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Mindful Schizophrenia Care
Guiding Patients Through Open Communication
Did you know that it only takes 1 minute of talking with a patient to make a lasting impression and build a strong relationship? A powerful tool that can help is Motivational Interviewing (MI), a communication technique that’s been studied—and found effective—in many chronic diseases, including serious mental health conditions, like schizophrenia or schizoaffective disorder. You can use MI as you guide patient conversations using these treatment resources.
What is MI?
MI was developed by clinical psychologists to uncover patients’ underlying beliefs, assumptions, or even fears, and help them find the motivation to make a positive change. MI can help to
- Uncover patients’ beliefs about treatment
- Understand patients’ resistance or barriers to treatment
- Introduce treatment options and elicit feedback
MI consists of communication strategies that put the patient in the driver’s seat–after all, the patient is the expert on his or her own life and experiences! Let’s dive into a few MI techniques and see how they work.
Use Your MI APRONS
Here are 6 quick, effective MI techniques you can use to engage patients. Try it by remembering to use your APRONS.
- Affirmations: Acknowledging what the patient or caregiver is doing well
- Permission: Getting the patient to agree before distributing information or an opinion
- Reflective listening: Rephrasing what the patient or caregiver said to clarify understanding
- Open-ended questions: Asking questions that elicit something more than a yes/no/maybe answer
- Normalizing: Communicating that having difficulties and challenges is not uncommon
- Summarizing: Pulling together key parts of the conversation
Using MI to Bring the Patient Into Focus
You can use MI to get to the patient’s true thoughts and feelings about what’s going on. Want to give it a try?
Imagine you’re having a conversation with a patient. Think about someone whom you want to have a conversation with about their treatment options. Now that you are envisioning that person, let’s get started.
Let’s see what we can learn by asking the patient an open-ended question about treatment experiences.
“What do you already know about treatment options?”
“Well, I’ve tried a couple different medicines, but I’m not sure that they worked, and I didn’t like how they made me feel.”
By asking an open-ended question, you learned more about the patient, such as their past treatment experiences and preferences.
Reflective listening is an MI technique that can establish trust and build rapport.
Let’s take a look at how it works.
“It sounds like you’re frustrated. You want to feel better. Let’s write this down together so you can bring this up with your mental health prescriber.”
“I know medication is important. My parents are always on me asking me about it. I am trying to take care of myself, but I wish they wouldn’t pester me so much, it makes me feel worse.”
Reflective listening helped you uncover that your patient hates being reminded about treatment but understands its importance.
Affirmations can help the patient feel like they are being heard and acknowledged. This facilitates open and honest dialogue.
“Even when you feel overwhelmed or pressured by others, you still see the importance of medication and taking care of your health—you’re trying your best.”
“It’s just hard. I wish my parents knew that. Maybe I should ask my psychiatrist for help. I’ll do anything to avoid going back to the hospital.”
By using an affirmation, you made the patient feel understood and respected. The patient even revealed a personal insight about hospitalization.
Asking permission is a powerful technique that ensures the patient is okay with sharing personal experiences or receiving information.
“I have some information that other patients have found helpful. Would you like to hear it?”
“Yeah, sure. I’d like to know how people like me manage everything!”
By simply asking for permission, you learned the patient is very open and maybe even excited about your recommendations.
Using MI With Your Patients
Using the MI techniques, you learned so much more about your patient’s perspective, past treatment experiences, what they tried and why they stopped, and what they are looking for now. Most important, you’ve established trust and rapport.
Now you’ve seen how MI can elicit more information—way to go! To help you use MI in all of your patient conversations, you can use APRONS. Sometimes, it takes time and several conversations before someone is likely to make a change. Don’t give up! Keep fighting for what you know is right for your patients.
These resources have been provided as part of a sponsorship with Janssen Pharmaceuticals, Inc. For more information, please visit choicesinrecovery.com.