Motivational interviewing is more than a technique. It’s a style of practicing. The “spirit” of motivational interviewing has several important elements:
- Collaboration between the therapist and the client
- Drawing out the client’s ideas about change
- Emphasizing autonomy
One of the most difficult aspects of motivational interviewing is change talk. There are several skills and strategies that can help the practitioner learn to evoke change talk in a patient.
“OARS” is a great way to remember the basic approach used to draw out change talk in patient.
O stands for Open ended questions. These are used to help create forward momentum used to help the client explore reasons and possibility of change.
A stands for Affirmations. Affirmations are used to recognize client strengths and help them view themselves in a positive light.
R is for Reflections. Reflections are done so that the client can feel that the therapist understands the issues from their perspective. They guide patient toward resolving ambivalence by focusing on the negative aspects of the status quo and the positives of making a change
S is for Summary. The therapist recaps to communicate interest, understanding, and call attention to important elements of the discussion. Summaries may be used to shift attention and prepare the patient to move on. They can also highlight both sides of the client’s ambivalence about change and promote discrepancy.
Motivational interviewing is a skill that needs to be developed through practice. One of the best ways to start implementing this in your practice is by letting the patient talk after you have asked your open-ended question. I’ve found that patients will reach their own conclusions if you give them space to explore the discrepancies in what they are doing and the goals they want to achieve. Remember, work smarter, not harder.
I included several links at the bottom of specific strategies and questions to ask to guide your practice.