Motivational Interviewing

I really enjoy learning and have challenged myself to learn something I consider substantial every year.  When I was in the first semester of my freshman year in college, it was learning how to learn.  When I completed graduate school, it was learning to read for fun.  One year, it was learning how to sail big sailboats and another year it was scuba diving.  When I turned 50, it was riding a motorcycle, not as a mid-life crisis but as a mid-life adventure.  I really look forward to learning the rest of my life.

If there is one thing I wish I knew when I was an early career psychologist and a young husband and father, I think it would have been Motivational Interviewing (MI), a skill or approach developed by distinguished psychologists, William Miller, Ph.D. and Stephen Rollnick, Ph.D.  MI as an approach is infused with respect and compassion for the clients we get to know and the people we talk with in our everyday life.  According to Miller and Rollnick, MI is done “for” and “with” a person and it is not something done by an expert to a passive recipient, like a master to a disciple. (Miller & Rollnick, 2013, p.15).

Even better, I would have learned this approach in graduate school as I would have been much better equipped to manage my first videotaped, supervised therapy appointment that involved an angry, 14 year-old adolescent who told me she was “forced” to come in by her parents and she would not be talking during the appointment.  Well, her commitment to not talk was a 10 on a 10 point scale, and I found out later in supervision that the videotape didn’t catch my heart racing and my fight or flight response kicking into high gear.  I suspect we have all had those experiences in our offices where we would like to push the pause button and head to Maui.

I suspect that if I would have been skilled in MI at the time, I might have anticipated the discord of the adolescent in being “forced” to come in to talk with some stranger.  Rather than experience my body go into a fight or flight mode, I would have had the client-centered listening skills to understand and effectively reflect her displeasure in coming in, and I might have been brave enough to evoke her ideas on the changes that needed to be made in order to get her parents off her back.

The importance of the therapeutic relationship as a concept crucial to facilitating change has been well documented, and what I like about MI is that it provides step-by-step guidance for engaging the client in a helpful connection and a working relationship.  It helps us focus on a particular agenda, evoke and strengthen the client’s own motivation for change, and finally to make a plan for how to change.  MI is not a canned approach and with practice, it starts to feel pretty natural in your office and in your conversations with others.

If I would have been skilled with MI in graduate school or as an early career psychologist, it would have made a huge difference when dealing with a number of therapy issues where ambivalence is common.  It is estimated that 25 cents of every health care dollar is spent on the treatment of injury or diseases that result from potentially changeable behaviors, things like smoking, alcohol abuse, poor diet, failure to use seat belts, overexposure to the sun, and lack of exercise.

While I don’t consider myself a salty old dog just yet, I am aware that there is wisdom from experience and the collective ideas of others.  Consider getting trained in Motivational Interviewing.  You can find a wealth of information and training dates on the MI web page at http://motivationalinterview.org/.

Also, know that MPA provides psychologists with a way to connect and share knowledge, ideas, stories, resources, PowerPoints, and even vacation destinations.  Please check out the MPA web site for a number of opportunities to learn and connect.

Scott Palmer, Ph.D. is the Director of the Behavioral Health Clinic at St. Cloud Hospital, an assistant adjunct professor at the College of St. Benedict/St. John’s University, and is President-Elect of the Minnesota Psychological Association.  He is a volunteer member of the Red Cross, where he provides psychological first aid to survivors of local or national disasters.  He is a member of the Motivational Interviewing Network of Trainers (MINT) and uses MI in his practice to help people move toward positive change.

Reference

Miller, W., & Rollnick, S.  Motivational Interviewing: Helping People Change (2013).  New York:  Guilford Press.

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