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Motivating our Clients!

May 18, 2012

Speech Pathologists find themselves surrounded by people everyday, whether it be adult or child clients, families of the people we work with, professionals from other disciplines or fellow SLPs. A big part of this interpersonal relationship is problem solving the many issues that may arise, such as deciding which direction to take treatment, convincing clients that they will benefit from SLP services, and dealing with professional differences in attitude or approach.  When counseling clients or problem solving with co-workers, there are certain approaches that might aggravate a difficult situation, and others that can be used to help conversations flow smoothly along to a compromise or solution.

My SPA900 research project this term, and a recent topic of discussion in class, is on the subject of Motivational Interviewing, a specialized form of counseling originating in addictions counseling and currently being used in many areas of the health care field. Miller and Rollnick, considered to be the grandfathers of the technique, defined Motivational Interviewing as a “directive, client centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.” By using the techniques that make up the counseling approach, clinicians help a client get to the point where they are self motivated to change and find a workable solution to their problem.

Motivational interviewing involves several principles, strategies, and aspects. In order to become a great motivational interviewer, you will need to learn how to express empathy through statements of understanding and reflection, develop discrepancy by helping the client to see the difference between where they are now and where they want to be, roll with the resistance that clients might offer you and instead focus on positive statements, as well as support the client’s belief in their own ability to change. To do this, clinicians are taught to use open-ended questions, affirmations, reflections and summaries to help collaboratively guide the client to a positive decision.  The goal of the technique is to collaborate rather than confront, evoke rather than educate, and help the clients realize their own autonomy rather than become dependent on the clinician.

Motivational interviewing can be applied outside the clinic room as well. Having spent a whole year researching this technique, I don’t think I realized how valuable it could be until we were asked in class to think about a conflict we had recently and decide if we were wrestling or dancing with our conversation partner, directing or guiding, and advocating or interviewing. If I would have tried to work in a partnership, value the choices I didn’t necessarily agree with, and draw out the ideas of the person I was arguing with, the conflict might have been resolved much quicker and more easily.

What I’ve described is only a small sampling of what Motivational Interviewing has to offer clinicians and other health care practitioners. It is not an easy skill to learn, but the benefits of using it with clients are numerous, from building a stronger, more open clinician-client relationship, to more efficiently managing problems that may arise! For more information check out and learn more about how you can use the principles of Motivational Interviewing to better counsel your clients, and maybe even sneak in a couple techniques when arguing with your roommate or boyfriend!

Are there any situations that you wish you would have handled better? How might this technique have helped to better resolve the situation?

Leave a comment below!

-Adele Courchesne

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