In MI training, we emphasize asking permission, before you offer unasked for advice or change the subject. The obvious question, then is what happens if the client’s answer is NO?
Here’s an opportunity to make a real connection with the client. A simple response is “Thank you, I really appreciate your honesty with me.” This can often be very disarming, since most people won’t expect that response.
There could be many reasons people answer “no”. They may feel angry, frightened, or resentful at having to talk with you in the first place.
Here’s a sample conversation in which this approach is used:
Counselor: I have some ideas about how you could go about quitting smoking. Would you like to hear them?
Client: No! I’ve had about enough of you medical people trying to tell me what to do and get me to change my life. I like my life the way it is.
Counselor: Well, thanks for being so honest with me. It sounds like people have been trying to get you to change a bunch of things and you’re fed up.
Client: That’s it exactly. I love smoking, and don’t plan to give it up any time soon. But, you know, there’s this cough I have that won’t go away. I always said if I coughed like my Dad I would stop, and now that’s happening.
Counselor: You’re concerned about the cough and wonder if it’s related to smoking.
Client: I KNOW it’s from smoking. I just can’t picture myself without a cigarette.
In this scenario, the client began being angry and defensive at being TOLD what to do. In the end, after just a few interchanges, the client expresses change talk, which is exactly the goal.
Sign up at www.TrainingWithDrEllen.com for a free chapter of my book, “Wellness, Not Weight…” to learn more about Motivational Interviewing.
