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IMPAQT | Improving quality of life for teenagers with asthma trial

Communicating with teenagers​

Motivational interviewing is a clinical style that can help patients to strengthen their motivation for making behaviour changes. There is a large evidence base to support the effectiveness of this approach when working with young people to instigate health behaviour changes. It is more about conversational skills than ‘interviewing’. You are likely to benefit from participating in a specific motivational interviewing course for teenagers.​

​The approach has four key stages:
(click a stage for more)​

ENGAGE Establish collaborative and trusting relationship FOCUS Jointly identify goal for change EVOKE Help teen voice motivation for change & assess if they are ready for change PLAN Help teen identify how to change behaviour, their personal goal and ways to monitor

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 patient 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​.

Here is an example of a healthcare professional using elements of motivational interviewing to talk to a patient about their recent asthma attack:

 

Engage: Open question allowing Edward to describe the asthma attack. Acknowledge it was a bad attack.​ Focus: Edward wants his mum to allow him to go out with his friends again. HCP wants to improve his ability to self-manage his asthma. These two goals can be brought together.​ Evoke: If Edward can convince his mum that he now knows hot manage his asthma, she is likely to let him go out.​ Plan: Education and training to support self-management of an attack including writing an asthma action plan. Barriers: i) forgets what to do  photo of action plan on phone; ii) mum not confident in his abilities  Edward talks his mum through how he would manage an attack at the end of the consultation. Goal: Edward to appropriately manage any asthma symptoms when he is out with friends.
 
Step 1: Engage
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