Responding to resistance
Resistance is a normal part of change and should be explored, not ignored. Some patients may have other issues, including psychological or social problems, that need addressing first. Others may have unhelpful health beliefs that could be challenged. We will learn how to do address these reasons for resistance the module 3.
If patients simply appear to be ambivalent, or lacking motivation, then continue using your motivational interviewing techniques to empathise, reframe, amplify and explore.
Don’t be disheartened if your patient just isn’t ready to change. The consultation is still a success if you can leave the door open, so that they can talk about it at a future date if they would like to. Some patients won’t commit to change in front of you, as they need time to think.
Below are some examples of statements from patients giving reasons not to change. Read the statements and think about how you would respond to each one bearing in mind what you have learnt so far.
I’ve tried to lose weight so many times I’ve given up
I can’t lose weight as I can’t afford healthy food
I’m not bothered about how I look
I hate exercise and I love my food
I’m not interested in losing 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: Three years ago
Summary
Chetan returns to clinic saying he has found it hard to make the changes to lose weight.
Which of the following responses are consistent with the principles, key elements and skills of MI?
