There may be many thoughts that come to mind when we think about the importance of speaking one’s own motivation for change; perhaps words such as ownership, commitment, accountability, and support come up for us. And our actual role as practitioners is to try to guide or facilitate the client in talking themselves into the change they want in their lives…since people are usually more committed to, and believe, what they themselves say versus what someone else says (like a practitioner).
We know that the process of behavior change in Motivational Interviewing is not unique and typically does not result from a single “insight” or “aha” moment. Change usually occurs after a period of ambivalence and when the perceived advantages begin to outweigh the perceived disadvantages. And most often, it is a gradual process of going back and forth until the natural process of ambivalence is resolved. Our role then is about moving the client forward and supporting them through this process.
And when I read the question from the blog subscriber, about the importance of speaking one’s own motivations, out loud, and in front of another person, it reminded me of how Miller and Rollnick offer this example of the subjective differences there are likely to be in making statements like “I am going running today” or “I forgive my father” if one is:
- Thinking about it silently to themselves
- Writing it down
- Looking in a mirror while alone and saying the words aloud
- Saying the words aloud to someone else
We may all have different experiences if we made these statements above, but to say them out loud, to a practitioner, where there is an established relationship, and where there is acceptance, listening, genuineness, and partnership, it can make a significant difference for the client.
This is why, in MI, we pay such close attention to when we hear “change talk” and how we may guide the client to continue exploring this talk. At the same time, this does not mean that we ignore “sustain” talk because we do want to acknowledge and reflect it, but we really want to be able to keep the client focused on talk that is related to changing behavior instead of sustaining behavior.
Again, a great question and perhaps one that we can all reflect on individually or with colleagues. And next month, we will review several ways of evoking change talk.
For more information about Motivational Interviewing resources, contact Eunice Akinyi Okumu, by phone (919) 843-2532, or by email, eunice_okumu@med.unc.edu.