Motivational Interviewing and the Psychiatric Patient
Amanda Doyle
McKendree University

Motivational Interviewing and the Psychiatric Patient
A nurse’s role in counseling psychiatric patients or those with emotional trouble, is to listen to the patient, assess the patient to be sure there are no thoughts of self-harm, and to guide them through their choice to make a behavior change, and to help them make that change.
Psychiatric patients often have a hard time trusting others due to being judged for being different, being made fun of, and because of their own feelings about themselves. When interacting with a patient who suffers from a psychiatric illness or an emotional problem, it is best to introduce yourself first, and be firm about what is expected from nursing staff, and the patient, upfront before the conversation begins. As well, it is important to ask permission from the patient, or legal guardian if the patient is underage or not able to consent due to the psychiatric condition. Once the conversation starts, the patient should have the full undivided attention of the nurse; the nurse shouldn’t be distracted by other patient calls, her personal or work phone, or be writing during the conversation. Actively listening helps build the trust of the relationship, which is essential for getting the patient to divulge thoughts of self-harm. “MI guides the therapist to listen actively to the patient without communicating criticism, blame, or other judgements, regardless of personal opinions of biases.” (Behrman, 2006, pp. 215-225) Once reputable trust has been established, asking open ended questions is key. It allows the patient to open up, and really answer the question in depth, and lead to the next topic. Closed ended questions don’t allow for the flow of conversation and really feel as though the patient is getting the third degree from the nurse. “In