Motivational interviewing in General Practice - PowerPoint PPT Presentation

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Title:

Motivational interviewing in General Practice

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Cheerleading. Bring the focus back to the patient. Practising the techniques ... Stop cheerleading, get back to pt's point of view ... – PowerPoint PPT presentation

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Title: Motivational interviewing in General Practice


1
Motivational interviewing in General Practice
  • How to get people to change their behaviour

2
Aims and objectives
  • Increase our understanding of behaviour change
  • Introduce suggestions for motivational
    interviewing
  • So we can
  • Increase our effectiveness in helping people
    change their behaviour
  • Reduce frustration for both ourselves and
    patients

3
Session plan
  • Interactive presentation on behaviour change
  • DVD on motivational interviewing
  • Practise techniques in small groups
  • Reflection and summary of what weve learned
  • Evaluation

4
Helping people change behaviour - your experience
  • Think of a patient whom you tried to help to
    change
  • What did you try?
  • What worked?
  • What didnt work?
  • Any ideas about why it worked/didnt work?

5
Change
  • Change isnt a simple discrete event, its a
    process
  • Sometimes a crisis can precipitate a sudden
    change
  • Stages of Change - precontemplation,
    contemplation, change
  • Change usually involves loss as well as the
    perceived gain

6
Our role
  • Traditional advice-giving isnt useless but
    absolutely depends on timing
  • Need to understand the behaviours meaning for
    the patient - how do they see the benefits and
    problems of the change?
  • Help patient prepare for change
  • Encourage to experiment with small steps
  • Provide information when the patient is receptive
  • Accept that people have relapses (and help
    patient accept this too)

7
(No Transcript)
8
Principles of motivational interviewing
  • We need to enable the patient to
  • Believe that change is important
  • Have confidence in their ability to change
  • Dancing vs wrestling
  • Start positive

9
Some tools
  • The dinner plate, to let them choose which
    behaviour to change first
  • Scaling questions
  • How important is this change to you on a 1-10
    scale? Why is it in that position on the scale?
  • If you were decide to change, how confident are
    you that you could do so? Why is it in that
    position on the scale?

10
Some more tools
  • Use Elicit - Provide- Elicit technique
  • What do they know/want to know?
  • What additional information can you provide?
  • What do they see as their options?
  • What might their family and friends think?
  • What do they think?
  • Help them set realistic goals/targets
  • What do they think will work?

11
Patients potholes on the road to change and how
to get past them
  • Helplessness
  • Agree its hard, empathise
  • Help them recall past successes
  • Resistance
  • Summarise what theyve said (instead of getting
    into an argument)

12
Clinicians potholes on the road to change and
how to get past them
  • Lecturing
  • Go back to asking questions about the patients
    point of view
  • Cheerleading
  • Bring the focus back to the patient

13
Practising the techniques
  • Choose patient and doctor
  • Either -
  • Act the part of the patient you described earlier
    OR
  • Patient come to ME for scenario
  • Play the consultation as realistically as
    possible
  • Other group members observe techniques used,
    write down?
  • Doctor say how it went for them
  • Patient give feedback on how it felt
  • Rest of group give observations
  • Or choose another doc and pt and start again

14
Dance, dont wrestle
  • Help patient believe change is important
  • Help them get confidence they can change
  • Start positive
  • Dinner plate
  • Scaling questions
  • Elicit-provide-elicit
  • Help patient set realistic target
  • If pt helpless, empathise,remind of past success
  • If pt resistant, summarise what theyve said
  • Stop lecturing and get back to pts point of view
  • Stop cheerleading, get back to pts point of view
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