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GLIDING TOWARD CHANGE WITH MOTIVATIONAL INTERVIEWING

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Pam Pietruszewski

Integrated Health Consultant

GLIDING TOWARD CHANGE WITH MOTIVATIONAL INTERVIEWING

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As a figure skater, my two single blades gliding across the ice had to work together. Movement involves a series of coordinated footwork, choreographed to counterbalance each jump, spin and curve along the way. A perfect routine requires practice, precision and the right conditions. No matter how much you practice, the ice isn’t always smooth and you have to adapt.

Just as the ice isn’t always smooth on the rink, our conversations with clients aren’t always smooth. Do you sometimes experience juts in the ice, so to speak? Do your clinical conversations with a person experiencing addiction leave you feeling stuck, like the relationship involves two wobbling left feet? How do you get back into alignment?

The spirit of motivational interviewing, a collaborative conversational style to strengthen motivation toward change, invites us to adjust the routine and do a gut check. What do I bring to an interaction? What is my heart and mind-set when it comes to helping people change? This is the music that we must tune into before we can start to glide.

The addictions field experienced a shift in the 1980s when the developers of motivational interviewing began noticing reduced “resistance” when clinical conversations included what later became known as the motivational interviewing spirit: a way of being that demonstrates compassion, partnership, evocation and acceptance. Client language started to shift from what couldn’t be done to what was possible. It turned out that meeting a person where they are created greater alignment and progress toward change.

It’s understandable to feel jaded — to develop a deficit world-view when seeing the challenges and consequences of addiction. We have knowledge to offer and we want to provide solutions. We give so much to our clients and we work hard. The spirit of motivational interviewing invites us to consider the competence worldview. The ability to heal, to find answers, lies within our clients and our role is to help discover them. Motivational interviewing training helps us to use that spirit to guide our clients toward change.

We don’t always know our impact and must continually redefine success. Moving toward change can come in the form of fewer no-shows or decreased substance use. Sometimes the smallest steps carry the most impact. Our clients tell countless stories every day about their experience of the power of partnership and enhanced autonomy. We can’t assume that a person who is not “ready” to change is not willing to be met where he or she is. Motivational interviewing gives us the strategies to know when to take a step forward with the client or when we are too far ahead and should circle the ice to join them again.

In the past 30 years, there have been more than 30,000 articles published demonstrating motivational interviewing’s success in areas ranging from addictions to adherence. At the National Council, we infuse motivational interviewing in our programs as part of our commitment to support treatment organizations providing comprehensive, high-quality care that leads to client recovery. From the Hilton Foundation’s Reducing Adolescent Substance Abuse Initiative to CCBHCs, motivational interviewing training is an essential skill set for clinicians seeking to be viable in the fast-changing field of health care.

Our members who tirelessly work in addictions, trauma and mental health have experienced renewed hopefulness and reduced resistance with the addition of motivational interviewing training. Rediscover your compassion and partnership, your ability to elicit and accept that while there will be cracks in the ice, you can always get up and glide again.