Ahead of the 2018 Virginia Oral Health Summit on November 8, we’ll be hearing from some of our speakers about their work to improve health. I recently spoke with featured speaker Dr. Matt Allen, a dentist and motivational interviewing expert, to learn more about the role of motivational interviewing in dentistry and health care.
Dr. Allen has been changing the way patients and dental teams interact for the past three years as a motivational interviewing trainer. As the only US-based dentist member of MINT, the Motivational Interviewing Network of Trainers, Dr. Allen works with clinicians across the country to change how clinicians communicate with patients.
The following Q&A has been lightly edited.
1. Tell me about your background and how you got started in motivational interviewing.
I started my career in a community health center in Denver that was one of the highest performing health centers in the country. While working there we had motivational interviewing trainers come in, and throughout the training I kept asking myself: Where is this in dentistry? What does this look like for a dentist in the room with a patient? I was excited about the role it could play in providing better patient care and was looking for resources to implement, but found there were none directly related to dentistry. So, I went and spent a couple of years getting trained to understand what the core skills were that could make me a resource for the dental community on motivational interviewing, which led me to where I am now. Through my work I’ve come to see myself as someone who prevents disease, and I’m working with dental teams to help them see the possibilities in motivational interviewing to keep people healthy, too.
2. What role does motivational interviewing play in providing the best care for patients?
Patient centered care is becoming a feature of modern dentistry, and I think that that’s really exciting. It’s hard to be patient centered if we don’t listen to the patient, and for a long time, oral health was telling people what to do and how to do it, and spending little time actually talking about why patients might want to do it or how their life might improve if they were to do it. Many of the questions that we might ask a patient in motivational interviewing help them understand and develop their intrinsic motivations to want to do something and help us understand the barriers they face. For example, a patient may live in a community where the closest place to buy food is a convenience store 30 minutes away, and there’s no healthy food options there. That patient may have the desire and motivation to eat healthy but they lack the resources, and through motivational interviewing we can understand and help address that.
3. How can dental teams integrate motivational interviewing into their work?
Two of the important skills we teach right away are collaborative sharing of information and reflective listening. For the first skill, we recognize that there are two experts in the room. We know we have important dental information to share, but we often forget to hear what that might mean to a patient. Questions like “How do you feel about that?” or “What questions do you have about the information?” after sharing information can help make a monologue into a conversation, creating partnership and developing trust. The second piece is reflective listening, which helps people feel listened to and validated, not judged. Reflective listening is a skill that we aren’t taught so it can be challenging for a lot of people. To really integrate motivational interviewing the key is to see the patient as someone already capable of doing the right things for their health; we’re simply trying to help them understand that and evoke it from within. We’re walking alongside them as partners instead of gatekeepers to health.
4. The theme of this year’s Virginia Oral Health Summit is advocacy, equity, and access. What role do those themes play in the work you do?
For me, all three are integral. Motivational interviewing needs advocates right now, especially around payment reform. One of the biggest challenges I hear is how to make time for this; creating the space for these conversations takes time, and to do that we need to create more sustainable payment methods. On equity, I think there’s a fundamental shift that occurs with motivational interviewing on who holds the power in the conversation, makes the care more equitable. As I mentioned above, the dental profession has historically viewed itself as a gatekeeper to oral health, but with motivational interviewing, we attempt to honor the autonomy of the patient and help them take control of their healthcare. And on access, a lot of what we talk about in terms of access revolves around people getting in to see a dentist, and while this is important, we also need to ensure that when people get into the dental chair the experience is different, more inclusive.
Register for the 2018 Virginia Oral Health Summit to hear more from Dr. Matt Allen and the rest of our exciting speakers.