The motivational interview

Abstract

The motivational interview is a type of interview, centred on the patient, that seeks to help in exploring and resolving contradictions concerning unhealthy behaviour patterns or habits. It attempts to increase the awareness of patients of the health risks they are running and their capacity for doing something about this. Besides, it fosters the mental health of the health workers since it increases their satisfaction as professionals and prevents a sensation of impotence. The will power to change an unhealthy habit or behaviour pattern is the motivation that one has to desire such change, and its greatest driving force is the discomfort in the person arising from the difference between what he does and what he would like to do. If we can help the patient to become more aware of his situation and his/her desires, we will make change easier for him and it will be less difficult for him to pay the price represented by the suffering he will undergo on giving up a habitual behaviour pattern. The patient is the protagonist and we can facilitate his process of change. At times, it is difficult for us to forget our habitual tendency to try and obtain rapid results, and we move ahead of the patient's rhythm. Depending on the type of relationship that we offer him, we will facilitate or hinder change. An empathetic attitude, one in which the patient feels supported and not judged, favours change and, on the contrary, insistence on his abandoning the habit can generate resistance to change. There is a series of techniques that we can learn and that will help us to improve the motivational clinical interview. There are also certain characteristics in the health professional that provide an ideal atmosphere of security and support for change: empathy, emotional warmth and authenticity.