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Table 1 Guide for motivational interview appointment

From: Effect of motivational interviewing in hypertensive patients (MIdNIgHT): study protocol for a randomized controlled trial

Key points
Acts by activating the patient’s own motivation for change and adherence to treatment
Approach is patient-centered
Collaborative spirit, evocative, and with respect for patient autonomy
Allows exploring and solving ambivalence
Offer critical resources that provide the space for a natural change
Techniques Skills
- Open questions - Empathy
- Establish schedule with the patient - Avoid arguments
- Reflective listening - Talk about behavior change
- Request permission to inform - Draw attention to discrepancies
- Stimulate the plan of action - Respect autonomy
- Summarize the conversation - Empower the patient
- Use evaluation scales - Joint decision-making process
- Resist the reflex of repairing unhealthy behaviors  
  1. The motivational interviewing counseling for each ambivalent behavior included the following steps:
  2. (1) Assess the patient’s motivation and confidence on subjective scales of 1–10, to observe motivation to modify ambivalent behaviors and to evoke conversations about change
  3. (2) Detect facilitators for changing these behaviors
  4. (3) Elicit the “pros” and “cons” of any concerns
  5. (4) Provide a menu of options to address any barriers or concerns about improving behaviors. The patient is asked about solutions for any barriers that present; if the patient does not present any barriers, the investigator encourages the patient to maintain their current behavior
  6. (5) Assess the patient’s values and goals. This helps to create ambivalence between current behaviors and goals/values. Patients are asked to sort a list of values in terms of personal importance and to select around five that are most important. They are then asked to briefly discuss why the values/goals selected are important to them and then to explore what connection, if any, they see between their current health behavior and their ability to achieve these goals or live out these values
  7. (6) Establish an action plan and make an overall summary of the appointment. The appointment, when appropriate, ends with an action plan to change the patient’s behavior, and the investigator summarizes what was talked and agreed upon and incorporates the patient’s suggestions and values
  8. These strategies were reinforced during every monthly appointment