Way to go! You got this! Keep up the good work!
Those words may be encouraging, even motivating; but they’re not what is meant by motivational interviewing, says Jaclyn Boyle, Pharm.D. (’12).
During a Pathways to Pharmacy session, Dr. Boyle, Northeast Ohio Medical University College of Pharmacy assistant dean of student success and an assistant professor of pharmacy practice, showed the visiting high school sophomores, juniors and seniors the differences between traditional interviewing and motivational interviewing, and how pharmacists use it to provide more patient-centered care.
Dr. Boyle began by asking the students what major health problems plague the U.S. She received a number of correct answers, from smoking and addiction to diabetes and cardiovascular issues. She selected one condition that’s especially concerning: obesity.
Then she used the condition to explain how motivational interviewing differs from the discussions (mostly one-sided; not really an interview at all) that physicians and pharmacists have traditionally had with their patients. The provider probably would instruct their patient to eat healthy foods, take their medications routinely and exercise five times a week. End of discussion.
Answers from within
“Motivational interviewing is a new way to interact with patients to help meet their goals,” says Dr. Boyle. When conducting motivational interviews, physicians and pharmacists empower patients to better themselves, step by step. By asking the patient thoughtful questions, they guide them to find the answers themselves.
For example, a physician or pharmacist might ask an overweight patient how many days a week they feel they are capable of exercising. How do they feel when they exercise? When they don’t? It’s ok for patients to say, “I feel good when I skip exercising! I enjoy watching TV and eating pizza,” if it leads to a productive discussion. Honest answers are the goal, so that the patient addresses their own barriers to what they often know they need to do — but can’t make themselves do.
“We need to remember to tell our patients it’s ok to fail. We all do at one point or another,” says Dr. Boyle. “Asking them about times when they felt encouraged or successful will remind patients that they are not failures.”
Try, try again
When patients are in the midst of change, they go through a cycle — pre-contemplation, contemplation, preparation, action and maintenance. At any point in the cycle, patients may relapse and find themselves starting over again.
Dr. Boyle shared an example of gyms and fitness centers.
“Why are gyms never full? They’re always packed in January from New Year resolutions, but then attendance tapers off throughout the year,” she explained. “It happens to the best of us, but what’s most important is that we encourage our patients (and ourselves) to work towards getting back in that cycle.”