Obesity> Module 2

Module 2: Basic Motivational Interviewing

Eliciting change talk

Using open questions and reflective listening does not mean that the health care professional is a passive listener: the skill is in knowing which questions to ask. By using challenging questions and responses, the HCP can encourage the patient to talk about their own reasons for change. This ‘change talk’ can be divided into four categories: DARN - desire, ability, reason and need.

  Desire Ability Reason Need
doctor

Healthcare Professional says ...

How would you feel if you managed to lose weight?

What has worked for you in the past? How could you get round that barrier?

What are your main reasons for wanting to lose weight?

What would be your concerns be if you didn’t manage to lose weight?
patient

Patient thinks ...

I want to lose weight

I can lose weight

I should lose weight

I must lose weight

Patient Scenario: Chetan

Patient Details

  • Name: Chetan Chowdhury
  • Age: 35
  • Ethnicity: Bangladeshi
  • BMI: 29
  • Waist circumference: 98 cm
  • Occupation: IT worker
  • Family Background: Lives with his wife and mother who has type 2 diabetes. Attends for support with smoking cessation.
  • Last Appointment:

Summary

Now you have seen examples, formulate your ideas for eliciting change talk with Chetan. Try to use a range of open questions, affirmations, reflections and summaries. Once you have submitted your suggestions you will be able to see a typical motivational interviewing example..

  Desire Ability Reason Need
doctor

Healthcare Professional says ...
Submit

Here are some more examples:

"So you say the last time you were comfortable with your weight you weighed about X."

"How would you feel if you were able to get back to that weight?"
Submit

Here are some more examples:

"What changes do you think you can realistically make?"

"What do think would help you to keep going with the changes that you have mentioned? "
Submit

Here are some more examples:

"What do you know about the link between diabetes and weight for people of Bangladeshi origin?"

"If you managed to lose weight, what would be the main difference to you on a day-to-day basis? "
Submit

Here are some more examples:

"What would concern you if you continued to put on weight?"

"You said that your mum has developed diabetes, is this something that concerns you?"
patient

Patient thinks ...

I want to lose weight

I can lose weight

I should lose weight

I must lose weight