As discussed in our most recent blog, change is difficult for people, no matter the reason for the change. We identified several reasons patients resist change, the “Yeah-But Dance” between provider and resistant patient, and the need for a 50/50 partnership between providers and the patient and his/her family member.
The big question that remains is, how do providers create this partnership and help patients who are resisting change? There are four key strategies providers must remember (Huffman, 2014):
- Actively Listen
- Address patient concerns
The use of Motivational Interviewing (MI), which is “a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence”, will allow providers to employ all four of these strategies using an efficient, effective method (Butterworth, 2008, p. 22). The basis of MI lies in the use of open-ended questions as a means to encourage the patient to explore his or her own feelings of resistance in order to uncover the true reasons for resistance. This process also gives the patient opportunities to suggest his or her ideas on how to change the necessary behaviors (Huffman, 2014).
The provider should begin by using open-ended questions to understand what the patient already knows, clear up any misunderstandings, and begin to collaborate on a plan of action for change that will suit the patient’s lifestyle (Butterworth, 2008). The provider can and should use empowering open-ended questions, such as “Would you like to know more about…” or “May I give you a brochure on…” to empower the patient and help him or her feel more in control (Huffman, 2014).
As the provider asks questions, he or she must also use active listening when the patient is responding. The patient must feel understood and the provider should be empathetic and ideally even share a time he or she struggled with changing a behavior in order to relate to the patient (Huffman, 2014). By using these methods the patient’s concerns should be revealed, understood by the provider, and addressed fully, empathetically, and in a way that allows the provider and the patient (and his or her involved family members) to collaborate on a plan of action (Huffman, 2014).
Butterworth, S. W. (2008). Influencing patient adherence to treatment guidelines. Journal of Managed Care Pharmacy, 14(6 Supp B), 21-24.
Huffman, M. (2014) Using Motivational Interviewing Through Evidence-Based Health Coaching. Home Healthcare Nurse, 32(9), 543-548.