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Dr. Becky’s Top Ten For Patient/Client Centered Conversations

I have found it helpful for myself and participants in my motivational interviewing trainings to summarize key concepts or take aways from the information provided. From my perspective of many years of training practitioners on patient centered conversations, these ten key thoughts provide a strong foundation of the learning. Narrowing these 10 down can be helpful.

Which are your top 3?

10. Provide a strong introduction to who you are and how you want to work together for them to be the healthiest they can. “I want to partner with you on your health journey.”

9. Let the patient chose the next step, plan or goal. Find a focus together on a single behavior, an action, that the patient is willing, ready and that is important for them to work on.

8. Assist the patient in breaking down the next step or goal into specific steps using the SMART acronym. Specific, measurable, action oriented, realistic with a time deadline. “I will walk around my block for 20 minutes, 3 times a week on Sunday, Tuesday and Thursday evenings at 5:00 p.m. beginning this Sunday. I will check back in with you in two weeks.” Have a follow up time set.

7. Minimize the “righting reflex” where we want to problem solve, fix it, or come up with the ideas for the patient. Evoke from the patient what their ideas, suggestions and ways to deal with the situation would be. Use open ended questions. “What ideas do you have that could assist in this situation?” And then listen.

6. Have the patient restate and summarize the conversation. Sometimes known as “Teach Back”.

5. Have you, the practitioner, summarize the conversation focusing on the positives and “change talk” the patient has stated. “You are ready to take your medications as prescribed as you understand the importance of being consistent and you have decided to use a medication box starting tonight.”

4. Ask permission before giving information or advise. “I have some thoughts may I share them with you?” This gives the individual a sense of control in the conversation.

3. Look for what the patient is doing well and provide an affirmation. “You have worked hard to include more fruits and vegetables into your diet.”

2. Reflect what the patient has said especially at the beginning of the conversation, so the patient knows you are listening. Reflect rather than asking questions. When in doubt, reflect.

1. Listen to understand rather than to reply. Listen with eyes, ears and heart. And smile. ☺

As you reflect on these Top Ten, which one can you implement today?

If you know of others, perhaps your leadership team or a friend, who would be interested in learning more or receiving this and other blog posts, please feel free to forward to those individuals.

If you are interested in bringing me to your organization for a refresh training or coming to a public training, I’d love to hear from you. Send me a comment or email at beckylang@icloud.com.

Tranform Conversations. Transform Lives.
Dr. Becky Lang

“Dr. Lang’s training provided me with a better understanding of the motivational interviewing process. The skills I learned from her training have helped me feel more engaged and thoughtful when listening and talking with those around me. Dr. Lang is energetic, knowledgeable, passionate and provides a great learning environment.”

Nancy AdrianseBSDH, Oral Health Manager, Iowa Primary Care Association

“The training I received in Becky’s motivational interviewing class was invaluable. It laid a wonderful foundation for me to effectively empower my patients to develop and implement positive changes for their health. Becky created such a nurturing, nonthreatening environment that allowed me to freely learn and practice. This is certainly a class I can recommend to anyone wanting to learn to assist others with behavior changes.”

Robin GeorgeRN, Motivational Interviewing training participant

“At the YMCA, we have worked with Dr. Becky Lang for over a decade now to help us shift and shape our culture. As an organization committed to strengthening our community, the coaching and training skills that Dr. Lang has provided have helped us immensely. With her education and guidance she has helped us establish a culture that focuses on building meaningful relationships with our members, focusing on their needs, and coaching them towards success in their pursuit of a healthy lifestyle. Dr. Lang has trained all levels of our staff from our front line Wellness Coaches to our Executive Directors and Leadership Teams. Her on-going support has allowed the coaching-culture to come alive in our organization.”

Kim Stewart Kim Stewart Director of Operations, YMCA of Greater Des Moines

“The training Becky provided has been one of the most rewarding nursing experience I have had in 30 years. The style of interviewing and teaching patients is rewarding and positive. Her techniques drive the sessions to be more personal and patient-centered. Through Becky’s teaching, I was comfortable to practice and get familiar with the motivational interviewing process. Becky is an exceptional trainer and I recommend her training to all health coaches and educators.”

Sandy LovelessRN, Motivational Interviewing training participant

“The motivational interviewing techniques Becky teaches allow patients to set goals and work toward changes that are important to them. Patients feel in control of their own health and allow me to be in a more supportive roll. Becky has a positive and uplifting spirit that makes her classes extremely enjoyable.”

Tyra CarltonRN, Motivational Interviewing training participant

“Rebecca Lang was a respected colleague who diligently served as a teacher and mentor to hundreds of students over her long career at Grand View University. I had the distinct pleasure to work with Becky and regularly witness her vocation to Wellness education. She motivates those around her by a strong and genuine commitment to a lifestyle which promotes health and well-being.”

Katharina TumpekPhD, Professor and former Chair, Dept. of Health Promotions, Grand View University

“It has been a pleasure to work with Becky Lang over the last 25 years. Within a variety of contexts in the wellness arena, I have witnessed Dr. Lang’s mastery as a wellness educator, a health coach, a professor, and, most recently, as a health coaching trainer. I could go on at length about Dr. Lang’s passion, enthusiasm, high energy, wisdom, and deep knowledge in health promotion and behavior change. One of the attributes that impresses me most, though, is her ability to create a relaxed, fun, interactive, and content-rich training environment. Her refreshingly supportive, inviting, and empathic style of training and coaching allows learners to take risks, experiment, try on new skills, and participate authentically in role play exercises without feeling awkward and intimidated. Through Dr. Lang’s coaching and training, people learn–often more than they imagined.”

Jill NorrisRN, MPH, PCMH-CCE, Director, Care Management, University of Iowa Health Alliance