Current Pedorthics | September-October 2018 | Vol.50, Issue 5 | Page 55

day in your pedorthic career. You just may not have realized what you were seeing. Psychological research has shown that proper utilization of the basic principles of Motivational Interviewing in the area of drug addiction has allowed patients who had little to no motivation to get better to overcome that deficit and find reasons to want to recover. While this seems to be an extreme example when we are talking about assisting someone who is dealing with foot pain, the parallel is in the fact that the person we are trying to help does not like the help we have to offer them and therefore is not motivated to change. Often what we are suggesting they do is to discard the shoes and shoe styles that they prefer and start to wear ones they don’t like. I will cover the research done specifically on the psychological impact shoe choices have on a person’s self-image in a future article but suffice it to say right now that the impact is there. Motivational Interviewing, employed properly, is a discussion that you will lead that will help the client to come to conclusions on their own. From there, they will naturally develop the desire to change. When the idea behind the treatment, in this case changing shoe styles, is their own, the patient is not resistant, they are leading the charge. prepared for the fact that in some cases the person will be willing to go just so far on their own. Many times, you can accept this as a fair compromise and baby step them towards the styles and treatments they really need over a period of time. In other cases, you will have to abandon the technique, dig your heels in and push them to what is appropriate. Knowing when to do which is part of being a good pedorthist. The man who squashes toes that look like a cauliflower floret into narrow dress shoes could be allowed to choose something dressy, but not as restrictive. The fully neuropathic patient with the same forefoot conditions may need to be handled more firmly, and fit to rounder toed, extra depth shoes that eliminate all pressure or the fitting abandoned altogether and the patient referred back to their physician, for example. Hopefully, employing MI will eliminate instances of the latter. There are five principles of Motivational Interviewing. They are: 1. Express empathy through reflective listening. 2. Develop discrepancy between clients' goals or values and their current behavior. From the pedorthist’s perspective, calmness and compromise are the keys to make this successful. Be 3. Avoid argument and direct confrontation. Motivational Interviewing, employed properly, is a discussion that you will lead that will help the client to come to conclusions on their own. From there, they will naturally develop the desire to change. Current Pedorthics | September/October 2018 53