Motivational Interviewing: Another Perspective

Sitting here in May, I've accumulated more patient stories in the last five months than I have in four years of college. People come into clinical settings and say the darndest things. Sometimes patients will come to us at Fantus Family Planning who know exactly which birth control method they want and are ready to go. Other times, it's more common for the patient to not know what they want. The patient may have tried many different types of contraception that she just didn't like, so she is now ready for something else. I usually have the privilege of talking to those women. We'll sit down together so I can learn a bit about her past reproductive history, like how many pregnancies she has had, what she has used in the past for birth control, and if she wants to have children in the near future. Usually these three questions will start a conversation and give me a sense of where to steer the conversation. It is interesting how three questions can tell me a lot about a women, even more than I know about my own friends. Over the next few minutes, we will have had enough of a conversation that it will be time for her to make a decision. And when she chooses a long-acting contraception device, part of me gets really excited. There has been an overall trend in the United States to provide more long term devices and as a result, the unplanned pregnancy rate has dropped. I like to think that I have helped contribute, even in a small way, to this dropping rate.

One day, a girl who came to the clinic told me that she wanted to get her tubes tied. She was 21 years old with two children at home. She was adamant that this was her decision and that she wouldn't try anything else. So, I started with my typical questions and came to find that she had only used one birth control method prior to this. We started talking more and I began to inform her more about intrauterine devices (IUDs), which have the same effectiveness rates as sterilization, but they can be reversed, while sterilization is permanent. Ultimately, to my delight, she chose to get an IUD. I spoke about this encounter with one of the clinic's physician assistants and we started to talk about a technique called motivational interviewing and how it can help someone make a decision by coming to their own realizations. Without knowing it, I may have used motivational interviewing to guide this woman to her own decision.

At one of our past Inservice meetings, a woman came to train our Corps on motivational interviewing. It seemed self explanatory; by asking questions and actively listening to the person you're speaking to, you can help guide the person to make their own decision. However, it's a lot easier said than done. Since that Inservice day, I've made a conscious effort to try and tailor my counseling sessions according to the rules of motivational interviewing.

This post was written by NHC Chicago member Nilofer Chollampat.

Nilofer serves as a Health Educator at Fantus Health Center.