I was conducting an introductory Motivational Interviewing training for dietetic interns this spring, when one student asked me something really interesting. I was talking about the “spirit” of MI, in which we really listen to what our client is saying, and through reflective listening, help them to clarify their own goals and values regarding the changes being discussed.
This is in sharp contrast to the approach that dietitians have been taught for many years, that our job is to TEACH the diet, whether the client wants to hear about it or not. Our job is also to CONVINCE the client that our way is the RIGHT and only way to do things. In my experience, this approach almost always wastes everyone’s time, both mine and the client.
This student asked me if I was being “too lenient” with my clients with this approach. Her comment assumed that I had some sort of authority to be either strict or lenient. That’s actually the opposite of what I had been teaching this group of interns, and the opposite of the MI approach.
The only thing we are trying to convince our clients about is that we are listening, can be counted upon to reflect what we hear accurately, and can be counted upon to accept whatever decision the client makes about changing behavior. Using MI, clients can actually convince themselves about making behavior changes. By encouraging the client to talk about what’s important in their lives, and what their goals and values are, we can help them to see the places in which their behavior doesn’t jibe or line up with those goals.
This “spirit” of MI is really the way we hold our relationship with the client. How do you see your role with your clients? Are you a collaborator or colleague or are you a top-down authority? You’ll get much further in terms of fostering health behavior change when you communicate to your client that you are a collaborator.
