In recent years, motivational interviewing has been increased in the field of public health and health promotion to maintain lifestyle or behaviour change. It is commonly used in the area of substance misuse or addiction. Motivational interviewing is promising to other interventions and treatments. The skills which are required for the motivational interviewing are the reflection, open-ended questioning and active listening. The interviewing is used to detect the clients inherent value and targets and use them for behaviour change. Motivational interviewing practices include scaling tools like belief scoring and confidence. The scaling tool is used in the valuation process of clients self-regard development (Madson, Schumacher, Baer amp Martino, 2016, p.1). The motivation interviewing required various techniques for intervention. The process starts with revealing the various question categories of an interview. This essay will analyze the interview technique and analyze the theory of health behaviour change in the situation of substance disorder.
Motivational interviewing involves the various aspect of interviewing to an individual. The first most important point is building a healthy relationship between the interview and interviewee as it allows the greater communication between both. And sometime relationship built automatically without putting effort into it. But in some cases, the interviewer has to put effort to build a relationship with the interviewee through creating bonding on a specific matter or showing sympathy to the interviewee that interviewer understands their viewpoint. The interviewer should actively listen to the person to form a bond. When the interviewer structure the interview then they need to prioritizes the questions and the structure of interview which will involve the interviewer body language, confidence, maintaining eye contact and facial expression (Garbarski, Schaeffer amp Dykema, 2016, p. 1).In the motivational interviewing the interviewer boost the client to interact about the required changes and their personal motives for changes. The part of the interviewer is majorly raising a discussion about commitment and change. The questioner pays attention and reflects back the clients view so that the client can listen to their motive. Motivational interviewing is a short term counseling that needs one or two sessions.
The motivational interviewing developed from the client-centered approach which supports the people who need a process of health behaviour change. The interviewer uses this process to boost personal motivation and ready the client towards the behaviour change. Generally, this process is used for clients who are addicted to substances. The role of the interviewer is listening to the client and then intervening. The interviewer requires formal training and experience in the context of motivational interviewing and health behaviour change. The motivational interviewing identifies the client with the substance disorder according to their understanding of the requirement to change their behaviour. The motivational interviewing involves the stages of change because substance use disorders stand at a different level with the view of their behaviour and requirement level to change their behaviour (Prochaska, Redding amp Evers, 2015, p.125). The interviewer determines the client who uses the substance and needs to change their behaviour with the help of stages of change which is mention below
Precontemplation - It is an early stage where the person behaves little motivation or interest to change their behaviour.
Contemplation - It is a stage where client observe that their behaviour is creating the problem. And the person is considering the requirement of behaviour change.
Preparation - At this stage client need to know the positive and negative aspect of their behaviour. So, the person makes the promise to change the behaviour.
Action - At this stage, the person starts making an effort to change their behaviour.
Maintenance - At the maintenance, stage client has created the level of competence to allow them to change behaviour and form the fresh behaviour pattern.
Termination - Here, the client has adopted all types of changes and able to overcome new challenges.
During the motivational interviewing the interviewer uses the various techniques to support the client who uses the substance and wants to change their behaviour (Bommel et al., 2017, p.644). The motivational interviews techniques are as follow
Self- Efficacy - The client requires the motivation and confidence to change their behaviour pattern. With the help of self-esteem, the client can become self-efficient. The interviewer helps them by giving good plans or providing extra encouragement that they have to keep going.
Empathy - In these techniques, interviewers put themselves in the interviewees perspective to understand the behaviour of the client effectively. Through this technique, the interviewer is successful to change client behaviour.
Amplify - Ambivalence In this technique, the interviewer wants that client should continuously think about their conflicting behaviour that they have to change their behaviour.
Express empathy - The interviewer needs to understand the clients struggle. And actively listen to the client problem.
Columbo Approach This is the technique used by the interviewer, where the interviewer asked the questions to the clients about the behaviour to collect more information. And when interviewer found the information contradictory, then they present that information in a way so that they can make the client think about their attitude.
As already know the motivational interviewing is the cooperative, target- oriented process of communication and specifically attentive towards a change of behaviour (Copeland, McNamar, Kelson amp Simpson, 2015, p.401).So, the interviewing process uses the spirit of motivational techniques which have three key factors that are collaboration, evocation and autonomy.
Collaboration - The collaboration develops the relationship and facilitates trust between the interviewer and interviewee. Her, the interviewer process concentrate on the mutual understanding not on the interviewer being right. It is a partnership between interviewer and client.
