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When you’re working as a counselor, therapist, or social worker, it’s tempting to tell a client how to fix their problems, then judge their behavior and get frustrated when they get stuck and self-sabotage instead of changing their lives for the better. Fortunately, there’s a more effective way to connect with clients: Motivational Interviewing.
The Motivational Interviewing technique can help human service providers alleviate their clients’ resistance to change, identify their goals, and create sustainable change—as well as reduce the providers’ own burnout.
A three-session Motivational Interviewing training is currently being offered by the Alma Institute’s Co-Founder, Shawn Smith, for Public Policy Institute grantees and coalition partners. During the first two sessions, attendees have learned how to use this conversational style to help clients come to their own conclusions about why they need to change, and how. In doing so, the served person uses their own motivation and wisdom about their life and choices, which increases the chances that they will sustain the change.
“Don’t get the person on your path,” Smith counseled. “Get them on their own path.”
As Smith explained, William Miller, Ph.D., began developing the seeds of Motivational Interviewing more than 40 years ago when he was studying at UW-Madison and working with clients who abused alcohol while interning at the VA hospital in Milwaukee. As Miller recalled in an interview with the journal Addiction in 2009, “I essentially asked these people—mostly men—to teach me about their experience. ‘How did you get to this place in your life?’ ‘What’s been happening in your life?’ and ‘Where are you going from here?’ I didn’t have any therapeutic advice for them, so I just listened, and they seemed to appreciate that, to respond well.”
Miller’s approach, which showed respect and empathy for his clients, contradicted the then-common view of alcoholics as untrustworthy, manipulative liars.
In the early ‘80s, Miller began to focus on creating the conditions that would allow the client to make their own arguments for change—in other words, to zero in on their motivation to change. The result that evolved was Motivational Interviewing, which showed early success. Studies at the time showed that problem drinkers who received a Motivational Interviewing session and treatment were twice as likely to abstain from alcohol than their peers who got treatment without Motivational Interviewing.
Miller told Addiction that the key to Motivational Interviewing’s success is making the client feel accepted in a safe environment free of judgment but full of empathy.
“I think that as people are enabled to talk about their present situation without immediately being told what to do, without being given advice, without with being judged, shamed, scolded and so forth, they literately talk themselves into changing,” Miller said.
As the Alma Institute’s Smith told his practitioners-in-training, primarily from SET Ministry and The Parenting Network, Motivational Interviewing targets the served person’s stated desire to change their behavior in very brief conversations, sometimes clocking in at under three minutes. Motivational interviewers allow the client to tell their own story, and encourages practitioners to listen empathetically, identify “change language,” and reinforce the client’s motivation, strengths, and ability to resolve their problems. Although interviewers learn how to offer reflections that can provoke insights, they don’t confront their client, which can create defensiveness and distrust, or negate or judge that person’s experiences. Instead, the reflections let the served person know that they have been heard, understood, and affirmed.
“Motivational Interviewing allows an individual to source their own wisdom, which increases the chances the person will sustain the change,” Smith said.
An added bonus is that using Motivational Interviewing reduces the service provider’s burnout, compassion fatigue, and vicarious traumatization and increases their success and self-awareness.
During Smith’s highly interactive training sessions, attendees learned step by step how to use the Motivational Interviewing technique. They started with simple conversations about one specific behavior; by the end of two sessions they were role playing as a client and Motivational Interviewer, both in pairs and in a group setting.
Smith has also added a Trauma-Informed Care component to his sessions to help practitioners address their clients’ feelings of powerlessness, a primary trait of traumatization. As Smith explained, those who have experienced trauma benefit from Motivational Interviewing’s creation of safety, trust, collaboration, empowerment, and compassion between the speaker and listener. This demonstration of respect can help the individual who has experienced trauma to learn how to appropriately respond to emotional triggers, build problem-solving and critical-thinking skills, and find a sense of purpose and determine future goals. That will create long-lasting changes not only in the person’s behavior, but in their physical body.
“Our brains will rewire throughout our lives with awareness, intention, and effort,” Smith said.
Practitioners also can use Motivational Interviewing outside of a therapeutic setting. Smith said he occasionally switches into Motivational Interviewing mode when a colleague or partner wants to discuss a thorny problem. And it’s easily adaptable to any personal relationship, including the parent/child relationship, as it fosters a partnership based on mutual respect.
PPI will likely offer another opportunity to learn Motivational Interviewing this autumn. Sign up for PPI's Prevention Journal to learn about it when it's announced.
Posted Dec 13, 2017
Posted Dec 1, 2017