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Introduction: Motivational Interview Intervention Theory
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In today's world, changing is the only thing that is constant. Especially for mental health reasons, it is important for an individual to recognize where or what they can change to make their life better. The idea behind Motivational Interviewing is based on the fact one's individual motivation might help to inspire positive change within them.
Motivational Interviewing is the process of treating an individual by mental health providers that explores the client's motivation and personal values to change their behaviour for the good. This treatment supports the clients' own motivations for change and provides them full autonomy over it. The fundamentals of this treatment include having compassion and respect for the client's rights and aspirations and gently guiding them through their own motivation to change. Motivational interviewing was first developed for people struggling with addiction but it has widened its scope for various health issues such as chronic diseases, mental health disorders, oral health practices and so on.
This paper is going to discuss the history and origins of motivational interviewing and how it is applied in the modern world, especially for the nursing sector. This essay will discuss the applications of this theory and the limitations it has that needs to be improved upon.
History of Motivational Interviewing
Motivational interviewing is a process developed as a counseling approach in the early 1980s in order to treat patients with addiction. Two clinical psychologists at the time, William R. Miller and Stephen Rollnick developed the theory while studying the treatment of people with alcohol addiction. The theory is supposed to be a person-centered approach in which the providers help the client to change their problematic behaviors. The theory was seen more as a directive rather than some concrete method of treatment. The two psychologists gave more information on these concepts in 1991, when it was tested on various patients and it showed positive results (Miller & Moyers, 2017).
Process of Intervention
Motivational Interviewing is seen as a collaboration between the provider and the client with one similar goal to improve the mental health and motivation of the client. There are several aspects that should be embedded in the spirit of motivational interviewing, which includes acceptance, partnership, evocation and compassion. Partnership refers to the joint efforts of both parties to contribute to the wellbeing of the client. Acceptance refers to the importance of the clients' efforts in the process and respecting that. The client should receive absolute support for however they are wishing to bring about the change. Empathy is a huge part of the acceptance process as it shows the client's perspective of things. The client should be allowed autonomy over their actions and not be controlled by the provider. Compassion is a huge factor in the spirit of motivational interviewing as its sole motivation should be to promote the wellbeing of the client and not for personal gain or for the purpose of exploitation. The base assumption of the method is that the client wants to change and is capable of it. Evocation is the factor of MI which helps the provider evoke the clients' motivation to change by focusing on the strengths and weaknesses of the client (Hardcastle et al. 2017).
The intervention process consists of a few steps that need to be followed. They can be divided into four parts that include engaging the client, focusing on them, evoking them and finally the planning process. Engaging with the client is the first step to knowing about their life and the motivations that make them tick. In this process the provider makes the client feel comfortable enough to discuss whatever problems they have that they need to deal with. This exercise helps the client gain trust and the provider to understand the client's perspective on the matter. The provider should let the client open up without rushing to provide a fix or judging their situation.
The next step involves focusing on the problem area. The providers help the client focus on where they need to focus their energies and what areas they need to improve. In this process the client should feel like they are working on the goal together and they have full autonomy on the matter. Evoking is the process through which the provider makes the client open up and answer their own questions of why they should change the particular behavior. The provider should provide support and direct the client towards strategies that can work towards that change. The last step in the process is the planning. When all the discussions are over and both the parties have agreed on a strategy, the provider helps the client some up with the step by step planning process of it. This part of the process focuses on setting goals that can be executed by the client.
Limitations
Even though the process of MI has been met with a lot of positive results in the enforcement, it still has a lot of limiting factors. This theory works on the basis of the client's efforts to change them. People with various mental health disorders might have underlying factors that can leave them unmotivated. The process of MI deals with changing only the behavioural factors and might not get deeper into the root of why the client acts unmotivated and that they might be suffering from some condition that makes them unmotivated to change.
Another limitation in this process can be the client's trust. Some clients find it very hard to trust the medical professionals and might be resistant to the treatment. The only way to help the situation might be to provide an environment of trust and allow the client to open up on their own without pressuring them to follow a set path (Naar, & Suarez, 2021).
Motivational Interviewing in Nursing
Motivational interviewing is used as a tool for many applications and various healthcare sectors. However, the nursing sector makes the use of motivational interviewing primarily for a lot of mental health patients and individuals who need lifestyle changes.
