If you want actual strategies to increase motivation, I really recommend Stephen Rollnick's articles. He co-authored Motivational Interviewing with Miller but some of his journal publications are a bit easier for practical application. "Why are you at (chosen number) and not at a 1?" "What could I do to help you to move from (chosen number) to a 10?" As a health psychologist working in Preventive Cardiology, I have found that these strategies became second nature very quickly and work extremely well. Nothing is more frustrating than trying to catapault a patient from contemplation into action stage before they are ready. I think that Prochaska said that only 20% of of individuals are ready to take action on problem health behaviors at any time but 80% of our programs are designed for pts in an action stage. Long-term follow-up studies of our cardiac patients has convinced me that this approach really works and keeps both me and my patients from feeling like failures when the decision to change is not made immediately. A couple of citations are below. Rollnick, S, Butler, C, Stott, N. (1997) Helping Smokers Make Decisions: The Enhancement of Brief Intervention for General Medical Practice, Patient Education and Counseling, 31, 191-203.
Rollnick, makes the point that motivational interviewing is an attempt to resolve ambivelence and thus close to a polar opposite of advice giving. Rather than getting into the "don't you think you should..." which is met with the "Yes, but" - a confrontation-denial trap, the therapist's goal is simply to help patients to explore the ambivelence about change, reasons for concern and arguments for change.
For example, the therapist could ask "if on a scale from 1 to 10, 1 is not at all motivated and 10 is 100% motivated, what number would you give yourself at the momement?"
This really helps in taking the pressure off of you and usually will elicit thoughtful responses from patients who have become accustomed to being very defensive with health care providers about their problem health behaviors.
Rollnick, S. Heather, N. and Bell. A. (1992). Negotiating behavior change in medical settings: The development of brief motivational interviewing. Journal of Mental Health, 1, 25-37.
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