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Negotiating Behavioral Changes Using Motivational Interviewing
By Diana Cullum-Dugan, RD, LD, RYT
Even the healthiest among us are loathe to change our habits. Now consider the multitude of
changes required for a person with pre-diabetes or diabetes:
• Dietary change – like eating smaller portions and more fruits and vegetables
• Beginning purposeful activity
• Drinking less alcohol
• Cutting out sodas and sweets
• Eating out less often – meal plan
• Monitoring blood sugar regularly
• Taking meds as prescribed
Compound that with barriers due to language, culture, socio-economic status, depression, physical
stamina. Are we expecting miracles?
At the Fall 2008 DCOM Conference, Registered Dietician, Diana Cullum-Dugan gave a presentation
using the technique of motivational interviewing to register an internal change within patients so that
they could imagine and decide for themselves whether and how to effect necessary change in their
life. No easy task, Cullum-Dugan’s presentation and practicum showed how motivational interviewing
is effective because it is the patient, not the provider who makes the argument for change and
describes the course of action. In contrast, traditional methods tend to increase resistance and
reduce chances of positive behavior change.
The provider, according to Cullum-Dugan, can provide so much more than medical care and
information. They can leverage their patient’s own internal motivation through understanding the
dynamics of change, and through employing key features of motivational interviewing, including:
• Non-judgmental, sensitive approach
• Letting patient have control
• Withholding advice until asked
• Eliciting what patient would like to do
Some of the techniques include the following:
• Permission & open-ended Q’s
• Assess readiness to change
• Reflective listening & exploring
• Develop discrepancy thru ambivalence
• Values, willingness & confidence
• Summarizing
The break-out session included a theoretical section, including understanding the stages of change
and practical skills training exercises for providers to begin to internalize the techniques learned. By
the end of the session, we wanted more, and had all started to visualize ways to incorporate
motivational interviewing into our patient visits and counseling sessions.
back to home page
By Diana Cullum-Dugan, RD, LD, RYT
Even the healthiest among us are loathe to change our habits. Now consider the multitude of
changes required for a person with pre-diabetes or diabetes:
• Dietary change – like eating smaller portions and more fruits and vegetables
• Beginning purposeful activity
• Drinking less alcohol
• Cutting out sodas and sweets
• Eating out less often – meal plan
• Monitoring blood sugar regularly
• Taking meds as prescribed
Compound that with barriers due to language, culture, socio-economic status, depression, physical
stamina. Are we expecting miracles?
At the Fall 2008 DCOM Conference, Registered Dietician, Diana Cullum-Dugan gave a presentation
using the technique of motivational interviewing to register an internal change within patients so that
they could imagine and decide for themselves whether and how to effect necessary change in their
life. No easy task, Cullum-Dugan’s presentation and practicum showed how motivational interviewing
is effective because it is the patient, not the provider who makes the argument for change and
describes the course of action. In contrast, traditional methods tend to increase resistance and
reduce chances of positive behavior change.
The provider, according to Cullum-Dugan, can provide so much more than medical care and
information. They can leverage their patient’s own internal motivation through understanding the
dynamics of change, and through employing key features of motivational interviewing, including:
• Non-judgmental, sensitive approach
• Letting patient have control
• Withholding advice until asked
• Eliciting what patient would like to do
Some of the techniques include the following:
• Permission & open-ended Q’s
• Assess readiness to change
• Reflective listening & exploring
• Develop discrepancy thru ambivalence
• Values, willingness & confidence
• Summarizing
The break-out session included a theoretical section, including understanding the stages of change
and practical skills training exercises for providers to begin to internalize the techniques learned. By
the end of the session, we wanted more, and had all started to visualize ways to incorporate
motivational interviewing into our patient visits and counseling sessions.
back to home page
| Fall Statewide Meeting - October 31, 2008 |
|
