Current Pedorthics | September-October 2018 | Vol.50, Issue 5 | Page 56

Motivational Interviewing
4 . Adjust to client resistance rather than opposing it directly .
5 . Support self-efficacy and optimism .
Let ’ s cover each in turn .
EXPRESSING EMPATHY THROUGH REFLECTIVE LISTENING
Empathy in this case is the ability to understand a patient ’ s meaning and perspective through the use of reflective listening . Reflective listening involves exactly that , listening rather than telling . In this , you establish yourself as the supportive and knowledgeable consultant who can provide potential solutions as the client identifies issues they would like to address . You must make them aware that you accept them as a person and respect their feelings while not necessarily approving or agreeing with them . Criticism and denigration must be avoided at all costs and you must compliment them on reaching conclusions and establishing goals . Gentle persuasion and guidance to reach certain milestone conclusions is the desired outcome . Helping them understand that there hobbies or spending time participating in activities with family and friends are worthwhile goals and that their foot pain is standing in the way of that , for example . In some cases , this may be what brought them to you in the first place . Acknowledge those goals and try to base the treatment around them .
DEVELOP DISCREPANCY BETWEEN CLIENTS ' GOALS OR VALUES AND THEIR CURRENT BEHAVIOR
You must help the patient to recognize the gap between what they are doing now and what is necessary to meet the goals you helped them establish through reflective listening . Helping them realize what negative consequences are resulting from the choices they currently make is the first part of this . One of my favorite examples of this is to trace the persons foot on a piece of paper while they are standing and then laying the insert from their old shoe on top of the tracing to show them how much they are compressing their foot to get it into the shoe . Properly couched as an “ experiment that I often do with patients just to see ” rather than an accusatory “ let me show you what you are doing wrong ” discussion is what puts this all in the realm of self-discovery by the customer and therefore part of Motivational Interviewing .
AVOID ARGUMENT AND DIRECT CONFRONTATION
This is in direct conflict with the process of MI . Empathy requires us to establish a trusting relationship with the client that expresses that we value their opinion . Arguing a point with them breaks down that trust and shows them that we are trying to dominate the relationship and enforce our will . This will cause almost every client to abandon any faith they had in the relationship and in you as a clinician . Remember that your goal is to walk with the patient down the path to wellness , not shove them along in front of you .
ADJUST TO CLIENT RESISTANCE RATHER THAN OPPOSING IT DIRECTLY
Rather than locking horns with the client , it is more productive to listen to their point of view and alter your guidance . First off , as stated above , it opposes proper Motivational Interviewing and will derail
Photo : @ iStock . com / Valeriy _ G
54 Pedorthic Footcare Association | www . pedorthics . org