How do you help when someone you care about is stuck in a rut? Some people leap in with advice, offering reassurance and insight. Others use logical argument and evidence.
These well-intentioned efforts may contain wise advice but rarely succeed in shifting behaviour. A clinical approach called Motivational Interviewing, developed by William Miller and Stephen Rollnick in the 1980s, has proven much more effective at helping people effect change in their lives.
Rather than teaching, reasoning and providing information, Motivational Interviewing coaches the client to discover his or her own motivations and capacities for change. The practitioner draws out and clarifies goals, listens to concerns and boosts confidence in the ability to change, eventually collaborating with the client on a specific plan of action. Learn more about M.I.
Here is a sample with a client who has struggled to begin getting in shape and change eating habits. The example employs standard M.I. questions, although actual sessions would dwell on each phase at greater length.
(Assessing the importance of change)
“On a scale of 1 to 100, how much do you want to get in shape right now?”
“I’ll say about 70.”
“Fairly high. Why did you choose 70 and not a lower number?”
“I’ve gotta do something. I’m worried about my health and miss having more energy.”
“What would it take to move you to a higher number?”
“Well, I guess if I had a medical episode, or if my partner left me, I’d be more motivated.”
(exploring values)
“Sounds like you value your health and your relationship. Any other priorities?”
“Admiration from my kids would be nice. And earning a living is important. I’m in sales and would like to feel sharper, more awake, which might come from being in better shape.”
“What would it look like if we were successful in our work to get you in better shape?”
“I guess I’d be feeling better about myself, more vigorous. Like I’ve accomplished something.”
(addressing ambivalence to change)
“You’ve shared important values just now. How does your current behaviour fit in with your values?”
“That’s just it. I don’t understand. I mean, I care about those things, really, but can’t motivate myself to do anything consistent to change them.”
“Can you describe how you are thinking, what you’re saying to yourself when feeling unmotivated?”
Sure. I feel weak. Confused. Like what’s the point, I’ll never change anyway, so why bother trying.”
“Thanks for your honesty about hearing that voice. Is that voice the whole of you?”
“No. Not at all. It’s kind of weird, but there’s a part of me that disagrees and feels disgusted by that defeated part of me.”
(identify the gap between values and actions)
“You’re describing a part of you that wants to let go, give up, take it easy. Is there any benefit to thinking that way?”
“I guess I’m trying to protect myself. Avoid defeat by not accepting the challenge of trying to change.”
“Sounds like that voice is trying to help. How do you feel about that side of yourself?”
“I hate it. It’s the voice of weakness and fear, but it’s usually in control”
“Then let’s explore this discrepancy between your values and actions. On a scale of 1 to 100, how confident are you that if you chose to make the change, you could change?”
“Not very. I’ll say 25.”
“I notice you didn’t say zero. Tell me about a time you made changes in your life. How did you do it?”
“I used to be late for appointments a lot. Then I decided it was insulting to others and stopped.”
(assess and build self-efficacy)
“That’s significant. What strengths helped you succeed back then?”
“I think I felt embarrassed. Maybe ashamed. I got determined to stop feeling like that.”
“Determination, and concern for others. If you decided to change now, what would enable you to do it?
“If I knew it mattered to my family that would help. I don’t think they think I can change.”
“Can you suggest how you might recruit them in inspiring you to begin?
“I’d have to speak with them about this first. Let them know it matters to me. Ask for their help.”
“Be specific. What would you want them to do? How can you guide them to help?
“Not nagging. That makes me feel worse. How ‘bout if we made a schedule of some physical activities we like doing together. Try to make it fun.”
“That’s a practical step. Fitness is clearly important to you in this change. Anything else?
“Shifting my diet is going to have to be part of it. I’m addicted to fast food. That’s the tough one.”
“What would you gain by changing the way you eat?
“Making meals at home would make for more family time. Better food. Healthier bodies.
“Yet you like fast food. What are the benefits to your diet the way it is?”
“Mainly convenience and craving. It’s just automatic and easy to buy fast food from a restaurant chain.”
“Then would you say convenience and craving are some of the main obstacles to overcome?”
“Yup. I think so, acting out of habit without thinking much about it.”
(decision-making)
“What resources do you already have to overcome those challenges?”
“Just talking this way is making me more determined. If I can feel good about improving my whole family’s diet that will help maintain my motivation.”
“These sound like important steps. You keep coming back to your family. How are they a resource?
“If I can encourage them to join in a bit then we’ll be able to share the load, support one another.”
“What first steps do you have as a goal between now and our next session?”
“I want to do some research online and talk with my family about making changes. Before we meet next week I’ll call a family meeting and hear what they have to say.”
Actual coaching would dwell at greater length on each of these topics, and require a number of sessions to progress through the stages that are covered more rapidly in this sample:
ABOUT THE AUTHOR
Mike MacConnell, founder of Reflective Mediation, is an accredited family mediator, conflict coach, educator and author. He is the highest-ranked mediator on Google in the greater Toronto area, with over 180 5-star reviews. To book your free consultation click here.
