How to Use Motivational Interviewing to Develop a Treatment Plan

Motivational interviewing is a brief psychological intervention designed to help people change unhealthy behavior. Motivational interviewing aims to empower a client to be their own agent of change rather than being pushed to change by a medical professional. Although motivational interviewing is a brief intervention, when effectively done, it helps clients seek other treatment options and stay involved in their treatment. A study done by Sune Rubak, MD, published in the "British Journal of General Practice" showed motivational interviewing was effective in helping people change a number of problem behaviors, such as overeating or alcohol abuse.

Things You'll Need

• Pen or pencil
• Notepad

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Instructions

The Motivational Interview

• 1

  Use open-ended questions to establish a connection with the client and demonstrate concern. Questions like "How do you feel today?" and "What are your concerns?" can help a client open up to the interviewer. The interviewer must also express empathy for the client. It is important that the interviewer keep an open mind and refrain from judgment or condemnation of the client's behavior.

• 2

  Approach a discussion of the client's problem behavior. Requesting permission to discuss the behavior by using a question such as "Would you mind taking a few minutes to discuss your alcohol use and how it affects your life?" can help the interviewer show support and concern for the client.

• 3

  Assess the impact of the problem behavior by asking open-ended questions. Reviewing the events of a typical day and drawing attention to the effects of the problem behavior on that day is one way to help a client see the effect his behavior has on himself and others. Another strategy is to explore what a client's life looked like before the problem behavior developed. Discuss good things and not-so-good things about the client's problem behavior.

• 4

  Provide feedback about the problem behavior in a nonjudgmental, empathetic way. Ask permission before providing feedback using questions such as "Is it okay if I offer some feedback about what you've been telling me?" Giving the client permission to correct the interviewer or speak up if they feel that the assessment is unfair is a way to empower the client to assess their own behavior. Provide specific feedback based on issues the client has brought up in the course of the interview. For example, if the client mentions issues with a relationship because of her problematic behavior, the therapist may want to highlight that.

• 5

  Explore a client's values in relation to the problem behavior. Help a client define the values important to him and create a picture of his ideal self. Then examine problematic behaviors and determine whether they conflict with the client's ideals and values. Looking forward can be a way to help a client see how his problem behavior might affect his values. Discuss with the client two divergent futures: his future if he continues on the same path without addressing the problem behavior and his future if he decided to change his behavior.

• 6

  Help the client come to her own decision about change. Explore the client's level of confidence and whether or not she believes she is capable of change. Review decisions made in the past and possible supports that can help the client change. Examine the pros and cons of change with the client, but let her make her own decision about whether or not she will attempt to change her behavior.

Developing a Treatment Plan

• 7

  Assess the client's readiness to change. Ask direct questions such as "How do you feel about your behavior?" and "Do you feel ready to make a change?" Weigh the pros and cons of change. Do not force a client to change, and be accepting of clients who are not ready to change their behavior.

• 8

  Work with the client to create a plan for change. Focus on immediate options rather than long-term plans. For clients who are not ready for change, provide information and support. For clients who are unsure about change, it is effective to review their feelings about further actions they might take by asking what concerns they have about their behavior and what the positive part of their behavior is. If a client is ready to change, offer appropriate treatment options, such as Alcoholics Anonymous groups for clients who abuse alcohol. Help the client examine treatment options and decide which one is best, then refer the client to that resource. Be supportive and empathetic towards all clients, no matter their willingness or reluctance to change.

• 9

  Help a client to clarify the ways in which he can change. Writing down reminders such as "The reasons I want to change are..." or "The steps I plan to take are..." can help a client to maintain change. Work with the client to find a support resource for his decision, such as a family member or friend who can encourage and help him. Provide resources such as treatment centers and plan for setbacks. Remind the client that setbacks are common and do not mean he is incapable of change. Empower the client to take change into his own hands by providing resources without pushing him to take them.