Building Competency in Diabetes Education THE ESSENTIALS

SELF-MANAGEMENT EDUCATION & SUPPORT: PROGRAM DEVELOPMENT| 11-23

• O  open-ended questions • A  affirming • R  reflecting • S  summarizing • P  providing information and advice with permission There are four key principles which are fundamental to the expression of the collaborative spirit which underlies the style of motivational interviewing (see Table 2).

Table 2. General principles of motivational interviewing (34-37) Use empathy

• Employ this learnable skill for understanding and accepting another’s meaning with the use of reflective listening. • Create a supportive environment. • Be aware of inconsistency between present behaviour and important goals. • Explore the person’s ambivalence about behaviour change and acknowledge that ambivalence is normal. • Ensure that the person, not the health-care provider, makes the arguments for change; in this way, • Shift perceptions, invite new perspectives from the person’s point of view. • Attempt to completely understand the person’s reluctance to change. • Avoid arguments. the person does not feel threatened or pressured.

• “You must have felt …” • “It sounds like you …” • “Tell me more about …” • “Help me understand …”

Note discrepancy

• “On one hand, you really want [fill in the behaviour] , but you also want to do [fill in the behaviour], as well.” • “How do you feel about fill in the behaviour] ?” • “What are some benefits of [fill in the behaviour] ?” • “Tell me the good things about doing [fill in the behaviour that is of concern]. ” • “It may be that you never [fill in the behaviour] .” • “It may be that by the time we are through discussing this, you will decide that it is too difficult to make that change. That will be up to you.”

Roll with sustain talk, avoid discord