Both recently certified health and wellness coaches and experienced health coaches may find themselves in situations where they feel resistance from a client to change. 

Rather than assuming that the client is “difficult,” you may want to examine your coaching techniques and mindset. One technique that can help create a safe space with your client while also allowing you to understand the barriers, difficulties, and confidence levels to adopt new health behaviors is motivational interviewing. 

Motivational interviewing is a technique used by health professionals to create a safe space with open communication that recognizes your clients’ agency and self-efficacy regarding the if, when, how, and what of change. It also is a space to bring the social determinants of health out into the open. Through effective motivational interviewing, you help clients verbalize barriers and other factors that are out of their control that may influence their health. 

The questions in this article are based on motivational interviewing techniques for healthcare professionals. 

 

5 Core Skills of Motivational Interviewing

When you master motivational interviewing, you shift from being a director to a guide. Strengthening the five core skills of motivational interviewing can help you make that shift. The five core skills are: 

  1. Asking open-ended questions: Questions should allow clients to reflect on how and why they might change. 
  2. Listening reflectively: Understand your client’s experience, and acknowledge when you can’t due to your own implicit biases and privilege. Use reflective listening statements that show you understand what your client is going through and roll with the resistance. For example, “Cooking meals at home just feels like too much to manage right now.” Avoid offering advice here. Reflective listening shows empathy. Encourage elaboration when client’s responses are vague or when they are showing resistance. 
  3. Providing affirmations: Affirmations are a great way to express empathy when your clients are going through a difficult time and demonstrate to your client that you recognize an aspect of their personalities or actions that might encourage them. Use them to recognize and celebrate your client’s accomplishments, including when they don’t see them as accomplishments at first. 
  4. Inform with permission. Ask permission to provide information to your client. Give them options for where to start. After you’ve provided information on a topic, ask your client to share reflections on what they think that information might mean to them. 
  5. Summarizing: Recap what your client expressed, and allow them to correct any misunderstandings. Depending on the goal of the session, it may be helpful to use summaries before leading into open-ended statements such as “I am wondering what you think your next step should be.”

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