Do you really know what the FOCUS Is?

A client makes an appointment to come see you due to drinking, depression, or some other desired change and through a brief conversation on the phone you think you know what their focus is. BUT…is that really their focus? Is the topic they called about really what they truly want to change in their life?

Focus is the second process in Motivational Interviewing after engagement is created and a collaborative working alliance has been established. We can easily fall into the trap of creating too much of an intensity around a specific focus which may break the alliance or cause a client not to return for another appointment.

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Empathy as Medicine

Research clearly indicates that the greatest predictor of why people change is empathy on the part of the professional.  So how do we show empathy in a conversation to allow our clients to experience empathy versus just generating an empty chair of sympathy?

How do we use empathetic reflections that allow our clients to know we understand their thoughts and feelings?  It starts with going beyond the content of what we are hearing. In Motivational Interviewing, we sometimes refer to it as the “backstory” of reflecting feelings or thoughts that have not been stated.

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Why does Motivational Interviewing work?

While in Ireland last month for the MI forum Bill Miller gave a talk on “MI and Social Dominance.” He begged the question “why does MI work at all? How is it that a relatively brief conversation can trigger change in behavior that has sometimes persisted for decades?”

He offered an explanation by Bill Neto, an Australian psychologist – that how MI influences behavior may lie in our evolutionary past.  “When faced with a dominance challenge, an individual may counter-attack, yield or withdraw…and these behavioral routines serve to promote survival of a species.”

He went on to say that “when directed or advised what to do, exerting the freedom not to comply signals a higher position in social dominance while submission represents subservience.”  Because our clients are the ultimate decision makers in their behavior, being noncompliant is a simple way to exert their freedom.

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Choosing WHAT to Reflect…

Your client who comes in weekly is stuck in ambivalence.  HOW do you help them get out of the quicksand and have a different kind of conversation?

One thing we teach in Motivational Interviewing is WHAT to reflect. Are you reflecting the ambivalence, or the vision of your client?  How do you cherry pick the flowers out of the shrubbery?

If you “invite” the client to discuss the problem, guess what you will hear for the reminder of the session?  You will hear more of the problem. Choosing what to reflect can be instrumental in turning the conversation towards change  and “change talk.”

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It’s Not about the Questions

When I’m talking to a professional about how to help their clients with conversations about change I frequently hear “I don’t know what questions to ask?” or “If I just knew how to ask the right questions I’m sure I would get more answers.”

What if it’s NOT about the questions? 

We want our clients to talk about change, about their lives and be authentic in their conversations.

In reality, a question is looking at the problem from the OUTSIDE.  But what about the INSIDE?  How do you get to the inside and trust the person in front of you has the answers and wisdom inside of them for whatever change they need to make?

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© Copyright 2018 SGJ Consulting, Inc. Motivational Interviewing Trainer