M.I. Allows us to Shift From Helper to CoachWant to help people? From nurses to social workers, most, if not all, in the health care industry chose their career because they want to help others. But sometimes wanting to help a client leads to trying to “fix” a client, and it’s impossible to “fix” others.
It is entirely possible, however, for care managers and care coordinators to elicit change.
How Can Case Managers Elicit Change? Through Motivational Interviewing.
Motivational Interviewing is a proven method of communication for helping individuals undertake and maintain behavioral change.
Motivational Interviewing is a collaborative, person-centered communication strategy that strengthens the client’s own motivation to change. This method “is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion,” according to Stephen Rollnick and William R. Miller, authors of the 2012 book, “Motivational Interviewing: Helping People Change.”
Although first developed for addiction counseling, motivational interviewing has since become an accepted technique in public health, health promotion and case management. According to the article by the University of Delaware, “Motivational Interviewing in Health Promotion: It Sounds Like Something Is Changing,” this method of communication “is neither a discrete nor entirely new intervention paradigm but an amalgam of principles and techniques drawn from existing models of psychotherapy and behavior change theory.”
What Skills Do Case Managers Need to Effectively Use Motivational Interviewing?
Motivational Interviewing involves two-way communication. Thus, care coordinators and care managers need to be able to talk and listen — two skills successful care coordinators and care managers should already have and continually nurture.
Dr. Kelly Pfeifer, director of High-Value Care at California HealthCare Foundation, explains that case managers need to become better listeners, especially as they take on more complex cases.
In 2012, the Henry J. Kaiser Family Foundation reported that as the population ages, California will continue to see a high percentage of Medicare enrollees as well as an aging population also eligible for Medi‐Cal. These aging dual-plan participants are estimated to have two or more chronic conditions.
“All of us in our professional careers get great satisfaction about sharing our expertise, which often translates into telling people what to do,” Pfeifer said. “The best care managers, the best clinicians, are the ones who can listen, can sit on our hands, and not do something when we feel like doing something.”
Instead of being a helper, case managers should work toward being a coach, she adds.
“That shift from helper to coach is critically important if we are going to get people the skills they need to make their health better, a year from now, or two years or three years after your case management interaction.”
Want to Learn More? Care Excellence Can Help.
Research has demonstrated that motivational interviewing can improve client engagement, help to resolve client ambivalence, and promote client activation in activities that lead to better health outcomes. Care Excellence offers an in-depth Motivational Interviewing course that teaches strategies to assess and strengthen an individual’s motivation to take action.
Experts in the field with significant care management real-world experience created the Care Excellence courses, including the Motivational Interviewing course. The Motivational Interviewing course introduces key concepts supporting this clinical approach. Participants learn 14 different Motivational Interviewing techniques that can be used to help clients identify and overcome reluctance to discuss to achieve their goals.
“Sometimes people are not motivated to achieve the goals we create for them regardless of what they have told us they want,” said Dr. Liz Barnett and Gary Gardia, the authors of the course. “When this happens, we call them ‘non-compliant,’ but it is we who are non-compliant. We failed to comply with that basic understanding of human nature … people will achieve the goals they are motivated to achieve.”
The course — which has been pre-approved by the Commission for Case Manager Certification to provide six hours continuing education credit to certified case managers — is intended for newly hired care managers and care coordinators, new nursing and social work graduates, experienced care managers looking for a refresher, or supervisors who can reinforce course content with their care managers.