Motivational Interviewing

Thoughts on Motivational Interviewing in Nutrition and Fitness by Dawn Clifford, PhD, RD, and Laura Curtis, MS, RD

Motivational Interviewing (MI) is a goal-oriented, client-centered counseling approach around since the 1980’s. I’ve been exposed to it throughout my career and it has certainly influenced my counseling style. And yet, only upon reading this book has it occurred to me how helpful MI may be in freeing us from preconceived mindsets. As used in nutrition counseling specifically, MI could be seen as an antidote to the diet mindset.

In essence, diets involve looking outside of the self for what (and sometimes when) to eat. I’ve often wondered if the help-seeking process can inadvertently mirror or perpetuate this outward-based “quick fix” mentality. That is, if a client has spent a lifetime trying one and then another diet, am I not offering more of the same if I give him a new detailed plan to follow the day he arrives to my office?

MI assumes that clients come to the office already bogged down with knowledge and awareness of what to do -- yet, for many reasons, have been unsuccessful in making changes. While a nutrition counselor who uses MI may be the “expert” in nutrition, this counselor regards their clients as the expert in well, themselves. MI seeks to empower clients to trust this self-knowledge whilst wholeheartedly supporting their autonomy. In contrast, rigid diet plans do little to support self-knowledge and autonomy and may indeed erode these over time.

Motivational Interviewing in Nutrition and Fitness is an invaluable resource for  “professionals who care about the success of their clients, not just the day, week, or month after their visits, but for years to come (p. 4).” This book devotes entire chapters to each MI microskill: Asking open-ended questions, giving strategic reflections and summaries, and perhaps most important, avoiding the “righting reflex.”

In my counseling practice and in this gem of a book, I am continuously reminded that what I know is only as valuable as how I share this information; and if a client is not ready for it, information can do more harm than good.

After all, with MI, “The purpose is not to give advice. The purpose is to cultivate change (p. 177).” As revolutionary as it sounds, only after the client has been given time and space to come up with their own ideas, does the practitioner offer hers -- and in true MI spirit, they ask permission before doing so!

Recommended for clinicians: 5/5 (designed with the clinician in mind: almost every concept is followed by examples of clinician-client dialogues)
Recommended for individuals trying to make a change: 2/5 (the concepts in this book might be more useful if formatted as a workbook)