motivational interviewing is awesome but what is an example of motivational interviewing and if i wanted to do one how do i start it in this video you'll hear from sandstone care ceo michael hunter as he explains the oars concept and how to use it to shape a motivational interview hey it's clint with sandstone care where we help teens young adults and their families overcome challenges that come with substance use addiction and mental health conditions all right let's get right to it so collectively what you're talking about is a is just a specific set of behaviors
so we're typically asking open-ended questions using affirmations reflective listening and summaries right that's all we're doing with motivational interviewing in terms of the behaviors themselves but it's how those behaviors get deployed that makes it motivational interviewing or not right rogerian or kind of non-directional conversations with clients use those same skill sets use those same behaviors so they just get employed differently part of motivational interviewing is understanding where folks are stuck in their ambivalence are they stuck uh because they feel like they can't make the change happen even if they want it to happen do they
feel like they're not able to make the change even if they want it or is it an issue of importance it's uh it's just you know they feel like they could do it if if they wanted to it's just not important right now uh in their lives and so you know in motivational interviewing if the issue is somebody feeling like they just can't do it oftentimes strategically what we're up to is helping to link other successful behavior changes in their life to the current struggle the gentleman in particular that i mentioned just a little bit
ago uh the key for him uh in his exploration was that he was the ceo of a of an organization he started at an entry level position and worked his way up through the company and and uh ended up in this uh really cool position there and he was very proud of that and so we started talking about all the things that made him successful in getting uh to where he was career-wise and uh it turned out that a lot of the strategies that made him successful there were strategies that he was able to employ
in the way he was thinking about uh addiction so he sort of came to know himself as being more powerful in addressing the behavior than he thought he was initially and that was very powerful and so one uh powerful tool of course is linking um the current struggles with previous uh successful behavior change and finding parallels between those another if if the change is not important is to help develop uh discrepancy between where somebody sees themselves now and important future goals or where somebody sees themselves at now and their set of values if people feel
like their values are in conflict with the current behavior it creates discomfort you know cognitive dissonance we don't like that experience as human beings we generally will either resolve it in one of two ways we're either changing our behavior or we compromise our values and change those and so in exploring those we help in some ways to turn up the temperature on that cognitive dissonance a little bit which can increase the importance and the urgency of making the change now so it increases the likelihood that someone will make the change so i'll get we can
give some examples of questions for sure um i think one of the challenges that comes up when learning motivational interviewing is that it needs to look a specific way and oftentimes that's one of the challenges that comes up when you see somebody demonstrating it is it's easy to assume that that person is doing it the one right way and so there's a tendency to want to emulate that and really motivational interviewing is an incredibly flexible system which is one of the reasons that for me i really fell in love with it is it is as
flexible as the clinician practicing it and so there is no one right way to to respond and um even though generally speaking right the strategy might be to increase change talk over time that doesn't mean that we don't explore the difficulties that people have in making the change oftentimes people can get stuck in feeling like other people don't understand their struggle and so until somebody understands the nature of the struggle it becomes difficult to move on from what makes it hard and so sometimes you have to sort of establish through you know often open-ended questions
or reflections what it is that's making an experience difficult for someone and so maybe a good opening a classic open-ended question and you know in a situation like that might be as simple as what are some of the good and not so good things about smoking marijuana and that's a lot of what motivational interviewing is about is it's about understanding the dynamics in conversation what kind of reflection or you know what kind of a response is this reflection or this open-ended question going to produce in the other person right for instance let's say you were
an adolescent coming into treatment and you were smoking marijuana and you really liked it uh it's just that your parents don't like it right even subtle language changes can can influence uh kind of how somebody is likely to respond so in that situation if i were to say tell me all the bad things about smoking marijuana i might get a response that's like well there's nothing bad about it the bad thing about smoking marijuana is that my parents are terrible and they want me to stop that's the bad thing right and and so using kind
of exploratory uh kind of um uh soft language around some of those explanations can help uh prevent it from becoming contentious you know um in motivational interviewing oftentimes what we talk about is that uh resistance or you know kind of that push-pull of the conversation is is actually created uh oftentimes by the person uh the clinician who's having the conversation with the client right in the language that they're using in some of the assumptions that get telegraphed to the other person remember the goal here is not to assert my values onto the person i'm having
the conversation with but to under but to understand their value set right what's important to them and you may find that there's alignment in unusual places right so the uh oftentimes when adolescents do make behavior change around something like marijuana for instance it's not necessarily because they're saying i want to remain sober for the rest of my life and that is the only thing that matters to me oftentimes it's a it's a subtle adherence to a non-obvious value like i want my parents off my back i want a good relationship with my parents i want
to do better you know in this other area of my life by kind of exploring those things and then in a in an open-ended non-judgmental there's that kind of the unconditional positive regard that you're going to see this person as an amazing human being no matter what it is that they share with you you see you're you're committed to seeing kind of the the nature in them that is powerful and good and positive and and um when people get a sense of that they tend to explore in a less guarded and um uh you know
in a way that's less set on stacking the deck against um behavior change yeah so affirmative affirmations typically recognize a strength or a quality of a person that admirable affirmations also at times are an opportunity for a potential reframe of something somebody else sees as a weakness but from a certain point of view is a strength so if i were having conversations uh a conversation with someone um and they mentioned well i've been to treatment three times before and the longest i was ever able to stay sober was was only a month and it's just