Evocation - In this approach interviewer drawing out the clients ideas and thought instead of imposing the commitment and motivation to change the behaviour. Here, interviewer convinces the client to change their behaviour. The interviewers draw out the idea of a clients inspiration and skills for change.
Autonomy - Motivational interviewing identifies the true influence of change rest within the client. This enables the power of the client and provides accountability for their actions.
The practice of motivational interviewing includes the skill and strategies to bring MI spirit. The skills like OARS is the basic approach used in motivational interviewing by the interviewer that is open-ended questions, affirmations, reflections and summaries. The interviewer used these skills to move the interviewing process forwards to change the behaviour.
Open-ended questions - The open-ended question allows the elaborated answer and thinking about the issue from the end of the client. It helps the client to look forward to the possibility of change.
Affirmation - Affirmation is used to determine client strengths. It helps the client to keep themselves motivated even when the last efforts were unsuccessful. It includes the reframing behaviour an indication of the positive qualities of the client.
Reflection - Reflective listening or reflection plays a significant role in motivational interviewing. The reflective listening is used as a strategy to guide clients for changing the behaviour (DSouza, 2019, p.27). There is various kind of reflection used in the interviewing session and they are applied according to the clients level of willingness for modification.
It a different kind of reflection where the interviewer recaps the all scenario occurred during the interview. The summaries talk about the understanding, interest and concern about the important factors of the conversation.
The motivational interviewing involves the skills and strategies as well as it includes change talk which means a statement or nonverbal communication from the client side that reveal the client is considering the motivation of change. The study shows that if there is a correlation between the statements of the client towards change and outcomes of change will lead to a successful change in behaviour. If the interviewee talks more about the change then there is a possibility of their change (Lord et al., 2015, p. 50). There are few strategies which evoke the change talk between the interviewer and interviewee.
The interviewer can ask a more evocative question to the client so the answer will likely towards the change talk.
The interviewer can ask the question related to the pros and cons of being change or stay unchanged.
The interviewer can ask about their personal goals and targets. And does it help to change the clients behaviour
The interviewer can motivate the client to look forward if they are 100 per cent successful to make a change.
The change talk can implement through the clients commitment, activation and taking steps. And the change talk can be determined through the clients statement which includes desire, ability to change their behaviour.
This essay concludes that motivational interviewing play a crucial role in the area of public health and promotion. The interviewing process needs to create a strong relationship between the interviewer and interviewee for changing the behaviour. The interviewer needs to be confident and good with body language during the interview. The interviewing process includes the stage of change to determine the behaviour of a person who is addicted to the substance. The stage of change of a client shows the requirement of the change. It also involves the interviewing techniques such as self- efficacy, empathy, express empathy and Colombo approach which support the interviewee towards the change. The motivational interviewing practices include the skills and strategies like OARS which enhance the interview processes and also provide a better understanding of the need for client behaviour change. During the discussion, interview uses the strategy that is Change talk which reveals the client states that he/ she consider the change. Hence, all these skills and strategies are used by the interviewer to improve the process of interview and provide a better outcome for the interviewee.
Bommel, J., Schoenmakers, T. M., Kleinjan, M., Peters, G. J. Y., Dijkstra, A., amp van de Mheen, D. (2017). Targeting hardcore smokers The effects of an online tailored intervention, based on motivational interviewing techniques.British journal of health psychology,22(3), 644-660.Copeland, L., McNamara, R., Kelson, M., amp Simpson, S. (2015). Mechanisms of change within motivational interviewing in relation to health behaviors outcomes a systematic review.Patient education and counseling,98(4), 401-411.DSouza, A. (2019). Motivational interviewing The RULES, PACE, and OARS.Current Psychiatry,18(1), 27-28.
Garbarski, D., Schaeffer, N. C., amp Dykema, J. (2016). Interviewing practices, conversational practices, and rapport responsiveness and engagement in the standardized survey interview.Sociological methodology,46(1), 1-38.Lord, S. P., Can, D., Yi, M., Marin, R., Dunn, C. W., Imel, Z. E., amp Atkins, D. C. (2015). Advancing methods for reliably assessing motivational interviewing fidelity using the motivational interviewing skills code.Journal of substance abuse treatment,49, 50-57.Madson, M. B., Schumacher, J. A., Baer, J. S., amp Martino, S. (2016). Motivational interviewing for substance use Mapping out the next generation of research.Journal of substance abuse treatment,65, 1-5.Prochaska, J. O., Redding, C. A., amp Evers, K. E. (2015). The transtheoretical model and stages of change.Health behaviour Theory, research, and practice, 125-148.
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