Urging a Healthier Choice? Use Motivational Interviewing

Research shows this technique leads to behavior change.

Posted Sep 27, 2019

Monkey Business/Adobe Stock
Source: Monkey Business/Adobe Stock

Most of us have had periods of our lives when we did not make the healthiest choices. Maybe you needed to lose weight, or your cholesterol was too high. Maybe you went through a stressful period when you drank too much, smoked cigarettes, or didn’t get enough sleep.

Whatever the problem, you may have told your doctor about it. And if you did, you probably got a lecture. Most of us know the feeling of sitting in a medical office being told that our choices are bad for us. The question is, do these lectures inspire us to change our behavior?

The research says no. But there is a substantial body of evidence that demonstrates there is another way. The method is called motivational interviewing, and it involves discussing sensitive topics in a way that respects the patients’ desires and struggles in an effort to inspire them to make a change.

A typical motivational interview may go something like this:

“Mrs. Jones, do you mind if we talk about your smoking?” (Asking permission to have the conversation is an essential component of motivational interviewing.)

The next step is to cite concrete evidence about the health risks associated with the behavior. “We know that smoking increases your risk of cancer, heart disease and lung disease. How do you feel about that?” (Asking again helps the patient feel open to share her feelings and become a partner in the conversation.)

The doctor then asks the patient how important she thinks it is to stop smoking and what barriers prevent her from quitting. Together, they come up with some practical steps she can take to work towards this goal. The method also includes a technique called reflective listening, which involves the doctor repeating what the patient said to make sure he or she understands. Motivational interviewing should not involve confrontation or conflict.

While it motivational interviewing is certainly more time-consuming that a lecture, the research shows it helps to change patient behaviors for a wide variety of health problems and lifestyle choices. Systematic reviews show motivational interviewing is effective in helping modify the behaviors of people with cancer, adults lose weight, patients adhere to taking their medicines, improve the diets of people with Type II diabetes and improve the health behaviors of children.

While it’s primarily been tested in clinical settings, you could try using some motivational interviewing techniques in your everyday life. This could be a constructive way to talk with older children or teenagers about their screen use or healthy eating; or discuss with a partner or spouse about their sleep habits or nutrition, or an aging parent about moving to assisted living.

The take-home message: the way you approach conversations about difficult topics makes a big difference in how effective your words are—especially when it comes to encouraging individuals to change their behavior.

Visit Cornell University’s Bronfenbrenner Center for Translational Research’s website for more information on our work solving human problems.