You want to use a person-centered care approach — working on meaningful goals and activities with the person you are treating — but it’s just SO. HARD. to know how to do that when all you have is a standardized score from the CLQT (see also: MOCA, WAB, RIPA, WJ-III, TEA, and on and on).
You’re not alone! It’s really hard to figure out a functional need when you’ve been focused on just getting those standardized scores. So what can we do about it? (*Practically. Realistically. We’re ALL on a time schedule here.)
Introducing: The Discovering Functional Needs Series. I’m blogging about real, practical tools so that you can feel at ease and prepared to treat with a person-centered approach from the get-go.
And this week we’re talking about: Motivational Interviewing
We’ve all been there: We have a patient who has NO. GOALS. (I’ve spoken about this before here). Or worse yet, they have goals but they aren’t YOUR goals. The patient is unmotivated, uncooperative, and doesn’t want to do speech therapy.
Have you tried a small but proven change in HOW you are phrasing your comments and questions? Motivational Interviewing is all about using evidence-based techniques and principles to guide your words, which in turn allow the patient to experience empathy, feel heard, and internally become ready to commit to changes and know why they want to make those changes.
Our field has sometimes been drawn to a persuasive style of speaking (“I’m noticing some challenges with your memory. Did you see how difficult it was to remember that? It would be helpful for you to write information down.”), but Motivational Interviewing focuses more on using Open-Ended Questions, Affirmations, Reflections, and Summaries to gently guide someone down the road to change.
How we choose to phrase our words in speech therapy can make a difference in motivating our clients to participate and engage in the therapy process. Motivational Interviewing is a person-centered interaction style, and evidence-based for supporting change and supporting goal-setting and motivation for therapy. Of course this won’t work every time, but research has shown it has no negative effect – so you might as well try it!
This can be tricky to do at first: I had to physically write down the way I wanted to say certain statements when I was learning this technique. And so, I actually created a Cheat Sheet for Motivational Interviewing to share with all of you. Sign up to receive this and be on my email list!
Have you tried Motivational Interviewing instead of persuasive? What did you notice?