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Feature Article: The 4 Processes in Motivational Interviewing
From Dr. Ellen's Blog: Powerful, Skillful Communication Skills
The Changing Times
Motivational Interviewing for Positive Behavior Change
Last week I was at the Motivational Interviewing Network of Trainers (MINT) annual conference in Fort Wayne, Indiana. I returned with many new ideas about effective ways to teach MI.
I was fortunate enough to attend a pre-conference workshop with Dr. Bill Miller, one of the founders of Motivational Interviewing (photo below). He is a very humble guy, quiet but charismatic. It was really a pleasure and a thrill to work with him!
The focus of the workshop was on the third edition of the text Motivational Interviewing, which is in press and will be available in mid-October. (Pre-order your copy here) http://amzn.to/ObmtI2 This book is the seminal text on Motivational Interviewing and I highly recommend it if you wish to learn more about spirit and technique of MI.
One of my favorite things about being an MI trainer is that there’s
always something new to learn. MI is not a static set of ideas, and
that’s in large part because of the MINT organization which is an
international forum for sharing ideas among MI trainers. I feel
privileged to be a member of such a vibrant organization.
The important new ideas in this third edition of Motivational Interviewing is the concept of the Four Processes used in Motivational Interviewing. These refer to the four basic sets of ideas that guide the clinician’s relationship with the client, and dictate how the guiding style of MI is operationalized. This month I will describe the first two of these four processes, Engaging and Evoking. Next month, I will write about Focusing and Planning.
Engaging refers to building a relationship with client. This process continues throughout any conversation with the client. How does the other person know you are listening and understand? The use of reflective statements is a key element of MI. They are a way of letting the other person know you heard, and of double checking that what you heard is correct. Other ways of thinking about the process of Engaging were presented by other MI trainers at the conference, including Steven Berg-Smith http://berg-smithtraining.com/. Berg-Smith talks about listening with “...presence and undivided attention, eyes, ears, and heart, using all of your senses, acceptance and non-judgment, curiosity and delight, silence, and the use of reflective listening statements”.
The second of the four processes is Evoking. We want to encourage or evoke “change talk” from our client. Change talk is the client, not the clinician, talking about change in a positive direction. Miller spoke of eliciting change talk as “a chance to find change talk in the conversation and pour a little water and sunlight on it to help it grow”. Remember that our goal in using MI is to foster change in behavior, and that change must come from the client. We want to help people convince themselves they ought to change, rather than listed to the clinician’s reasons for change.
Next month: Responding to change talk to encourage focusing and planning, the last two of the Four Processes.
You are welcome to use Dr. Glovsky's articles in any of your own publications provided you copy the following into the article: "Dr. Ellen Glovsky is a Registered Dietitian and Motivational Interviewing trainer. She is on the faculty of Northeastern University in Boston, MA, where she teaches courses in nutrition, public health and MI. Her website, newsletter, and blog are at Training With Dr. Ellen."
Ellen Glovsky, PhD, RD, LDN 2012. All rights reserved.
This summer my daughter Amy and her 2 children, Tiago who is 8 years old and Francesca who is 7 visited for three weeks.
I observed my daughter parenting her kids, and admire her as a mother. She emphasizescommunication, both hers and the children back to her. I watched her be so careful to be very clear in what she tells her kids, especially in what she expects of them and how much she loves them. It was very instructive. I was raised in a very different way. Seldom did people in my family say what they really meant, especially if it wasn’t “nice”. I find Amy’s approach to be refreshing and a huge relief!