According to the article written by Carr (2017), health care professionals across the world are identifying the need to engage and empower the patients towards their own wellbeing as a key approach for patients. Motivational interviewing is a crucial process in achieving that. While the providers and nurses were seen as the primary caretakers of the patients, the modern scenario is changing and involves the patients taking charge of their own wellbeing. This method allows the providers to implement a successful person-centred approach.
Even though MI is being implemented in a lot of healthcare settings, there still remains the problem of trusting the healthcare professionals. Development of MI as a standardized intervention procedure in Nursing Interventions Classification (NIC), might enhance and encourage its usage among all healthcare professionals. This in turn may lead to them using the method on a daily basis and integrating it into the main practice so it is more normalized (Lozano et al. 2021). Even in the case of adults who suffer from chronic diseases and need to go through a lot of restrictions and lifestyle changes, motivational interviewing has proved to be a useful tool. MI is more effective when it is provided by nurses or providers who are trained in the approaches and it often works best if it is delivered face to face to the patients rather than relying on digital communications to use the technique (Moisan, 2017).
Even though there has been a lot of research and studies conducted on the effectiveness of the intervention theory, the literature still lacks the methods that can be applied for its implementation worldwide in the nursing sector and how the training can be conveyed and used in practice by the providers.
Conclusion
In conclusion, it can be said that the motivational interviewing intervention theory is very crucial in the developing healthcare sector where the services are becoming more person-centered. MI helps the providers understand the patient's perspective and make a collaborative effort for the betterment of the patient. In this modern day, MI can help the providers find the root cause of the problem and help to unwind and change that from the inside out so that the client feels heard and understood and can take charge of their own well-being.
It is a practice that should be applied in various sectors even outside the basic healthcare system. Research can be done on the various ways the limiting factors of this intervention method can be eradicated to implement a more effective system, which can help all of the parties involved.
References
- Carr, D. D. (2017). Motivational interviewing supports patient centered-care and communication. Journal of the New York State Nurses Association, 45(1), 39-43. Retrieved from https://www.nysna.org/sites/default/files/attach/1142/2017/08/2017-08-01nysnaJournalv45n1.pdf#page=41 [Accessed on 30th May 2023]
- Hardcastle, S. J., Fortier, M., Blake, N., & Hagger, M. S. (2017). Identifying content-based and relational techniques to change behaviour in motivational interviewing. Health psychology review, 11(1), 1-16. Retrieved from: https://doi.org/10.1080/17437199.2016.1190659 [Accessed on 30th May 2023]
- Lozano, P., Butcher, H. K., Serrano, C., Carrasco, A., Lagares, C., Lusilla, P., & O'Ferrall, C. (2021). Motivational interviewing: validation of a proposed NIC nursing intervention in persons with a severe mental illness. International Journal of Nursing Knowledge, 32(4), 240-252. Retrieved from: https://doi.org/10.1111/2047-3095.12317 [Accessed on 30th May 2023]
- Miller, W. R., & Moyers, T. B. (2017). Motivational interviewing and the clinical science of Carl Rogers. Journal of Consulting and Clinical Psychology, 85(8), 757. Retrieved from: https://doi.org/10.1037/ccp0000179 [Accessed on 30th May 2023]
- Naar, S., & Suarez, M. (2021). Motivational interviewing with adolescents and young adults. Guilford Publications. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=3VczEAAAQBAJ&oi=fnd&pg=PP1&dq=motivational+interviewing+trust&ots=nwR0phcpby&sig=ypQdJ_HfzdmkdsqmqZW0MAFqY0Q&redir_esc=y#v=onepage&q=doi&f=false [Accessed on 30th May 2023]
- Zomahoun, H. T. V., Guenette, L., Gregoire, J. P., Lauzier, S., Lawani, A. M., Ferdynus, C., ... & Moisan, J. (2017). Effectiveness of motivational interviewing interventions on medication adherence in adults with chronic diseases: a systematic review and meta-analysis. International journal of epidemiology, 46(2), 589-602. Retrieved from: https://doi.org/10.1093/ije/dyw273 [Accessed on 30th May 2023]
