Because people feel such ambivalence about changing health risk behaviors, it is crucial to begin conversations with consumers by focusing on their own desire to and reasons for change. Rosengren (2009) discusses the way MI focuses the conversation on values and desire to change:
MI is a series of specific strategies, informed by respect for client autonomy and values, for maximizing the chances that clients will choose adaptive behavior change. MI takes advantage of the natural tendency of human beings to choose what is best for them in the long run by working collaboratively to identify clients’ desire for change within apparently destructive behaviors. (p. 19)
Why is it important for that particular person to change? What is important enough in this person’s life to take the difficult step to changing a behavior, like smoking or drinking or eating sugary foods that raise blood glucose levels. Essentially this way of focusing the conversation with people is about exploring people’s values. A value is a quality of our human experience that we feel a special regard for. Some examples of values include:
Acceptance— to be accepted as I am
Achievement — to have important accomplishments
Art — to appreciate or express myself in art
Authority — to be in charge of others
Beauty — to appreciate beauty around me
Accuracy — to be correct in my opinions and beliefs
Adventure — to have new and exciting experiences
So MI is essentially a values conversation, particularly when we are trying to build discrepancy and enhance motivation for change.
- Values are a felt-sense of what is important or precious to the consumer
- Values are linked to beliefs but are not the same as beliefs
- Values conversations build discrepancy between a person’s values and his/her behavior
There is a useful tool in MI to help clinicians engage a consumer in a conversation about values. It is called the MI Values Card Sort.