Medicine at the Wake Forest School of Medicine.
Dr Kaplan has additional Motivational Interviewing resources available here: https://www.guilford.com/author/Sebastian-G-Kaplan
Can you give a broad overview on motivational interviewing and its role in healthcare?
Sure, well, motivational interviewing in its most simplest way of defining it, is it’s a conversation about change. Now there’s all kinds of ways to have conversations about change honestly. So, what makes MI unique? So, one of the things that separates it is the interpersonal style that we strive for in every MI conversation. And it’s a style that is predicated on collaboration, on a lack of judgment or minimal judgment, one of acceptance of a person’s choices and whether they are choices that seem to be consistent with health or not, we’re accepting of their autonomous decision-making. And it’s a style that’s rooted in compassion as well. So that’s the like style of the conversation.
There’s also an intentional, strategic part of the conversation, which really does separate MI. The interpersonal style, that’s pretty consistent, at least in theory, on what other approaches would be about. But the specific strategy about MI is one that listens for and explicitly invites the patient to talk about change. And so again, that might seem like, well ok, that’s what all conversations are about. But there’s a really set of specific strategies and techniques that are used on top of that style that serve to build a conversation about change. But, most importantly though, it’s the patient’s own reasons for change. Their own desires and motivations for change. Not our imposition of what they should or they shouldn’t do. It’s designed to kind of draw that out from the other person.
What is the benefit of MI versus traditional health behavior change methods?
So, I guess we could start with what would traditional behavior change methods be. Broadly speaking in healthcare, right? We’re not only talking about psychotherapy, you know, because MI is something that’s broadly applicable. I would say a traditional conversation follows a, and this is a generalization of course, but follows a path where the healthcare provider, who is viewed as the expert on whatever the topic at hand is, gathers information. With that information they develop the, they arrive at a diagnosis, and they develop a plan for the patient. And then informs the patient what the plan is, and, you know, go along on your way to implement this plan. And again, this is a gross generalization. But in general, it’s a very, it’s fairly hierarchical where there’s one expert, and that’s the provider, and then the patient is there to, you know, tell the provider information about themselves but the provider is the one who has the answers, you know.
And, you know, so what are the advantages? Well, I guess, we know both from empirical research but even just our own experience, human beings aren’t great at following through with things when they’re told what to do. Right? And not just, you know, lectured or you know if it’s done in a harsh way, not even that. It’s, you know, we’re more likely to follow through with behavior change, particularly really challenging behavior changes that are discussed all the time in health care. We’re more likely to follow through if the plan, and if the drive and reasons for change come from within us.
It’s obvious that there are major benefits of using MI, so why do you think it...
