The Heart of Motivational Interviewing
As a trainer of MI for almost 20 years I am constantly thinking about how to train and teach this challenging language. Recently I came up with what I think is the heart of MI in one slide. If you stay with these 4 things, it will help you use the language without having to worry too much about technicalities and details.
1. Stay neutral – if you force a direction your client will likely take the opposite approach which is just human nature. Although you want the best for your client true partnership requires equal power sharing. You can still be directional (not directive) towards change with the skills. An example of a directional change (without having an agenda) might be “you would really want to figure out a way to stay sober” if someone is talking about their struggle and that they are considering sobriety.
2. Look for change words – whatever words the client states that go towards change reflect them back to them. Even if a client has only a few change words when you are saying it back to them it will plant a seed towards growth. For example, you might hear, “I know smoking is bad for my lungs, but I can’t imagine a day without cigarettes.” You could respond “you really care about your lungs and your health and are wondering what it even be like to give up smoking.” This shows you are saying what they want in an empathetic way.
3. Hold the hope – our clients come to us for hope and part of our job is looking for the hope underneath any struggle. For example, if your client says, “I hate my life” you can say back to them “and you’re looking for ways to make it better and that’s why you showed up today.”
4. Reflect and summarize hope and change and if not present evoke it. Even if you hear no hope or change words using the skill of “evoking” may be the first step. For example, “when you were able to do X (behavior change) what helped or seemed to work at that time?” You are pulling for past success to remind those you work with they have past successes and wisdom in how to help themselves. Many people forget they have been successful in the past and only focus on struggles.
Using these 4 skills of MI can change entire conversations and lives and our job as helping professionals is being intentional about all our words. Using the skills that are the heart of MI will help connect people with their own hearts which in turn can lead them towards the changes they truly desire.
