Has your G.P. every said to you “I’d like you to loose weight/reduce alcohol/exercise more/begin a new social activity” to improve your health and wellbeing? Have you then found that health professionals (including Psychologists!), friends and the media have lots of advice about how to change, yet their ideas don’t always fit for you or don’t seem to work? Has that drawn you into a harsh cycle of feeling badly about the lifestyle habit, trying to follow the advice of others to change it, being unsuccessful then feeling worse about yourself?
Join the club!
We have so much information today about which lifestyle factors help protect mental and physical health, and which increase the risk of poor health. For example, we know that reducing exposure to violence and traumatic events helps protect people from Acute Stress Disorders and Post-Traumatic Stress. We also know that eating a balanced diet, maintaining healthy blood-pressure and cholesterol, and moderate physical activity helps protect the heart from disease (ABDS, 2018).
In the past, much health care assumed that the reason why someone was engaging in health-risk behaviour was because they didn’t know the risks or didn’t know how to change. This led many health professionals to approach these situations by telling clients what was or wasn’t good for them and advising what to do to change.
However, for most of us, changing lifestyle habits is not straightforward. Habits exist for reasons.
For example, people in insecure work may consume more alcohol to deal with the stress of their financial problems. Parents of young children tend to struggle with sleep because their children need them during the night. Older people may lose connections with friends and community-activities because they are becoming more physically frail.
Motivational Interviewing (MI) was developed by G.P. Steven Rollnick and Psychologist Bill Miller to address this dilemma. Motivational Interviewing is a guided conversation between a professional and a person considering change which does not assume readiness for change or the need for advice. As Bill Miller put it so beautifully, what most people considering change needs is “a good listening to”.
In Motivational Interviewing the professional aims to guide a particular type of conversation with a client to help the client clarify how ready, willing and able they are to change. It does this by eliciting from the person, more about their life circumstances, values, goals and personal strengths to help them build their own argument for change rather than be subject to other’s views or directions. In the words of Miller and Rollnick (1995) – ‘I learn what I believe as I hear myself talk’ . This is the unique heart of Motivational Interviewing, to help people mobilize intrinsic motivation to change.
Motivational Interviewing is fundamentally humanistic, client-centred, non-judgemental and strengths-based. It honours the choice of each individual to move toward change or not at any given time, with the awareness that the individual may be more ready, willing or able to make change at another moment in time.
There is strong evidence for the effectiveness of Motivational Interviewing in helping people make health-behaviour change in alcohol and tobacco-use, diet and exercise, and chronic disease self-management (eg taking prescribed medication or attending regular health appointments), and in sexual health. There is also strong evidence for it’s use in the mental health field of addiction and growing evidence regarding eating disorders (Miller & Rollnick, 2013).
I was fortunate-enough to undertake Motivational Interviewing training with Bill Miller when he visited Melbourne some years ago. Bill was so inspirational because he embodied the values underpinning Motivational Interviewing – humility, respect, non-judgement and a belief in the potential of all human beings to move toward health.
I have found Motivational Interviewing an invaluable tool in my work with clients at MindEcology over the years, and that they respond to the humanity within it. I have also delivered training in Motivational Interviewing to hundreds of health and welfare colleagues such as doctors, nurses, dieticians, social-workers, dentists, counsellors and welfare-workers with positive responses.
If someone has suggested you change in a lifestyle habit or if you are considering this, entering into a Motivational Interviewing conversation would be a sound place to start.
Sources
Australian Institute of Health & Welfare. (2018). Australian Burden of Disease Study 2018. https://www.aihw.gov.au/reports/burden-of-disease/
Miller, W. R., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change, 3rd Ed. New York: Guilford Press.
Rollnick S. & Miller W.R. (1995). What is Motivational Interviewing? Behavioural and Cognitive Psychotherapy, 23, 4, 325-334.