Summaries are similar to reflections, however, instead of focusing on one thing at a time the client has shared, the clinician pulls together several things, and reflects back to the client. This offering back to the client can be affirming because it demonstrates that the clinician has been listening to the client and is curious about how it all fits together. By providing this summary, the client is better able to hold and talk about the experiences they have been sharing. This technique also encourages the client to continue expressing and exploring what is being discussed.
There are several different types of summaries but they all have a similar theme in pulling together several things the client has shared. The three main types include:
- Collecting summary: This type of summary brings together several related things the client has been talking about. For example, if the clinician and client were talking about parenting, and the clinician asked the client an open question about their strengths as a parent, the clinician would reflect back after hearing about 2 or 3 (e.g., committed and caring).
- Linking summary: A linking summary is where the clinician takes something the client has said in their conversation and links it back to something the client has shared in a previous session (e.g., if the client mentioned another strength about parenting, in an earlier session, and the clinician shared them all together: committed, caring, and available).
- Transitional summary: A last type of summary is a transitional summary and is used by the clinician when it is time to wrap up a topic or the session (e.g., the clinician may reflect back the strengths shared by the client, and then moves on to the next step, such as making a plan).
In addition to the different types of summaries, a key time to offer a summary is when there is clearly some ambivalence on behalf of the client. When the client is voicing both the advantages and the disadvantages of making a change, the clinician can offer a neutral summary back to the client in order for them to see, perhaps, where they are stuck, and more of the whole picture. Here is an example of a summary related to ambivalence offered by Miller and Rollnick:
鈥淭his friendship really evokes some strong feelings for you. On the one hand you鈥檙e drawn to him. He鈥檚 interesting. You鈥檝e never quite known anyone like him, and he鈥檚 had experiences that are way outside anything has ever happened to you. You also feel a kind of bond with him. He seems to understand you in uncanny ways. At the same time his perspective sometimes borders on the bizarre, and his insights can creep you out occasionally. He seems needy and lonely, and while that makes your friendship important to him, you also can feel drained by him. You鈥檙e drawn toward him and drawn away from him simultaneously. Both things are true, and it leaves you feeling confused about this relationship.鈥�
Again, summaries allow the clinician an opportunity to share with the client what they have said over a period of time. It pulls together several things and is reflected back how it all fits together. This skill can also move the process along to making a plan with the client. Next month, we will explore goals and values and how important it is to understand the client鈥檚 motivations for making the changes they want to see in their lives. I hope you all have a great month and have opportunities to use and practice Motivational Interviewing!
For more information about Motivational Interviewing or related services, contact Eunice Akinyi Okumu, by phone (919) 843-2532, or by email, eunice_okumu@med.unc.edu.