Page 126 - Nutrition Counseling and Education Skills: A Guide for Professionals

Partnership Resist the “Righting” Reflex
Evocation Understand Your Client’s Motivation
Honor Client Autonomy Listen to Your Client
Empower Your Client

Box 6-1 ■ Foundations of Motivational Interviewing.

Principles of Motivational Interviewing

In the past, Miller and Rollnick expressed their principles as expressing empathy, supporting self-efficacy,
developing discrepancy, and rolling with resistance.6,14 Recently, they expressed their principles with the
acronym RULE.7,15 These are a guiding framework for selecting approaches and techniques.

1. Resist the Righting Reflex.
2. Understand Your Client’s Motivation.
3. Listen to Your Client.
4. Empower Your Client.

Resist the Righting Reflex
Resisting the righting reflex refers to the tendency of counselors to give advice to correct or to fix the client’s
problems in the belief that they have the right answers. This overlooks client ambivalence and does not deal
with the need for client change. The problem is that most people tend to resist change and may not view it as
possible or necessary if satisfied with their current behaviors. “I know I need to lose weight, but I love good
food.” The counselor who argues for the benefits of different eating choices, for example, may increase client
resistance and decrease the likelihood of change. Instead the client is the one who should be giving reasons
and talking about possible changes.

Understand Your Client’s Motivation

The client’s motivation comes from within the client. We do not instill motivation in people, but instead
should try to evoke the client’s own motivation and help the person recognize and enhance it. One may
explore the client’s values, concerns, and perceptions in various situations and have clients tell us what they
should change and how they can do it rather than telling and advising them what to do differently. One may
ask if the person wants to change and the reasons why it is important to him or her.

Listen to Your Client
Listen rather than giving advice. See the clients’ world from their point of view. Communicate empathy and
create a collaborative atmosphere where clients can explore the conflicts of making a change in their personal
lives. In a collaborative atmosphere, clients can explore suggestions for possible changes while the counselor
communicates with empathy.

MI uses the skill of reflective listening with an understanding and accepting attitude of the client’s
problems, perspectives, and feelings. The reflective listener makes a guess as to what the client means and
reflects it back to the client as a statement, not a question.7 Although counselors have answers to problems,
the answer needed for making a change in a behavior comes from the client and requires listening for it as the

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