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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Taking the Good Lines

img_1919You are reluctantly remembering your last session with a client who wanted to quit smoking and feeling guilty that it did not go the way you would have hoped.

Your helper instinct kicked in and you were trying to have a conversation about the ramifications of his 2 pack per day habit of 20 years.  Unfortunately, it was like you were in the middle of a bad movie with you taking the role as the hero and your client being the villain.

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What are you HEARING? The 3 types of Talk in MI

IMG_3397Did you know that what comes out of your client’s mouth is highly influenced by what you are saying?

If statements from your client start with the word YOU it can mean they have perceived the conversation as potentially judgmental. In Motivational Interviewing we call this discord. Discord reflects the dissonance in your working relationship, and often conceals feelings of embarrassment, shame, guilt, or loss.

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© Copyright 2016 SGJ Consulting, Inc. Motivational Interviewing Trainer