Motivational interviewing was developed to address patient resistance and ambivalence to changing unhealthy behaviors, said Bruce Berger, PhD, president of Berger Consulting, LLC, and emeritus professor at Auburn University. However, he stressed, it’s not about persuading or motivating people to change.

He added that educating patients is a necessary precursor to behavior change, but knowing isn’t enough, because it’s difficult to change behaviors.

MI does two important things, he said: It uses specific skills to explore the concerns and feelings of patients, and it provides insight on how to address those concerns in a non-threatening way.

Berger said that his is a "sense-making approach" because "People are sense makers—we make sense out of everything." He noted that when people resist or are ambivalent to change, their sense making either "results from information that is incomplete; or contains errors or inaccurate information."

Berger’s sense-making approach to MI includes the following seven steps:

1. "Listen to how the patient is making sense
2. Clarify (nail down) the sense making
3. Reflect back your understanding
4. Identify needed information
5. Address the issue (with permission)
6. Invite the patient to consider the new information and draw a new conclusion
7. Summarize and discuss next steps"

Note: For information about comMIt: Comprehensive Motivational Interviewing Training for Health Care Professionals, Dr. Berger’s 8-hour online program centered around motivational interviewing, which is available to CMSA members at a discounted price, visit http://www.cmsa.org/mi-learning/.