Motivational Interviewing: Promoting Reflection as a Cue to Change

The following is an application of Motivation Interviewing as a technique to assist patients in reaching their behavior change goals.

When discussing a potential change in patient behavior:

1. Assess importance.

   “How important is it to you personally to change [insert behavior]? If 0 means “not important” and 10 means “very important,” what number would you give your feelings about changing this behavior?”

   Depending on the response, several questions may be asked to explore the importance and the factors that influence it:

   1. What would have to happen for it to become much more important for you to change?

   2. What would have to happen before you seriously considered changing?

   3. Why have you given this such a high score on importance?

   4. What would need to happen for your importance score to move up from X to Y?

   5. What stops you from moving up from X to Y?

   6. What are some things you like and dislike about [insert behavior]?

   7. What concerns you about [insert behavior]?

2. Build confidence.

   “If you decided right now to change [insert behavior], how confident do you feel about succeeding with this? If 0 means 'not at all confident' and 10 means 'very confident,' what number would you give yourself?”

   Depending on the response, several questions may be asked to enhance confidence and identify factors that influence it.

   1. What would make you more confident about making this change?

   2. Why have you given yourself such a high score on confidence?

   3. How could you increase your confidence, so that your score goes from X to Y?

   4. How can I help you succeed?

   5. Is there anything you have found helpful in any previous attempts to change?

   6. What have you learned from past experiences?

   7. Are there any ways you know that have worked for other people?

   8. What are some specific things you could do to achieve this goal?

Adapted from Miller WR, Rollnick S: Motivational Interviewing: Preparing People to Change Behavior. New York, Guilford Press, 1991