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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Taking off the Stems

IMG_4755You’ve just bought a beautiful bouquet of flowers and are heading home. What’s the first thing you do before putting them into a vase to enjoy? You take off the wrapping, pull out your scissors and cut off the stems so they have the best chance of survival for the week. Then you put the little flower preservation packet in the water before putting the vase on display.

Classically therapists were trained to use conversational stems such as: “it sounds like,” “I’m hearing,” and “I understand that.”

In MI we say “stems” dilute the meaning of a reflection and can actually be manipulative.

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What you Say MATTERS

IMG_2481Do you frequently come home tired?  Do you wish your conversations felt more serene?

Ever wonder how you can truly make a difference in your clients’ lives without having to try so hard?

I’m here to argue that Motivational Interviewing can save you energy, time and shift the conversation towards change.

What you say REALLY does matter!

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New Registered Dietitian Experiences Motivational Interviewing

IMG_2945Looking back on these past 6 weeks, there are so many new things I have learned from Susan and about myself. A highlight of my internship was finding out about motivational interviewing (MI) through the trainings I attended.

Motivational interviewing is a language to help resolve ambivalence with behavior change. What is remarkable about this language is that any profession can benefit from it. It is a language that gives you the tools to evoke change from within a client for what works for their individual lifestyle.

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Climbing the Wall of Change Talk

56e0c5a7-fbcf-4402-91a2-b839d1676dccThere’s no greater feeling as a practitioner when you hear your client arguing for change instead of you trying to convince them of change.

  • “I think I could quit smoking in the next 3 months”
  • “I really want to lose 10 pounds”
  • “Drinking is not the celebration I thought it once was”

So how do you generate those types of conversations and as we say in MI “shift away from the jaws of ambivalence?”

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Spicing up your Motivational Interviewing Skills

IMG_2113Motivational Interviewing is a language and skill that takes time to learn. As one of the founders of MI Bill Miller states:

“In some ways MI is simple, but mastering it is neither quick or easy.”

So how do you increase your skills besides just going to a workshop and reading MI materials?

Submit a client conversation tape for coding.  It’s the sweet way to build your collection of skills.

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© Copyright 2018 SGJ Consulting, Inc. Motivational Interviewing Trainer