An article from the Journal of Dental Education defines motivational interviewing (MI) as a “person-centered, goal-directed method of communication for eliciting and strengthening intrinsic motivation for behavior change.” In dentistry, MI is a strategy that can be used to improve patient outcomes and acceptance of treatment plans and suggestions for oral health care by increasing a patient’s motivation for behavior change.
According to a May 2004 review on motivational interviewing in health settings published in the Patient Education and Counseling journal, this style of communication changes how an appointment feels to a patient and provides dentists with the opportunity to work closely with patients who need to make a behavior change but are not ready to do so. Because of this difficulty, it is important to be aware of the tools that can be used to enhance success.
A June 2009 Clinical Psychology Review article said that one of the advantages of MI is that it is “kinder and gentler” and subsequently “less likely to produce resistance among patients.” In addition, this strategy can be used in a short amount of time and can be efficiently incorporated into patient appointments.
So how does MI work? In the book, “Motivational Interviewing: Preparing People for Change,” the OARS strategy is discussed, which outlines four ways to better prepare people to make positive behavior changes.
OARS stands for the following:
- Open-ended questions
- Reflective listening
Open-ended questions are central to motivational interviewing, as they are used to initiate dialogue. As future dentists, we can use open-ended questions to allow our patients to explain their reasoning for accepting or not accepting a treatment plan. We also can use open-ended questions to help patients understand a treatment plan and why it is most appropriate for them.
Affirmations are used to “support and promote self-efficacy” and “validate the client’s experiences and feelings.” Using affirmations allows a patient to feel heard and encourages them to realize that they can make a positive change. A little support goes a long way!
Reflective listening usually consists of repeating back or paraphrasing what is said. It makes the patient feel like you are engaged. Reflective listening can help us recognize where a patient is coming from and help us clarify whether we are understanding what they’re saying. If we are following along correctly, we can continue the conversation. But if we misunderstood something, our patients can correct us before continuing.
Finally, summarizing is a great tool as it “reinforces what has been said, shows that you have been listening carefully and prepares the client to move on.” This is an excellent way to end an appointment after making sure that the patient feels comfortable with the treatment plan and next steps.
Using MI with our patients is something we should consider pursuing. The Patient Education and Counseling review suggests that acceptance of MI is high among patients and can be used to help improve their oral health. It allows for an honest dialogue that will eventually result in positive behavior changes, enhancing overall oral health for patients and improving patient outcomes for dentists.
~ Joan Daniel, New England ’22