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KEYWORDS MOTIVATIONAL INTERVIEWING | BEHAVIOUR CHANGE | HEALTH PROMOTION
Motivational interviewing can help people improve their lifestyles but nurses need to understand its principles to spot opportunities to encourage this
ABSTRACT Scott G (2010) Motivational interviewing 1: background, principles and application in healthcare. Nursing Times; 106: 34, 21-22.
This first in a two part unit on motivational interviewing explores how nurses can use the technique to motivate and empower patients in healthcare and wellbeing. It discusses the core principles of the method and gives examples of its proven use in managing long term conditions and general health and wellness. The widespread application of MINT may also successfully address productivity issues in the NHS.
BACKGROUND
Motivational interviewing (MINT) is being increasingly used in the areas of health promotion, public health and primary care to support lifestyle/behaviour change. When it was first developed two decades ago, the method was used mainly in the fields of addiction and substance misuse. However, it may now prove to be useful in helping to address rising levels of obesity and associated increases in diabetes, liver disease and cardiac disease (Cook, 2009).
Results of this therapeutic intervention have been extremely promising as a precursor or complement to other treatments and interventions. MINT could play a significant role in services that are being developed in a climate that is increasingly client directed (Department of Health, 2008).
Originating from the Rogerian client centred counselling approach (Mason, 2009; Rogers, 1980) and formulated into theory by Miller and Rollnick (1991), MINT is a "well known, scientifically tested method of counselling clients. . . and viewed as a useful intervention strategy in the treatment of lifestyle problems and disease" (Rubak et al, 2005).
The skills that MINT practitioners need are those that also are needed for enabling communication in healthcare: reflection; active listening; and open ended questioning.
Unlike Rogerian approaches, the method can include elements of "direction" and is balanced with elements of "following". This shows a guiding style rather than the leading style seen in consultations over medical treatment or where advice is given.
Central to MINT is a belief in clients' inherent resources rather than extrinsic problem solving, which contrasts with the expert/novice dynamic of some professional client relationships. Box 1 outlines its...