Many of us experience a certain degree of ambivalence as to whether we can or, indeed, be able to change challenging situations or behaviours. These pages introduce carers to a general model of health change which allows them to perceive the notion of change in a relatively straightforward manner. It also introduces a therapeutic approach known as Motivational Interviewing (MI), used by clinicians to enhance personal motivation for change. Eating disorders thrive on conflict and disharmony. MI provides carers with a framework in which they can reflect upon and build more adaptive forms of communication to use with their loved one.
Motivational interviewing has been found to be particularly helpful for people who are ambivalent about change (Treasure, et al., 2010; Miller & Rollnick, 2002). In a recent systematic review the aim of which was to identify the effectiveness of MI when used with both patients and carers of people with EDs, studies indicated the potential for using MI in the field of EDs, particularly with regards to ''readiness to change'' (Macdonald, et al., 2011). Since resistance to change is particularly common in the field of anorexia nervosa, this approach has been incorporated extensively in the development of our carer interventions. To date, it has been a useful tool in working with family members in encouraging them to reflect upon and implement some of the cognitive and behavioural changes necessary to break vicious cycles of unhelpful responses to the eating disorder. Carers also find the skills useful in communicating more adaptively with their loved ones when instigating and eliciting change talk.
Motivational interviewing is not appropriate when there is an immediate danger to the sufferer. A sufferer who has been sectioned under the mental health act, or one who is suffering an acute episode may not be in a position to respond to motivational interviewing. Click here for further details on medical risk.
Our hope is that the practical skills and techniques presented here equip carers with a tool that will help them feel more confident and empowered in their caring role, reduce their anxiety, improve communication lines in the family and ultimately help them best support their loved one on their path towards recovery.