The Hammer Metaphor
If you have only been trained to use hammers (give health information & advice), you tend to see every risk behavior as a nail. Giving information and advice to patients about changing their unhealthy behaviors is equivalent to the placebo impact of nineteenth-century drugs. The use of this "drug" over and over again, when it is clearly not working, should be regarded as a medication error.
The Nut and Bolt Metaphor
But hammers do not work very well with a nut (risk behavior) rusted to a bolt (patient). Hammering away at patients may make things worst, and even damage the threads of the bolt so the nut never comes off.
The Gardener Metaphor
You will work effectively with patients if you change from using fix-it metaphors (your toolbox of hammers, wrenches, etc) to the gardener metaphor:
- Cultivating the soil
- Planting seeds
- Fertilizing the ground
Changing Metaphors and Roles
With this shift in metaphors, you can let go of being the take charge, "fix-it" adviser and no longer impose your perceptions and values on your patients. Become a motivational guide and let your patients to decide whether they want to change their perceptions and values about behavior change.
more about the book, Motivational Practice