In its purest sense, Motivated Interviewing (MI) is a therapeutic counselling approach originally developed to help individuals with problem drinking behaviour. However, since its initial development in the 1980s, MI has been integrated into many different contexts. MI is commonly referred to as a ‘person-centred’ counselling approach, related to the work of Carl Rogers who first introduced us to the idea of ‘core conditions of a person-centred conversation’. Essentially, without empathy, genuineness and acceptance, it is very difficult to have meaningful conversations; especially when those conversations are about change.
This is where the transferability and relevance of MI to Quality Improvement (QI) comes in. There are many opportunities to incorporate MI with respect to supporting people through changes in a QI context. As a psychologist, my recognition of the opportunities for MI in health and social care more generally comes from my experience of routinely witnessing the impact of conversations that are MI consistent (i.e., drawing upon those Carl Rogers core conditions of demonstrating empathy, genuineness, and acceptance) versus the impact of conversations that are not.
MI is a way of being with one another and so it’s not too difficult for most of us to understand how conversations with one another can be much more helpful and meaningful than conversations lacking in those core conditions, because it’s all about relationship. We also know that in really busy health and social care environments it can be quite easy to lose sight of these important relational conditions and become much more directive, particularly for those in a position of leadership
MI is one of the best fits for how Xytal helps health and social care organisations and I know it’s very important to us here within Xytal as an organisation as well. For all of us, when we are much more MI consistent in our conversations with one another we see routinely that it has a positive impact on everything that we do. I am trained in a range of different therapeutic and behaviour change approaches and in my role as an accredited Motivational Interviewing Network of Trainers (MINT) practitioner, I am well-positioned to oversee the incorporation of MI into all of our training programmes designed here at Xytal in order to better serve our GP clients and training programme participants. What this means is that the golden thread of person-centredness and behaviour change that features throughout QI and other areas is implicit in our approach.
One of the best examples of the real-world impact of MI that we’ve seen here at Xytal is the benefits provided to GP teams who have participated in our Enhanced Care Navigation and Communication Skills training programme, in which MI features very strongly. GP reception teams in particular consistently communicate to us that although they understand what care navigation is and why it’s important, they are often unsure of how to do it well and tend to lack the confidence necessary to have what can be very challenging conversations with patients.
With the understanding that it’s not just what you say, but how you say it, it comes as no surprise that MI, as a behaviour change approach, can provide all the necessary strategies to really address those concerns, ensuring that everyone involved is better equipped to care navigate more confidently utilising evidence-based skills. More specifically, it provides receptions teams with the support they need to engage in conversations that are truly person-centred. As a result, some of the outcomes we’ve seen consistently throughout our evaluation of the program include a reduced likelihood of inappropriate appointments being scheduled with clinicians inside the practices as well as increased patient confidence in their own self-care and management of their own conditions.
If you are curious about how your practice might benefit from these concepts, or to learn more about our Enhanced Care Navigation and Communication Skills training programme, please don’t hesitate to contact us here at Xytal. We are always eager to assist you in any way that we can so that you and your team can be better equipped to succeed!
This blog was written by Dr Charlotte Hilton.