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    4 Techniques for Motivational Interviewing

    Effective communication with your patients is an essential function in delivering high-quality care. Training on communication skills has been found to improve doctor-patient interactions, but those skills can become rusty over time.

    So that's why, during Patient Experience Week, we're reminding you to think back on your training and re-energize your commitment to expertly communicate with every patient. One great way to do that is by using motivational interviewing. 

    Why should I focus on doctor-patient communication?

    Improving your doctor-patient communication skills will increase your patient's adherence to your recommendations. In the long run, they'll be healthier, and you'll improve their quality of life.

    This is especially important when it comes to helping a patient stop a learned behavior, where change is particularly difficult. In this scenario, effective communication is even more crucial. 

    Because the negative repercussions of some unhealthy habits don't manifest until later in life, a discussion of disease prevention can fall on deaf ears. Patients might be resistant to lifestyle changes such as healthy eating, smoking cessation, and exercise routines. This can be frustrating—especially when you know the impact of smoking or obesity on your patients’ life expectancy and quality of life.

    Improve doctor-patient communication with behavior change counseling 

    Behavior change counseling is talk therapy that engages patients in a partnership to execute a plan to sustain healthy habits. It's rarely taught in medicine, but the principles can still be learned and applied in your practice. One way to bring behavior change counseling into your approach to difficult patient conversations is to use motivational interviewing.

    Motivational interviews allow patients to take ownership of their health. Unlike the prescriptive approach, motivational interviewing has been shown to improve patient behavior outcomes.

    These 4 motivational interviewing techniques will help you master behavior change counseling and improve your patients' lives. To remember them, use the mnemonic OARS:

    1. Open-ended questions

    Ask questions that can’t be answered with a “yes” or a “no,” such as, “Tell me how you feel after walking up the stairs.”

    This shifts the focus to the patient, and encourages you to be an empathetic listener, which is key to the success of the interview. Another good question to ask is, “If there is one healthy change you could make to your lifestyle, what would it be?” 

    2. Affirmations

    There is tremendous power in empathy. Support your patient in every small step toward health. If their goal is to eat a salad instead of a hamburger one day a week, affirm that choice. Once your patient experiences success in a small goal, they will gain confidence for a greater one.

    3. Reflective listening

    Reflecting is repeating what you think your patient means. If they say, “I have a hard time turning down sweets at the office,” you might reply, “That makes it more difficult to make a healthy choice.”

    The purpose of reflective listening is to keep the conversation going so the patient reaches their own conclusion, such as, “Maybe if I bring healthy sweets to work it will help me resist.”

    4. Summaries

    A summary recaps the conversation and allows patients to correct misunderstandings or add missing information. Afterward, you can ask, “So what do you think your next step should be?”

    When the patient suggests a goal, no matter how small, repeat it, affirm it, and write it in their chart for follow-up. For motivational interviewing to work, you must follow up frequently.


    Motivational interviewing is a skill. As a problem solver, it’s going to be hard for you to resist the urge to offer solutions.

    This type of behavior change counseling is also not a perfect science. Don’t take it personally if a patient is resistant to change. The goal is not to solve their problem but to help them begin to believe a healthier lifestyle is possible. Even a 5-minute session can have positive results! And when patients begin to take ownership of their health, it is worth every minute of extra effort.


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