M is for Motivation....

Or more precisely Motivational Interviewing (MI).

MI can be defined as ‘a client centred, directive method of communication for enhancing intrinsic motivation to change by exploring and resolving ambivalence’.

This definition comes from Miller and Rollnick’s 2002 book, Preparing People for Change.

MI skills are important for Occupational Therapists (and of course other professionals) as a therapist with these skills can greatly increase the efficacy of their interventions with clients, particularly when working on any process of changing to develop health promoting habits and routines.

To use MI skills most effectively, it is important to understand the stages of the change process. A well known model is that of Prochaska & Norcross in their book Changing for Good (1994). They set out the following stages (imagine making a change such as trying to give up smoking and they will probably make sense):

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance
• Termination

In understanding what point in the process someone is at, a skilled therapist can tailor thier MI skills in the most appropriate way. Of course, change is sometimes enforced, not chosen e.g. after illness of accident. The process of change does not happen in as neat and linear fashion as the model above might seem to suggest. Using the example of giving up smoking, it can often take several attempts and the stages need to be gone through more than once.

AS OTs, developing our MI skills can help us make the most effective use of our often limited time with clients, and to help them towards their goals more effectively.