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
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