by Dana Sturtevant, MS, RD
If you were going through a tough time and needed to talk to someone, who would be the first person you’d reach out to for support? What is it about this person that makes you reach out to them before all others? What is it that they do? What don’t they do? What are their qualities?
Now on the other side, who is the person in your life that you’d be least likely to reach out to when you really needed to talk to someone? What is it that they do? What don’t they do? What are their qualities?
Chances are the helpful person has these qualities:
- Good listener
- Asks how they can support you instead of telling you what to do
- Keeps the focus on you
And the not-so-helpful person has some of these qualities:
- Dominates the conversation
- Poor listener
- Turns the conversation to their own life and problems
- Minimizes difficulties
- Tells you what to do
I do this exercise in trainings with helping professionals and the lists are always similar. When I ask trainees to think about the doctors, dentists/hygienists, dietitians, health educators, and other helping professionals they’ve seen for their own health care, they say that many tend to have the qualities of the not-so-helpful person.
As a dietitian, I was trained to be the expert: to do most of the talking and overwhelm people with too much advice and information. I was trained to believe that knowledge is enough to change behavior.
Research, however, shows that behavior change is driven by motivation, not by information. It also shows that most of the advice we have to offer people has already been thought of and rejected by them. So telling people for the fourth, fifth, or twentieth time is not likely to create change.
Think about it. When you go to the dentist, do they blow your mind when they tell you to floss your teeth every day? Did you not already know this? Chances are you know flossing your teeth would be good for your oral health. And I bet you have floss at home and know how to use it. So if you are one of the many Americans (50%) who don’t floss their teeth every day, it probably isn’t because you’ve never been told to floss your teeth. You are likely ambivalent about the behavior. That is, you have reasons why you’d like to floss your teeth every day, and reasons why you don’t want to floss every day.
The conversations helping professionals have with patients are powerful ones, capable of supporting or inhibiting the innate change process that is alive in all of us. Talking to patients/clients about their own concerns, reasons for change, ambivalence about change, and ideas for change is a great place to start because people are more influenced by what they hear themselves say than by what others say to them. These are some of the basic principles of the counseling style known as Motivational Interviewing.
Motivational Interviewing (MI) is person-centered, guiding method of communication and counseling to elicit and strengthen motivation to change (Miller and Rollnick, 2013). Originally developed in the drug and alcohol field, over 200 clinical trials demonstrate the efficacy of MI across a range of populations, target behaviors, and medical conditions. At its core, MI is not a unique or entirely new approach, but a combination of principles, skills and strategies drawn from existing models of counseling and behavior change theory.
Dana Sturtevant, MS, RD works as a trainer, mentor, Kripalu yoga teacher, and nutrition therapist in Portland, Oregon. She specializes in Health at Every Size® and Intuitive Eating. Her upcoming training at the Kripalu Center for Yoga and Health, What Motivates Change? Translating Theory into Practice, is for those who want to enhance their skills in behavior change counseling.