1. Chet Fox MD Elizabeth Stewart PhD Brian Manning MPH
Motivational Interviewing Creating Patient Centered Health Behavior Change in diabetic patients
Chet Fox MD
Elizabeth Stewart PhD
Brian Manning MPH
“God thinks he is a doctor joke”

2. What is Motivational Interviewing
“MI works by activating patients own motivation for change and adherence to treatment”
Rollnick S, Miller W , Butler C, Motivational Interviewing in Health Care p. 5

3. Key Elements Promote desire to change Promote confidence
change is possible

4. Seven Principles
Motivation to change is elicited from the client, and not imposed from without
It is the patient’s task, not the clinician’s, to resolve his or her ambivalence
Direct persuasion is not an effective method for resolving ambivalence.
The counseling style is a quiet and eliciting one

5. Seven Principles (Con’t)
The clinician is directive in helping the client to examine and resolve ambivalence
Readiness to change is not a client trait, but a fluctuating product of interpersonal interaction
The therapeutic relationship is more like a partnership or companionship than expert/recipient roles. .

6. From Priest to Partner PRIEST DOCTOR Wears Collar Speaks Latin
Expert: tells person what to do
Has confessional
Parishioner admits sins
Gives penance
Wears white coat
Speaks Latin
Expert: tells person what to do
Has confidential exam room
Patient confesses what they did not do
Gives pills

7. How I got started
AI M-HI
The story of Larry

8. Notable Quotes
“ It is less frightening to come to you, I feel more like you are my friend”
“I don’t feel like I am going to the Principal’s office anymore”

9. Goal Setting Areas Nutrition Activity Emotional Well Being
Smoking Cessation
Substance Abuse
Diabetes self management
Need to be
Specific
What the patient wants to do (desire)
What the patient feels they can do (confidence)
Remember baby steps, we always want a positive result.

10. Remember Yoda
“Try not. Do or do not, there is no try.” -- Yoda

11. DEMONSTRATION

12. Workshop Assignment One
Pair up
Alternate being Doctor and patient
Set actual goals for yourself in the areas of nutrition, activity and emotional well being
If you need help, ask one of the 3 of us, Brian, or myself
Take 10 minutes each, then we will reconvene

13. Workshop Assignment Two
Break up into 3 groups
Take 30 minutes
How did you feel about the process
How did you feel about the interaction
Do you feel you can incorporate this in your practice
What could you easily do
What are some of the barriers
How would you apply this to your diabetic patients

14. Debrief (Whole Group)
Each group reports what it found