Very likely, most health care professionals support the concept, observation, and use of evidence-based practice (EBP). Technically, EBP means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Ideally, it results in more consistent clinical recommendations and practices across health care services. Motivational Interviewing (MI) research and its resultant evidence across a spectrum of health-ameliorating issues, demonstrate MI’s viability as an EBP. As health care professionals, we get to decide what kind of evidence we think meets our threshold of EBP and that might differ somewhat across professions as well as our varying use of evidence in working with the needs of our individual clients or patients. At the same time, it is important to consider what ‘evidence’ our patients/clients bring to us. Years of experience and observation suggest that clients rely on their perceptions of evidence about their health behaviours and potential changes. There is an old adage, the best predictor of future behaviour is past behaviour or, more simply, the past is prologue. There is, in fact, very little real evidence to support this adage as a blanket proof of behaviour. Common sense suggests, in terms of behaviour change, most of us prefer our comfort zone (see our blog on comfort zone meanings and potential) or, ‘we love the beast we know.’ What is intriguing and very likely a great reminder to professionals is how clients perceive their evidence. We are what we believe, as one colleague has told us. In some ways, it is as though we go through life gathering ‘evidence’ to support what we believe, almost as though we carry an evidence basket under one arm:
The idea here is that our clients often seek out and carry as ‘evidence’ only those ideas that support their viewpoints, other people who corroborate their ideas, what they choose to read etc. Any information that counters their current beliefs is often kept out of the basket in order to protect their evidence or point of view. In short, they might live in the land of MSU – Making Stuff Up to put into their evidence baskets – in deference to looking at their situation from a variety of perspectives. What can we do to help our clients see their evidence baskets without judgement but rather in service of them letting go into other ways of perceiving their situations? What questions can we ask to take them into the land of potentials for change? What mirrors can we hold up to show them what is possible when they are ready to make changes?