Change talk


How to use motivational interviewing to help change patients behaviour

Please refer to the disclaimer before reading the case studies.
 

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GPs and PNs often find it challenging to help patients change their behaviour. They feel frustrated with their current approaches and often believe that alternative approaches, such as MI, are too difficult or time consuming. In the GPs Assisting Smokers Program (GASP), GPs and PNs attend a 2.5 hour workshop that provides information on effective MI strategies and opportunities to practice/hone their approaches with simulated patients using vignettes that reflect real-world examples. Experienced facilitators oversee the role-plays, provide feedback and demonstrate effective strategies. One MI skill is the ability to elicit ‘behaviour change’ talk. This means eliciting the beliefs, needs and reasons that often underpin the patient’s motivation to change their behaviour. One strategy is to ask about the patient’s desires, ability, reasons and needs. Possible questions include the following:
Desire

  • How would you like things to change?
  • What don’t you like about how things are now?
  • What do you hope will be different?

Ability

  • What do you think you would be able to change?
  • Of the options you have considered, what seems most possible?

Reasons

  • Why do you want to lose weight? To stop smoking? To be more physically active?
  • How do you think your diet is affecting your health?

Needs

  • What about your behaviour causes you concern?
  • What worries you about your behaviour?
  • What concerns you?
  • What can you imagine happening to you as a result of your behaviour?
  • What do you think will happen if you don’t make a change?

GPs and PNs found their perceived skills and confidence rose following the workshop, as did their preparedness to use MI in their own settings.

Assoc Prof John Litt and the GASP team, including Flinders University and Quitline South Australia.


Disclaimer

The information set out in this publication is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Nor is this publication exhaustive of the subject matter. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing. Compliance with any recommendations cannot of itself guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional and the premises from which the health professional operates.

Accordingly, The Royal Australian College of General Practitioners Ltd (RACGP) and its employees and agents shall have no liability (including without limitation liability by reason of negligence) to any users of the information contained in this publication for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in this publication and whether caused by reason of any error, negligent act, omission or misrepresentation in the information.