Motivational Interviewing INSPIRES

[Guest guest]

I made this into a pink laminated card and passed it out to docs

in the class I taught....

(front of card)

Motivational Interviewing

Health Behavior Change Strategy

A patient-centered, non-confrontational

communication that encourages change

through empathy and negotiation.

* Speak slowly

* Open ended questions

* Active listening (pt. does most of the talking)

* Reflective listening (repeat what pt. says)

* Summarize patient concerns

MY DOCTOR INSPIRES BEHAVIOR CHANGE

I (identify behavior)

N (non-confrontation)

S (scaling importance/confidence)

P (pros/cons)

I (information exchange)

R (roll with resistance)

E (explore extremes best/worst)

S (solution brainstorming)

(back of card INSPIRES - more detail on how)

Identify Behavior

* patient selects behavior to work on.

* narrow focus (quit TOB, no salt, bike 2d/wk)

Non-confrontation

* remember " SOARS "

Scaling Questions

* from 0- 10 how important is it for you to quit smoking?

* from 0-10 how confident are you in being able to quit?

THEN... what would take you from a 1 to a 2??

Pros & Cons (no change vs. change)

* ask patient to discuss the pros & cons under both the current

behavior and change. Start with the pros of current behavior.

Information Exchange

* when patient specifically asks your opinion.

* frame advice as " other " people have had success with...

Roll with Resistance

* don't " take the bait. "

* dance with patient rather than wrestle!

Explore Extremes

* looking 5 years ahead what would be the worst case scenario

if you did not make the change?

* looking ahead what would be the best case scenario if you

did make the change?

Solution Brainstorming

* allow patient to lead in creating list.

* which one suits you best?, what makes the most sense to you?

HAVE FUN!!!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

www.idealmedicalpractice.org