Motivational Interviewing to Consider Case study

The evidence base for effective interventions in behaviour change is increasing, however. In
particular, motivational interviewing (MI) has been shown to be effective in all the risk-taking
behaviours (Miller and Rollnick, 2013). There are NICE guidelines and Cohrane reviews that support
the use of motivational interviewing for exercising and healthy eating and healthy eating (obesity),
and mental health(Lai et al, 2010; Smedslund et al, 2011; Lindson-Hawley,2015). Motivational
interviewing is placing emphasis on uncovering a person’s intrinsic motivation to make changes. It is
a gentle style of communication that promotes autonomy and personal choice and is a skill that can
be taught.

Motivational interviewing works by allowing patients to work through their issues and developing a
plan which work for them. It is a person-centred, goal-directed counselling method for resolving
ambivalence and promoting positive change by eliciting and strengthening the person’s own
motivation to change’ (Miller and Rollnick, 2002).

Researches shows that motivational interviewing is effective for:

 Disease Management
 Lifestyle changes
 Couple counselling
 Changing any undesired behaviour
 Addiction/substance abuse

She is vegan and moderately obese, very spiritual and very practicing her religion (Hinduism) strictly,
this also shows her strong beliefs and religious ties. In term of her family support it is also seen that
there is a communication gap between the children and parents. Her daughter, pregnant and
teenager, and not revealing her pregnancy to the parents, clearly indicates a mistrust situation. It
can also be analysed from religious and cultural believes that she will not accept the current
situation of her daughter teenage pregnancy and social and family pressure. partner is also a mental
health patient.

social and financial status is also very low and no other means of economic support and family
support. The diagnosis of hypertension made the situation more intense and stressful for Mildred
and provoked her level of anxiety and paranoid thoughts about the medication.

As a RMN I have chosen Motivational Interviewing. Firstly I am going to engage by, introduction,
rapport building, seek consent. Royal college of nursing, 2020) and, explained, how introduction
connects professional and patients. I will offer her a seat, respecting her privacy and assure her of his
confidentiality and comfort. NMC Code of conduct (2018) states that I need to seek consent before
any care and support is given to patient.

According to Rollnick et al, (2016) Motivational interviewing is a way of talking and listening to
people and helping patients to identify their own reasons for change through guiding and not
directing. Motivational interviewing has four process engaging, focusing, evoking and planning.

I will focus on setting an agenda respecting s values, goals and priorities as well as set goals for mine.
This is to create direction of a change plan. I will do this by actively listening to and carefully
observing her.
Four processes of Motivational Interviewing Miller and Rollnick, (2013)

Engaging this makes the patient values and understood (to talk about her family, daughters and
health)

Focusing on the topic, set goals and priorities (what to change? Thoughts about medication?

Evoking the best ideas for change from the client

Planning developing a change plan that d agrees to for her to return her autonomy and
empowerment.

By following the elements of Motivational interviewing, I as a nurse will build a partnership and will
do this by work with as a partner on the same level. I will give my acceptance to by respecting her
autonomy and ideas. My compassion will do keep me focus on best interest in mind. Evocation it is
believed that the best ideas come from the client.

References:

Miller W, Rollnick S (2013) Motivational Interviewing: Helping people change. Guildford Press, New
York

Nursing and Midwifery Council (2018) The Code.NMC, London. Available online:
https://www.nmc.org.uk/nmc-code.pdf

Journal of Community Nurse (2017) The use of motivational interviewing in community nursing.
Available online: hura.shu.ac.uk/16435/1/Day%20-%20%20the-use-of-motivational-interviewing-in-
community-nursing%20%28VoR%29.pdf