Motivational Interviewing

Are your clients stuck like these people in this video?

I am sure you have clients like this.  Positively Absolutely.

How do you respond?

What do you do?

Are you the repairman in the video or do you have another role not shown in the video?  Why or why not?

What would a person practiced in motivational interviewing do to help these people?

Please go to my blog and post your comments and thoughts!

If you are like most, you didn't relish the shift from toward "resistance" when the book Motivational Interviewing first was published.  Next year, when the 3rd edition of Motivational Interviewing (MI3) is published, the concept of "resistance" will be gone completely. 

And I for one am glad.

Counselors who slap clients as in "denial" are pathetic and should surrender their license. 
        (what, you don't like being labeled?!). 

Fortunately, labeling clients as in denial has become in many places "politically incorrect" meaning is has been replace with "resistant" (code word:  "denial") when blaming clients for our lack of clinical ability.  What will these people do when this concept is gone in MI3?

MI3 has many changes -- it is looking like it will be as different from the second edition of Motivational Interviewing as the second edition was from the first.  But this shift completely away from "resistance" is, IMHO, the biggest (and best) change.  

"Resistance" has been replaced with sustain talk plus discord between the client and the counselor.

For those unfamiliar with motivational interviewing these days, we are focused on two client verbal responses:  

• sustain talk and 
• change talk.

What we know works is change talk.  The more the better.  And, at the risk of over simplifying motivational interviewing, our techniques in counseling are focused on getting more change talk and less sustain talk.

Two other factors come into play here:  the client is either connected with the counselor (there is harmony in the relationship) or disconnected with the counselor (there is discord in the relationship).  Make sense -- are you with me?

Now, let's look at what happens when these factors interact around a particular target behavior:

To illustrate, consider this framework using the example of stopping cigarette smoking as a target behavior:

The great thing about this framework is that all areas are impacted by the counselor. So blaming the client for clinical shortcomings should be a thing of the past next year!

What do you think?  Share your comments.