Guide to Moitvational Interviewing

Explore the person's thoughts and feelings about the good and not so good things about the issue (for example, about being very overweight, about smoking, about drinking harmfully)

Use reflective listening: listen to what the person says, and then summarise it back: (for example, "so, what you're saying is…", "so it seems that on the one hand it's…, and on the other it's…")

Show respect and willingness to understand person's perspective. You do not have to agree, but it is important not to show any disapproval, or to blame.

Give accurate health information that is relevant to him or her. Showing and explaining test results in graph form, or showing pictures may help.

Help the person clarify his or her personal goals or role in the community - what he/she wants to be, or what he/she wants to do in life. You could ask "what's important to you?" Then help the person to think about whether what he or she is doing now is helping to get there. (For example, "So what about when you drink…"). The person needs to see the conflict or discrepancy within himself/herself.

Avoid arguing - this will encourage the person to defend his or her opinion and behaviour patterns.

At times the person may be unwilling to consider the effects of his or her behaviour. Go with this and acknowledge the person's ambivalence or reluctance. Try another way to move forward with the intervention. It is important not to impose new views or goals, but rather to invite the person to consider new information or perspectives.

Encourage the person to generate the proposed solution. This means he or she will be more likely to follow it through. Help the person to set realistic personal goals for making changes.

Try to build the person's confidence. The person needs to believe he or she has the ability to achieve his or her goals and change behaviour.

Offer your help and support. Encourage him or her to identify others in the community who may be able to offer support. (For example, "Are there other people who have changed too?")

Example of a motivational interview

Health staff:		You say you've been drinking for a long time. What do you like about drinking?
Person:		I like the taste, and when I'm there with my friends we have a good time. All drinking together, it makes me feel good
Health staff:		What do you mean, feel good?
Person:		More confident, talking and laughing
Health staff:		Is there anything you don't like about drinking?
Person:		Makes me feel sick sometimes, next day you know. Hangover. Then I've got no money and my family they get mad.
Health staff:		So what you're saying is, you like drinking because it makes you feel confident and you can join in talking and laughing, but on the other hand you don't like drinking because it makes you feel sick and gives you a hangover. And causes trouble with your family because you spend the money on grog. Is that right?
Person:		Yeah, that's right
Health staff:		Does your family get upset with you for any other reason when you're drinking?
Person:		What do you mean?
Health staff:		Well, tell me what you're like if you've been drinking too much
Person:		Sometimes I fight with them, shout at them. My kids, they get frightened. Sometimes they run away
Health staff:		Does that worry you?
Person:		I don't want my kids to be scared of me.
Health staff:		So, what are you like when you're not drinking?
Person:		I look after my family. We have good times, good family times you know?
Health staff:		So when you're drinking you get angry with them and fight, but when you're not drinking you have good times together. Is that right?
Person:		Suppose so
Health staff:		Which person would you like to be?
Person:		I'd like to be happy with my family, but I can't be when I'm drinking Health staff: What do you think you want to do about that?
Person:		Maybe I should stop that drinking
Health staff:		What would be a good thing about that, if you stop drinking?
Person:		My family they'd be happy with me. And I wouldn't feel sick maybe
Health staff:		What about your health? What worries you about it?
Person:		I get sick in the gut sometimes, lots of pain - especially when I'm drinking
Health staff:		Yes, you were in hospital a few months ago, weren't you? Your liver has been hurt from drinking. What would be hard about giving up the drinking?
Person:		I'd lose my friends, they're good friends you know. We've been drinking together a long time
Health staff:		So, what would you like to do?
Person:		I need to think about it. I can see it's best for me to stop that drinking, but it's not easy, you know?
Health staff:		I'm here to help you if you decide to stop or ease up. Or if you want to talk to me some more about this…

Guide to motivational interviewing