Page 125 - Nutrition Counseling and Education Skills: A Guide for Professionals

The counselor listens to the client to understand her point of view.

One seeks a collaborative partnership between the counselor and client for conversation to understand the
client’s situation, points of view, and goals. In the conversation, there is joint discussion of the problems that
only the client can solve and change. There should be an empathic understanding and supportive atmosphere
in responding to client remarks. This is a way to activate the client’s motivation and resources for change.7

Evocation
Evocation involves drawing out the client’s thoughts, feelings, and situations. One seeks to “evoke” or call
forth the clients’ own motivations, goals, and aspirations in the interest of their health. Clients know their
specific challenges and barriers to change. The counselor’s goal is to draw out the client’s reasons for change,
plans, methods for making changes, and if asked, provide ideas for the client to consider. The role of the
counselor is that of a guide who offers assistance along a path to change that the client selects.

Honoring Client Autonomy
Honoring client autonomy means that decisions are left up to the client even though the counselor may have
other preferences or opinions. People do not like to be told what to do. Simply giving clients advice to change
often is ineffective.7 The client has the right and freedom to select the path to change. In honoring client
autonomy, the counselor recognizes that it is the client who decides and that being told what to do may elicit
the “Yes, but . . .” response. For example: “You need to exercise more and eat less.” “Yes, but . . .” (See Box 6-
1).

The responsibility for change lies with the client: “It’s up to you to decide what to do. It’s your choice.” The
goal is to increase the client’s motivation, so that change arises from within rather than being imposed from
without.7 The client, not the counselor, needs to develop and speak aloud the arguments for change.

MI can save time by focusing the discussion on changes that make a difference and avoiding unproductive
discussion. While the counselor directs the collaborative discussion by guiding it, the focus is on honoring
client autonomy in decision making and eliciting the client’s own motivation for change.

Spirit of MI Principles of MI

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