Motivations Webinar for Professionals
Content by: Sarah Bigbee, RD
The buzz word of recent in all coaching circles is Motivational Interviewing (MI). It’s an incredible technique, but it’s only one step in a full process of the Transtheoretical Model. Learn more!
What is the Transtheoretical Model, and how does it relate to MI?
The Transtheoretical Model is a framework for thinking about behavioral change. It was developed in the 70’s, as a part of observing the process of smokers trying to quit on their own or with treatment. This model is a cycle that can be used at any stage with a client. Transtheoretical Model accounts for the very human aspects of readiness to change, challenges and support that must be addressed to sustain changes in our lives.
What are the stages of this cycle?
1. Precontemplation where a person has not yet acknowledged that there is a behavior to change
2. Contemplation in this stage a client acknowledges that there is a behavior to change, but isn’t ready to make that change
3. Preparation this is when a client enters the active phases where they are making goals and planning on how they will achieve these new goals
4. Action/determination/relapse is when a person is actively implementing a plan for change and trying to move towards new behavior goals. In this phase, it’s important to have support to manage relapse. Relapse and regressions are a normal part of this cycle
5. Maintenance is the phase where clients now know their triggers for relapse and plan ways to avoid and respond to triggers. They continue to work towards goals and have a sense of confidence.
6. Termination is the stage where there is no longer any temptation to relapse and the client is able to care for themselves.
So where does Motivational Interviewing (MI) come in?
MI is a key tool in this model. The 4 pillars of MI are The OARS!
O = Open ended questions
A = Affirmations
R = Reflection and reflective listening
S = Summarizing
MI as a tool can be used as an approach for engaging a person’s intrinsic motivation to facilitate change. It’s goal oriented and client driven. It promotes behavior change by helping explore a person’s desire and reasoning behind change and help to resolve ambivalence.
Key aspects of MI:
● The client set’s the agenda and is in the driver’s seat during the conversation vs the clinician. Important for the provider to put your agenda away…at least until you meet their needs first. The client sets the tone and pace of next steps.
● During sessions questions are asked to seek understanding/gain perspective vs gaining information/crossing off a checklist. MI uses open ended questions used to allow people to explore their own thoughts in a safe space. This also allows clinicians to gain valuable insights and gather information without as much effort.
How do MI questions differ?
● Do you cook? vs Who cooks at your house?
● Do you exercise? vs Tell me about your daily activity?
Advanced MI includes the use of reflections and affirmations to provide validation and allows us to get on the same page.
Example: So, what you’re telling me is, you are working very hard and just not seeing the results? Or, So, it seems no matter what you do, your blood sugar is still high when you miss your daily walk?
Setting goals in MI
● Based on the principle that people intrinsically know what they need to do and the best laid plans are self-generated. Clinicians are there for support and to “ride along” (DJ).
● Take the “fix it” hat off - build on suggestions from the ideas of the client vs your own.