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Motivational Interviewing for Clinicians

When working with patients towards a positive behaviour change, it’s important that you are able to recognise particular signs in the individual’s language (and in their body language), which relate to their readiness for behavioural change.

When working with patients towards a positive behaviour change, it’s important that you are able to recognise particular signs in the individual’s language (and in their body language), which relate to their readiness for behavioural change.

As the clinician, the aim is to listen for change talk and to evoke it by asking questions that open up and encourage the client to consider making a change.20, 21, 23-25 For example:

  • “How important is this to you?”
  • “What do you imagine is going to happen if you continue…?”
  • “What concerns you the most about…?”

Evoking change talk can be tricky – it needs to be done sensitively with genuine care and empathy.

DARN CAT Change Talk

When engaging in conversation about change, what can also help to reinforce motivation, is to listen out for the ‘DARN CAT’24, 25 in conversation and to reflect this back to your patient throughout the consultation to strengthen their reasons to change.

The first part ‘DARN’ represents a preparatory stage of change, where the individual expresses a Desire, an Ability, a Reason or a Need to change. For example, “I’ve got a few good reasons to improve my fitness.”

The second stage ‘CAT’, is where you start to mobilise and implement change. This can begin once the individual is engaged, there has been a change goal identified and the individual is sufficiently motivated to achieve the goal.

‘CAT’ represents planning for behaviour change and involves the patient’s Commitment, Activation and Taking steps. The aim is to recognise and elicit the following types of statements from the individual as highlighted in the image/table below, and for the patient to reflect how committed they are to make the change or not.24, 25

Change Talk. DARN CAT. Desire: I want to change. Ability: I can change. Reason: It's important to change. Need: I should change. -> Commitment: I will make changes. Activation: I am ready, prepared and willing to change. Taking steps: I am taking specific actions to change. -> Behaviour change.

To help reinforce the key principles presented to date, please watch the short video below to help you understand the constructs of motivational interviewing and the importance of recognising and eliciting change talk from individuals during a consultation.

Watch:

This video (2mins) provides a brief summary of MI:

This is an additional video, hosted on YouTube.

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