A motivating interview is a technique in which you become an assistant in the change process and expresses your acceptance of the customer. A motivating interviewer must go with strong intent, clear strategies and skills to achieve this goal and lack of timing in critical moments. The general five principles that must be kept in mind are express empathy through reflective listening, conflict between customers' goals or values ​​and their current behaviour, avoiding arguments and direct confrontations, adapt to customer resistance rather than directly opposing it, and supporting self-efficacy and optimism. Know that you are not changing or managing your client, but rather making it easy or helping your customers change. These include learning skills in motivation areas such as; communicating customer respect, acceptance and emotions, encouraging an unbeatable and cooperative relationship, giving you the opportunity to be a solid and knowledgeable consultant or practitioner, sincerely favours pleasure rather than smashing, listening rather than tells persuades him or her to understand that the change decision is customer support and support throughout the restoration process. Finally, do know when to close the conversation.

Asking open questions will help you understand from the point of view of your customers and help customers make the most of the speaking in MI counselling. Open questions facilitate dialogue, they cannot be answered with a single word or phrase, and they do not require any specific answer.

Barriers:

Learning and Practicing MI is effective for many practitioners because it requires a new way of thinking and behaviour.

The organisation of treatment processes, staff and capacity can prevent MI.

There is the need for more training skills in the MI area.

Because of the heavy workload, there is no time.

MI techniques take longer than traditional methods.

The higher the depth of the customer relationship with the service provider, the better advice is, if the service providers receive only one or two sessions with their client, this may not be enough to maximize the impact.

Customer feedback plays an important role in assessing the quality and quantity of MI professionals.

Practitioners uses of MI are not effective unless there is recognition that an important health problem must be resolved.

Benefits:

Practitioners feel more confident using MI with clients who have health compromising behaviours and or risks that the practitioners feel they have expertise in.

It possesses a theoretical base rather than simply being a collection of techniques.

MI points out that a good relationship where customers are considered as an expert in their own life tends to minimise the resilience of change and thus increase motivation.

Its job satisfactory when practitioners aim and objectives are achieved.

Mary Opare-Ababio, my apologies, I tried to answer this before and the answer wouldn'nt submit :( You've done a wonderful job summarizing MI for anyone reading this question series. Your barriers and benefits are similar to what I've heard in some cases, although I have a couple of questions for you ;-)

1. The heavy workload is a common barrier I hear in workshops. Yet, when a provider uses elements of MI they also find their client satisfaction is higher. And in a couple of videos (MI and Non-MI) an “provider” (actor) sees the same client and the conversations are both around 5 minutes, yet the MI conversation seems to move the client from precontemplation to contemplation (in Stages of Change Model) whereas the non-MI suggests the client might not return. Realize the non-MI is a bit over-dramatized, yet frequently workshop attendees can identify having a similar provider visit… Here are the videos MI: https://www.youtube.com/watch?v=URiKA7CKtfc and non-MI: https://www.youtube.com/watch?v=80XyNE89eCs

2. Can you or others clarify more what you mean about Practitioners of MI are not effective unless there is recognition of an important health problem? Do you mean the provider must have a goal in mind to use MI effectively?

3. Similarly, can you clarify your understanding of the client/provider relationship? I agree that a well trained MI provider can increase satisfaction for both the client and the provider 

I believe that the previous two responders answered this question quite well. I would echo that the large work load is certainly a barrier. I would add that the rapport (or lack thereof) is also a significant barrier. In the minute amount of time that a health care worker with a patient, it can be difficult to develop enough rapport to even broach the subject of change. Furthermore, depending on the environment (ED vs.clinic vs. acute care vs. psychiatric inpatient), the rapport may take a lengthy time to build, so MI may have to wait until the 3rd, 4th, or 5th interaction, particularly if the patient is solidly in pre-contemplation.

The isia is to really find out how your patient see's thier world and issues vs. our medical model way of seeing thing (witch is very usefull) Being open and non judmental with your patent is of paramont importace in responding to open ended quiestions you are using in MI so you start from where they are at. Is very helpfull or me having been in the field for 40 years I can see they are say depressed anxouis etc. so helps me not go thier so fast.

It does take time but spending time to do rapport development if that is all you can do time wise say in an ER setting then it is worth it!

Mike and Sarah, thanks for your insights. Sarah, I agree that many factors influence the issues of connecting with a patient in our high tech and busy health care environment. Yet, Mike, your thoughts seem to suggest that having MI as your foundation can make this a more effective use of time for the busy practitioner.

I'll share a story from a recent workshop I gave with a busy medical care practice. There were a variety of health care workers there including Physician, Nurse Practitioner, Certified Nursing or Medical Assistants and others from different clinic practice fields. I provided an Introduction to MI over 2 days with practice sessions. One CNA told me she practiced her MI skills with a highly resistant & angry patient. He went from a 10 on a scale of resistance to a 1 with her novice skills and they ended up talking for 2 hours about all the life issues that led up to his resistance. He went from "you can't do anything for me" to her exploring the options of counseling referrals and other services the clinic had to offer. She did share that typically a 2 hour window was impossible, but the patient load had been light that day allowing her to spend the time. I guess the question is- is it worth it? You can guess my answer :-) and I believe the Coordinated Care Organizations within Oregon (a state in the US) are finding that deliberate use of rapport building and subsequent referral to services is making a huge impact on the economics of health care around the state. http://www.oregon.gov/oha/HSD/OHP/Pages/Coordinated-Care-Organizations.aspx

I'm not linking MI to the CCO information- simply suggesting that taking the time to create networks with and for patients has proven beneficial.