Use of Empathy by Healthcare Professionals Learning Motivational Interviewing: A Qualitative Analysis

Abstract

Background. Many chronic health conditions like diabetes and hypertension require patients to make life style modifications such as changing dietary and exercise habits and taking medications. Healthcare Providers (HCPs) often don’t empathize with patients’ concerns and this can affect patients’ motivation to engage in life style modifications and HCPs resort to advising patients even though the effectiveness of advice giving is as low as 5-10%. This study focuses on the empathic behavior of HCPs while learning motivational interviewing and empathy is considered as the foundation for the effectiveness of motivational interviewing. Objective. The main objective of this exploratory study was to identify the problems that HCPs have in empathizing with and addressing patients concerns while learning motivational interviewing. Sample and settings: The study sample consisted of videotaped consultations of HCPs who were learning motivational interviewing at Auburn University Motivational Interviewing Training Institute (AU MITI) during 2007 and 2008. A total of 136 video consultations were studied comprising 82 HCPs interacting with standardized patients. Method. This was a qualitative study using discourse analysis to identify the problems that HCPs have in empathizing with and addressing patients’ concerns. A total of 55 consultations were transcribed within which 20 consultations were fully transcribed and 35 were partially transcribed to illustrate the patterns of HCPs’ responses to trained standardized patients’ concerns. Results. The problems that HCPs face in empathizing with and addressing patients’ concerns were (a) examining patients knowledge, (b) supporting self-efficacy without empathizing with their concerns, (c) running/forcing a predetermined agenda, (d) treating patients as a source of information, (e) discounting patients’ concerns, (f) generalizing patients’ concerns, (g) focusing on superficial details and not on the motivational issues, and (h) not making connections for patients while eliciting or providing information. Empathizing with patients’ motivational issues was observed to be important in the effective use of other MI skills. Conclusion. This study suggests that empathizing with patients’ motivational issues is crucial to MI not only in terms of reducing relational resistance in patients but also in initiating and supporting the process of addressing issue resistance in patients.