I am often asked how to use the effective skills and spirit of MI in brief health settings. In Tip #126, I shared a simple format based on MI called Brief Action Planning. This format keeps you focused and moving forward with clients who have at least some readiness to change.
Motivational Interviewing is about how to think about being
with a person more than just a set of tricks to do with or to them.
Joel Porter
Storytelling is a way of giving
someone great and lasting wealth.
Joseph Bruchac
Another way to address this concern of limited time is to follow a few basics with all client contacts, including the brief ones. These can become so much a part of who you are that you will be MI consistent all the time.
Engage in high-quality listening. This includes listening carefully to the client’s deepest values and goals and reflecting them back. Complex reflections (Tip #171) are most effective and efficient. When you hear ambivalence, even in brief encounters, reflect it (Tip #55).
Pay careful attention to change talk (Tip #69). Noticing and reflecting whatever change talk is present from the very beginning of a contact keeps the process focused on change.
Support client autonomy. Do this by using choice language from beginning to end of the session and by asking permission before offering information or advice.
Offer information in an MI manner (Tip #59). Keep it brief and as simple as this client needs. Most people cannot take in more than three small pieces of information at a time. Don’t forget the most important part of the information exchange: the client’s response. Ask for it, and then listen.
Support a plan, even if small. Look carefully for any and all commitment language and clearly reflect it back. Perhaps the client is only ready for a very small step (looking into gyms nearby or checking out recipe sites). An even smaller step would be “thinking about” something. For example, “You had not realized the effect of sweet liquids on your overall health and are going to think about ways to use substitutes.” When clients leave a session with a specific plan, they are more apt to do it.
If possible, set up a follow-up contact.
A final note: These concepts may sound simple and intuitive. That does not mean they are easy. It takes more skill and experience to maintain MI consistency in short contacts than when there is ample time. Keep practicing each and every time you can, and you will eventually find it is your natural style.