As health care providers we sometimes (or maybe often) feel a strong urge to tell our clients what to do. After all, we have been trained to know what would be best for our clients. We’ve worked hard to learn our craft, and have strong feelings about what behaviors clients should change. We want them to feel this as passionately as we do, and it’s tempting to share this information with them.
In MI we call this urge to tell clients how they should change the “righting reflex”. This is that strong urge to tell them the solution to their problem, because we feel we know what would work. It’s that urge to make them “right”, and to fix them. We may even feel anxious or worried about the client’s behavior. For example, that diabetic or hypertensive client who doesn’t take their medication. Or the eating disorder client who binges and purges several times a day. We know how risky those behaviors are, and the dire consequences that can result.
That worry or even fear is your problem, not the client’s. People change when they are ready, which may or may not be when or how we think they should. This might involve managing your own feelings about the client. If you are upset, or frightened, or anxious about the client’s behavior, how can you soothe yourself? The idea here is to learn the skills calm those difficult emotions in yourself, rather than project them out to your client in the form of directions for change. One way to do this is to talk with a colleague or supervisor in your work about your concerns. Telling our clients what to do doesn’t work most of the time. It’s tempting, but a real trap. So, avoid the righting reflex. Instead, make a reflection or summary of what the client is saying. Emphasize whatever change talk you have heard and ask for clarification. The goal is to have the client come up with the solution, not you.
