Introduction

Motivational interviewing

• A clinical style that can help patients to strengthen their motivation for making behaviour changes.
• There is growing evidence base to support the effectiveness of this approach when working with young people to instigate health behaviour changes.
• More about conversational skills than ‘interviewing’!

The approach has four key elements:

Engaging - establishing a collaborative and trusting relationship

Focusing – jointly identify and agree the (initial) target for change (e.g. improving adherence, minimising trigger exposure).

Evoking – helping them to voice their motivation for change (e.g. if I only rarely forget my preventing I will be able to do X because my asthma will be better controlled) and assess whether they are ready for change.

Planning – helping the adolescent work out how to change a particular behaviour, what their personal goal should be and how this can be monitored (eg particular reminder to help remember preventer at least 6 days a week).

Within a consultation the conversation should move to the next stage when the patient is ready. Sometimes it will be necessary to move back, if for instance it become obvious that a patient is actually ambivalent to making a behavioural change. Such a change is only likely to be successful when a patients feels able to make the change and feels that it will achieve the desired goal.  

For a teenager to change their behaviour they need to:

• Recognise that their current behaviour is a problem or concern
• Believe they are able to change
• Believe that they will be better off if they change​