On the invitation of the owner of Peace of Mind Counseling, a fellow student at FICAM, I went to the impeccably planned, informative, well attended and deliciously catered CEU session held at Casa Tequila Mexican Cuisine on June 20th. While there I networked with other mental health professionals and listened to Mary T. Curtis speak about Motivational Interviewing. While the communication principles found in her presentation was primarily for those in the field of mental health counselors, they are also applicable to a number of other formalized relationships. Translated to the discourse of effective management, for instance, it’s a form of interaction and communication effective in instilling a convivial relationship that encourages long-term partnership.
Mary first had us explore some of the intrinsic and extrinsic motivations for personal changes that we’d made in the past. By exploring the risks we perceived we were making by committing to change, examining the struggles that we had with it, and identifying the various resource used in order to get there she pointed out how it was the job of counselors to be know these tracks and patterns as they relate to change and be able to assist clients. Mary then outlined out the cycle of self-transformative change. The cycle – precontemplation, contemplation, preparation, action and maintenance – was not made from air but emerged from the research of Dr.’s Prochaska and DiClemente.
Based upon the research contained therein, Curtis presented five distinct communication principles to follow in order to master the art of motivational interviewing.
1. Express sympathy.
2. Support self-sufficiency.
3. Create discrepancy in expressed intentions and actions.
4. Avoid arguments.
5. Roll with resistance.
Each of the five principles could easily make up a long essay. Summarized into a few sentences, however, they could be expanded as follows. First, have all of your attention and capabilities be devoted to the person across from you in such a manner that it’s clear your intent to assist them. Relate to their struggle to get better, but do not feel bad for them over the poor decisions they’ve made. Create and maintain rapport or the rest isn’t possible. Secondly, encourage efforts through praise when appropriate and make sure to provide directions in the form of leading questions as much as possible. This oblique form of direction will assist the transformation of their thought processes. Thirdly, through the aforementioned questioning process, don’t just inquire on actions but underlying motivations. Doing so will lead to the most significant changes. Fourth, one of the reasons which arguments occur is from the breaking of affinity. If and when this occurs use linguistic Aikido so that their resistance transforms into transference. The fifth principle refers to the fact that until the new habits are incorporated into the daily life there will exist a split of sorts in the interviewee’s personality and the better angels of their nature should be appealed to. Using their own spoken phrases as much as possible to restate the goals they’ve already voiced and their own assessments is the optimal way to interview them.
As is clear from the above, motivational interviewing is not merely an other-directed practice but one that requires a great deal of self-confidence to be able to accomplish the above practices without coming off as wooden or scripted. Embodying qualities of empathy, compassion, collaboration, commitment, willingness and acceptance are also key MI components. One must do this as expressing too much upset or disappointment over a violation of a stated goal breaks rapport. Instead help them self-search as to the causes to their failure and imagine how they could go act next time if placed in a similar situation. One’s role in the motivational interviewing process is supposed to engender feelings of Autonomy, Collaboration and Evocation. Encouraging ACE to develop in them means that they will learn to better self-discipline.
It is our ability to propel and direct ourselves into the future that determines where we go in life. Since counselors and managers are navigating the future together on a bark of sorts with their clients or employees, those leading must use OARS as one of their strategies for direction. OARS is an guiding strategy for meetings between clients or employees that encourages the growth of skills rather mere directive comments which engenders agency dependency. OARS consists of Open-ended Questions, Affirmations, Reflections and Summaries. These are the linguistic forms used to encourage ACE. Some examples of these are as follows:
Open Ended Questions
“What do you think are the main goals that we need to accomplish today?”
“What are your motivations for the cessation of your habit of __________?”
“What is preventing you for accomplishing your goals right now?”
“How would you rate your level of withitness today? Is there something that you can do to quickly raise your state of presence?”
Affirmations
“You should be proud of the fact that just last week it took you ___ amount of time and that now you can do it in less.”
“It looks to me by the way you are holding yourself in that you’re in a good mood. Did the _____ thing I suggested to do when face with _____ help?”
“Based upon the story you shared with me I can really see your commitment to _____.”
“You are doing excellent work.”
“You ability to take directions has markedly increased!”
Reflections
“Do you realize that your continuing to do _______ is in opposition to your statement that you want to stop?
“Do you realize that your continuing to do _______ is in opposition to the previous directions I gave you?
“Were you really doing your best on this project, or were you distracted by something?”
“When you saw that your abilities were not sufficient to complete the task, why didn’t you ask _______ or myself for assistance?”
Summaries
“It seems to me from what you’re saying is that the reason you began doing _________, which you no longer want to do, is because of __________. If you were to stick with instead of shirking the protocols that I gave you, your repetition compulsion would no longer be a problem. What needs to happen to get you to do such?”
“In what you shared with me you presented a very good manner for dealing with ________ that we’ve never discussed before. I think that you’re able to approach those triggers with novel solutions really indicates how committed you are to making that change.”
“Now everyone, before we close this gathering let’s just run down the tasks. A is doing this, B is doing this, C is doing this, and I am doing this. Any questions, you know where I’ll be!”
“Today we covered a lot of ground and I’m certain that once you leave our shared space you will maintain the strength you’ve shown here.”
These, which when combined can be said to be the concretization of Desire, Ability, Reason, and Need for change will lead to that change when a plan is set in place. To learn more, you can also download the accompanying Powerpoint here.