an absolute failure and i can't believe i i couldn't do it and so i don't think i'm going to be able to do it here because i you know just it's just more failure um right you know uh potential the potential um strength there is that you actually are talking about a person who every day for 30 days woke up made the decision to be sober and then was successful throughout the course of the day no matter what came up you know a powerful reframe there right is wow okay you were able every day to
stay sober for that period of time what were you doing during that 30 days that made you so successful or you know oftentimes you're talking to uh someone and they frame something in a conversation in a way that's different than you would have thought to frame it and you know that may be an opportunity to say wow you know i really like the way that you you framed that uh or you know you've done an impressive job of hitting your goals this week right and for many folks affirmations are not a natural cadence in their
conversation and generally speaking it can be powerful to do that especially for somebody that's coming to you who who is face to face with this massive struggle this thing that they are up against and they may feel like nobody sees them as strong capable or competent and so recognizing those areas where they are any of those things and more can be very powerful in terms of building that sense of self-efficacy or that sense of one's own ability to accomplish change so you're you're kind of actively reinforcing those qualities as they become evident through the course
of the conversation i think affirmations are also more powerful the further they are removed from the person giving the affirmation so if i were to say something like wow that's you did a really amazing job hitting the goals that you had set last week right it's a little detached it's sort of a it is a quality assessment of what they've done but it is uh it is different than saying wow i'm really proud of the way that you did x y or z right where somehow i'm inserting myself as an important figure and my pride
somehow should be impacting you or uh you know that sort of dynamic that gets created by inserting a little more self of clinician than than really what is necessary if that makes sense in other words the conversation really is about the person you're talking with not about us and so whether i you know my my own value judgments uh to the degree that i can let those drop away and be framing even the affirmations in their language and and according to their value system that only is going to reinforce their likelihood for success kind of
an interesting uh rabbit hole there is a i did two years where i was working on doing ongoing kind of advanced level motivational interviewing training for a woman's uh shelter and one of the things that they shared with me is that often times when a woman would leave her abuser that this was a process that would statistically occur about three times before that person would leave for good and that oftentimes for clinicians there was a tendency when they were finally ready to leave to jump on the bandwagon of really bashing the person that they were
leaving and what they found is that doing that really communicated in a strong overt way the value system of the clinician which made the clients less likely to come back to that same location in the future if they went back into a relationship with that person whereas if that value system wasn't overtly sort of you know blasted on to that person then they they felt that there was less judgment that they could come back that they could have those conversations reflective listening is uh is just the coolest thing there has ever been uh in the
history of human communication it is the clinical skill most highly correlated with good client outcomes and it also tends to be difficult to learn and it's difficult to learn to do it well reflective listening is a way of hearing what someone is telling you and then checking your interpretation of what they are telling you back with them by kind of reframing it and giving it back to validate that you understand what the person is telling you there are all sorts of reasons that communication can break down there are all sorts of reasons why i met
might misunderstand you and so uh reflective listening closes the loop on that sometimes you may be talking with somebody who doesn't have the uh vocabulary to articulate in detail exactly what it is that they're struggling with and so maybe their words don't even at times match the intention of the message right and so being able to to check our interpretation against theirs is an important uh part of validating that we're on the same page as them right wow sounds like you're really struggling in this relationship with your mom uh because she nags you all the
time about your marijuana smoking which you don't think is that big of a deal right so kind of checking am i getting this am i getting what you're putting out there and in the beginning uh reflective listening is powerful in that function it it serves the function of validating conversation but with skill and practice over time what you learn with reflections is you're going to be thoughtful about what you reflect so you're picking out the parts of the client statement deliberately that you want to reflect back so that that's what they're likely to run with
and so especially where change talk is concerned right you might hear someone say something like um um you know like i wish i could stay sober but you know over and over again i fail and um and you know that my relationship with my wife is terrible as a result of it and and you know to be honest i'm not i'm not even sure that um that anything in in my life really makes a difference that i do right there's a lot there there's tons to unpack and so what you reflect out of that statement
kind of will determine where the person moves next and so you can you know so you mentioned at the beginning of that statement that you wish you could stay sober and so there's some part of you that that uh seems to be kind of hanging on to that despite all of these things that are coming up for you so summaries essentially are are kind of complex uh reflections where we're taking bits and pieces throughout the conversation pulling those together kind of presenting them back uh david rosengren who's one of the folks that uh taught at
the training of new trainers when we did that uh in new mexico said you know we're kind of gathering these bits and pieces and handing it back to them in a bouquet right so uh summaries can help bring things together uh transition to a new topic or uh frame the totality of the conversation what's been accomplished uh so far and so so those are kind of your your basic skills um with motivational interviewing and you're really uh employing those along the lines of certain principles so you're up to four things using those tools and and
so you're developing discrepancy as i mentioned rolling with resistance so resistance in motivational interviewing is not generally directly confronted and um it's it's it's more of um a style where you know we're working on collaborating you know we're not directly challenging things and so there tends to be at lower friction in those kinds of conversations we're expressing empathy which is basically reflective listening checking our understanding against theirs and then we're supporting their self-efficacy or their sense that that they have the ability to accomplish what they what they set out to accomplish if you want to
learn more about treatment options for you your teen or young adult then tell us about your situation on a confidential call using the number linked up in the description box below or live chat with us at sandstonecare.com we'll connect you with the treatment that you need and if we're not the right bit we'll get you where you need to go be well and remember that change is possible [Music] you
