What with this, that, and the other, people don’t take their medications properly. They don’t take them on schedule or for the full duration. They forget. They feel better. They experience side effects. When people fail to complete a prescribed drug treatment, the treatment is more likely to fail which then leads to a repetitive cycle, costing more time, money, and resource and sometimes along the way leading to premature death. If you are going to take the damn pill, take it the way it is prescribed! How to get people to take the damn pills?
Drugstore chains are training pharmacists to specialize in conditions like diabetes and teaching them motivational interview techniques that can help elicit patients’ reasons for not taking their medicines . . . In a study published in April in the online journal Patient Preference and Adherence, a group of patients taking cholesterol-reducing statin drugs for the first time participated in two face-to-face counseling sessions with a pharmacist at Walgreen’s and had better adherence to their meds than a group who didn’t receive counseling.
Motivational Interviewing is a well established clinical technique aimed at increasing the Other Guy’s motivation to get better. MI started with problem drinkers, found some success, then expanded out to other clinical problems. Properly done, MI works better (about a Medium Windowpane) than no treatment control or placebo treatments. While there are many features to MI (nicely outlined in this extensive pdf) the most notable element is the Central Route.
Along with standard psychotherapeutic tactics aimed at empathy, efficacy, and other “feel good” elements, MI is a talking strategy that makes the Other Guy get on the Central Route and engage the Long Conversation in the Head over the key Arguments behind the Change. The therapist keeps the focus on the Other Guy (following closely the second rule of Persuasion, It’s About the Other Guy, Stupid) and provides as little outside pressure, instead asking questions that make the Other Guy define all the TACTs (both good and bad behaviors), all of the Arguments, strong or weak, for all the TACTs, then a relentless focus on goals (Implementation Intentions, anyone?).
The therapist thus pushes the Other Guy into the persuasion gravity of Self Persuasion. Sure, the Other Guy sees a therapist or that pharmacist at Walgreen’s standing there, but all of the cognitive action and work stays in the Other Guy’s head, where it belongs.
Motivational Interviewing also understands and follows the persuasion Rule, If You Can’t Succeed, Don’t Try. A crucial element in MI – along with virtually all clinical interventions – is handling client resistance. Some therapies directly confront the conflict between therapist and client and work it through which typically produces many persuasion failures because clients are often highly motivated to successfully resist getting better. If the client can turn the interaction into a war between the client and the therapist, the client wins, the therapist loses, and the bad TACT continues.
MI handles resistance with persuasion insight – accept it. Take the Other Guy’s complaints about Changes at face value and do not try to counter argue them. In other words, don’t start a transaction where you as the persuader will often fail. Instead, when the Other Guy resists, simply redirect back to what the Other Guy has already said or done that is positive. In essence, change the topic and put the persuasion back where it belongs: in the Other Guy.
Now, let’s make a pivot from this clinical application to other persuasion Locals. We typically see Motivational Interviewing used with problem behaviors related to health and safety in a clinical setting, but the technique is general and could be used effectively in a profit setting, for example, especially when there is a longer time horizon in the relationship between buyer and seller or agent and client.
Take the practical problem of buying and selling houses. If you think about it, the real estate agent is highly similar to a therapist and the customer is like a client with a problem that requires change. MI would focus the agent’s efforts on getting the client to engage that Long Conversation in the Head over all the Arguments that are most relevant to the client, not the agent. MI also makes the client create and keep commitments with a relentless emphasis upon Internal Attributions (Why are we looking at this house? I said I wanted a house in a kid friendly neighborhood, not because the agent is pushing something on me).
The persuasion foundation and application of MI should be obvious. While it is employed in therapeutic settings, don’t let appearances fool you. MI functions as a coherent persuasion blueprint aimed at Central Route change within the Rules of Persuasion. MI actually works better on TACTs that are complicated with lots of contingencies and uncertainties. Your goal is to push the Other Guy into the persuasion gravity of Self Persuasion. Question the Other Guy. Make the Other Guy engage that Long Conversation. Focus the Other Guy on the Arguments he actually makes. Keep yourself in the background and don’t ever try to convince or counterargue the Other Guy.
Read up on MI and learn to adapt it to your persuasion Local when you seek Central Route change.
P.S. Just to be Professor PoopyPants, the WSJ headline writer describes MI as a Nudge. That, of course, is entirely incorrect, so hold out your hand while I smack it smartly with my persuasion ruler. Nudge, as the class knows, is Peripheral Route play that uses Cues to motivate Change. MI is a Central Route play that uses Self Persuasion on the Other Guy with that Long Conversation in the Head over Arguments. Of course, the headline writer is one of the highest paid employees at WSJ while Professor PoopyPants sits around the computer in his pajamas drinking Mountain Dew and eating Slim Jims. I’d rather be Right than Well Paid!!!