Compliance to medical treatment relies on the patient’s or client’s willingness to change. And as many providers of medical services can tell you, patients and clients come to treatment with varying degrees of motivation to do what their providers say they should do.

Therefore, providers of medical services are not only in the position of diagnosing and informing patients and clients, but also joining with them in a partnership to promote change.

Promoting change begins with understanding what the block to change is, then knowing how to resolve it. Blocks to change may include:

• The patient/client is underinformed.

(That sounds better than “ignorant.”) Clients simply don’t understand why they need to change and what the consequences of not changing may be.

Even if they nod their head in response to your verbiage, ask for feedback on what they heard. Say, “I just want to make sure what I’ve said is clear” versus “I’m not sure what you have understood.”

The former appears less condescending, which can be off-putting to someone who may already be defensive or overwhelmed.

• The patient/client is overwhelmed.

Validate new information, especially regarding one’s health, can feel overwhelming.

Remember, the patient/client has entered your world, where the concepts, words, sights and sounds are common to you but foreign to them.

Think about how you would react if you were thrust into a factory environment where your health depended upon quickly assimilating a lot of new information.

If the patient/client appears overwhelmed, break the treatment plan down into steps.

• The client is defensive.

Defensiveness is often related to feeling powerless. Work with the client’s attitude, not against it. Otherwise, you set up a power struggle — the last thing you want between you and your patient/client.

Obviously, you have to lay out the treatment plan and the consequences of not following the plan. Still, compliance is always the patient’s or client’s choice. If the patient/client balks at the whole treatment plan, ask what he or she is willing to change now.

• The client is overinformed.

There are many ways patients/clients receive medical information ranging from the Internet to their Aunt Sally.

The Internet — with its mix of authoritative Web sites and those of commercial or anecdotal value — may give patients and clients a false sense of knowledge.

If your patients or clients are Internet savvy, give them a list of germane Web sites with accurate information.

Don’t try to argue the merits of what they’ve learned from TV commercials or a relative. Just say, “Based on the information about you from exams and tests, I think this is the best course of treatment for you. I can’t speak to all the variations or alternatives you may encounter from other sources. Each person is an individual. These are my recommendations for you.”

• The patient/client perceives the provider is not invested in treatment outcomes.

It is easier to trust providers who appear genuine in their efforts to help the patient/client achieve greater health. Ways providers can convey genuine interest include listening to the patient/client with an open attitude and attempting to understand any objections to treatment.

• The patient/client is depressed.

Depression zaps motivation. If your patient/client exhibits an attitude of “I don’t care” or “It doesn’t make any difference to my health if I try or not,” screen for depression.

Stephanie Hittle is a licensed professional clinical counselor in Centerville and can be reached at hittlesa@gmail.com.