Demystifying Health Coaching: What is Motivational Interviewing?
In this series on Demystifying Health Coaching, we’re excited to offer clarity on some common misconceptions we often encounter in the health and wellness worlds. These articles are meant to generate important dialogues about the past, present and future of health coaching — and without conversation there is no dialogue! We look forward to thoughts from our community on these articles and suggestions for future topics.
A person in motion stays in motion… As health coaches, we know that positive change takes the two Ms: motivation and momentum, and they’re deeply intertwined. Our job as health coaches is to activate intrinsic motivation through behavioral techniques to drive momentum for our clients so that they can stay on a path towards health and happiness.
One of the most powerful tools in our health coaching toolkit for making motivation happen is, of course, Motivational Interviewing. It’s been shown to improve negative emotions, social pressures and discomfort associated with losing weight (Mirkarimi et al.) and is recognized as a successful approach to improving substance abuse disorders.
We’ve broken down some of the key components of Motivational Interviewing, also known as OARS (Open-ended questions, Affirmations, Reflections, Summaries), to help you explain the benefits of this technique to your clients. In order to master this critical skill, it’s important to look into certification opportunities so that you can learn from the experts. Feel free to message us for more info!
Part of what makes Motivational Interviewing so successful is that it’s rooted in core human emotions, like empathy, that help us get to the heart of our clients’ values. Open-ended questions allow us to express empathy by encouraging our clients to expand on thoughts and feelings, explore where they intersect, and dive deeper to their source. They also help clients think more critically about their current state and their future goals. Some examples of open-ended questions may include:
- What kinds of foods do you reach for when you’re stressed?
- What excites you about the day when you wake up in the morning?
- When during the day do you feel most energized?
Affirmations aren’t a pat on the back or empty praise, they’re an acknowledgment of real progress rooted in fact, no matter how large or small. This helps to ensure that your statements have an impact and truly promote self-efficacy for your clients so they can meet their goals. Point to relevant strengths and successes (past or present) that will encourage your client to continue in pursuit of their health goals. This shows that not only have you been asking meaningful questions, but more importantly you’ve been listening to their answers. Some examples of affirmations include:
- You kept to your sleep schedule last week, despite distractions at work.
- You’re a very strong person, you’ve shown that by adjusting your exercise this week despite your trauma.
- You completed a week’s worth of journaling even on your busiest day.
Similar to affirmations, reflections depend on active listening, especially when asking your thoughtful, open-ended questions. These are thoughts that showcase your clients’ responses, that go beyond just restating. Instead, they point out what you heard, perhaps connecting it to something else your client shared the week before. Effective reflections should suggest that not only have you been paying attention that day, but you’ve been paying attention during every session. This is where true collaboration and client partnership comes into play. Below are some examples:
- I hear that you’re struggling with signing off at the end of the workday and last week you mentioned that you turned your computer back on to work even after you’d committed to going to sleep. Maybe what we need to try is moving your laptop to a separate room, so that we can conceptually separate your work and living spaces, even when you work from home.
- That’s an interesting point you made, that having a second coffee in the afternoon makes you more tired. There’s scientific backing to why that might be happening and maybe we can swap coffee for iced tea.
Summaries, like reflections, help show your clients that you’re listening and are a presence to help them refocus on their priorities when it counts the most. Summaries can look and sound different depending on the conversation but overall they distill important and actionable meaning from a conversation or series of conversations. They can also help you get the conversation back on track should things veer off course (which is totally okay, by the way!). Below are some examples:
- Based on what we talked about today, and some of our conversations from last week, it sounds like one of your goals in addition to eating healthier is getting some more movement during the day.
- We spoke about how spending time with friends during the week makes you feel happy and less stressed, is that correct?
Health coaches are agents of change and part of what makes them so impactful in helping clients reach their health goals is by leveraging scientifically-proven techniques to activate this change. Motivational Interviewing is just one of the many ways health coaches make change happen for their clients, while ensuring that they feel supported and empowered to reach their goals.
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