What are the best strategies for helping patients who resist lifestyle changes?

1 Build rapport and trust

The first step to helping patients who resist lifestyle changes is to establish a positive and respectful relationship with them. Show genuine interest and empathy for their situation, concerns, and preferences. Listen actively and avoid interrupting, judging, or lecturing. Use open-ended questions and reflective statements to elicit their thoughts and feelings. Acknowledge their strengths and successes, and express confidence in their ability to change.

2 Assess readiness and confidence

Not all patients are at the same stage of readiness to change their behavior. Some may be unaware, ambivalent, or reluctant, while others may be prepared, determined, or actively engaged. To tailor your interventions and avoid pushing or discouraging your patients, you need to assess their level of readiness and confidence. You can use tools such as the Transtheoretical Model, the Readiness Ruler, or the Confidence Ruler to help you gauge where your patients are and what they need.

3 Collaborate and negotiate

Instead of telling your patients what to do or setting goals for them, you should collaborate and negotiate with them to identify and prioritize their own goals and action plans. Ask them what they want to achieve, why it is important to them, and how they plan to do it. Help them explore the pros and cons of changing and not changing, and the barriers and facilitators of change. Encourage them to choose realistic and specific goals that are meaningful and attainable for them. Support them to develop strategies to overcome obstacles and monitor their progress.

4 Educate and inform

Sometimes, patients may resist lifestyle changes because they lack knowledge or information about the consequences of their behavior, the benefits of change, or the available resources and options. In these cases, you can educate and inform your patients in a clear and concise manner, using evidence-based sources and materials. However, before you provide any information, you should ask for permission, assess their current knowledge and beliefs, and tailor your message to their needs and preferences. You should also check for understanding and address any questions or misconceptions.

5 Motivate and empower

One of the most effective ways to help patients who resist lifestyle changes is to use motivational interviewing techniques. Motivational interviewing is a patient-centered and directive approach that aims to enhance intrinsic motivation and resolve ambivalence by exploring and resolving discrepancies between current behavior and desired outcomes. You can use motivational interviewing skills such as affirming, summarizing, eliciting change talk, and rolling with resistance to motivate and empower your patients to change.

6 Follow up and reinforce

Finally, you should follow up and reinforce your patients' efforts and achievements regularly. Provide feedback, praise, and encouragement for any positive changes or attempts, and avoid criticism or blame for any setbacks or relapses. Help them review and revise their goals and plans as needed, and address any challenges or difficulties they may encounter. Remind them of the benefits and rewards of change, and celebrate their successes and milestones.

7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?