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My blog for health care providers using MI about the process of change!

3 Tips to Remember (If You Wish) When Using MI!

Whether you recently attended a Motivational Interviewing (MI) workshop or you attended a training some time ago, it's always nice to keep a short running list of reminders to pace your practice of MI with ambivalent clients.  

Here are 3 tips to tuck away in your mind or to jot down as reminders when using MI in your work with clients!

1. The Michaelangelo Belief: Everyone has the inherent ability and resources to change. In treatment, our clients are faced with thedecision to change or not.  As health care providers, we can arrange the conditions so that change (in alignment with the client's values and goals) is more likely to occur.  The way we relate to our clients promotes change.  Warmth, acceptance, compassion, and respect are all necessary factors to help explore ambivalence about change, tip the balance, and to promote a safe place for decision-making.  

2. Remember Your Intention Behind Intervention: As health care providers, we can shape client language around change. Recent research (Barnett et al., 2014) suggests that counselors'  positively valenced reflections (e.g., "You're ready for a change") were more likely than negatively valenced reflections (e.g., "Quitting is something you don't think you can do") to be followed by change talk (language in the direction of change).  

At the same time, client language can influence therapist language.  Counselors were likely to positively reflect change talk and to negatively reflect sustain talk (language about not changing).  Counselors can strategically steer client language toward changing by using positive reframes in response to sustain talk.  For example:

Client: I'm giving this weight loss plan my best effort, but I feel like giving up on it every day.  It's soooo hard!

Helper: You are persistent and dedicated to this weight loss, even when you feel overwhelmed and discouraged. 

Once the sustain talk softens and change talk increases, continue to cultivate more change talk!

3. Reflect first!: Hold the reflex to ask questions while rapport-building or information-gathering.  Reflections differ from questions as they convey deeper understanding and acceptance.  Reflections sometimes yield more information than questions! When we reflect what a client is not saying (the best reflections) we strategically move the conversation along.  A win-win!

I hope these tips have been helpful.  Please feel free to share your tips that have been helpful in your MI journey!

Citation: Barnett, E., Sprujit-Metz, D., Moyers, T. B., Smith, C., Rohrbach, L. A., Sun, P., & Sussman, S. (2014). Bidirectional relationships between client and counselor speech: The importance of reframing. Psychology of Addictive Behaviors, 28, 1212-1219.

4 Comments to 3 Tips to Remember (If You Wish) When Using MI!:

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Anonymous on Saturday, July 16, 2016 12:16 AM
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Angela Bethea-Walsh on Saturday, July 16, 2016 7:36 AM
Thanks for the feedback! :)

Pam Lassila on Monday, February 06, 2017 10:29 AM
This is so good to remember that we all have the ability and resources to change! That is inspirational to think about. I have everything in my life that would help me be ready for a life change. I also love doing self-reflection and thinking about how I can improve. It's something I think that everyone should do.
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Angela Bethea-Walsh on Tuesday, February 07, 2017 4:22 PM
Thanks for your comment, Pam! It is SO empowering when we accept that we already have the resources we need to help us become our best selves. I also hope that everyone can learn and practice this, instead of believing the (sometimes) distorted stories that others tell them about themselves.

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