When the clinician begins meeting with the client, and rapport is being established, it may become clear as to what is going to be the focus of the session or sessions. However, sometimes it may take some time to determine where things are headed. And it can be confusing for the client, at times, because even though we want to listen to them and have them decide on the best direction to focus on, the client may not only have their thoughts, but also the thoughts from a partner, a judge, a friend, etc. So, how can we be of assistance to this client in this process? Below you will find three approaches to this question where some have more limitations than others. Let鈥檚 take a look:
Directing
In this style, the clinician is typically directing the focus, working harder than the client, and offering several recommendations. The motivation for this may be coming from their own agenda or from the agency or place of work. This approach, however, has numerous limitations since we really want the client to come up with what is meaningful for them in order to explore and direct the focus of the session(s).
Following
On the other end of the spectrum, there is following the client鈥檚 lead. This approach can build rapport with the client and allows for the client鈥檚 priorities to determine the direction and content of the session. The concern is that oftentimes, a clear focus does not get established, or it may take a very long time to get there.
Guiding
And in the middle of directing and following is guiding. This style invites both the clinician and the client to create the focus for the session(s). Honoring the client鈥檚 agenda is significant and using your expertise to keep the client continuing to narrow the focus to an established goal is a collaborative process that is often the most effective.
Even though guiding may be the most effective style for focusing, and is likely the place you want to spend most of your time together, the clinician can easily move into directing or following if it feels appropriate. There may be times when you want to build more rapport and follow, or need to be a little more directive if the client is moving quickly from topic to topic. You obviously will get to know your clients and get a good sense of how best to facilitate the session(s). These are just some styles that are often present in a session.
We have been discussing the importance of maintaining a direction in the conversation through Styles of Focusing and are reminded that adjustments may need to be made along the way, and to see this as an ongoing process. Next month, we will take a closer look at several different focusing scenarios. 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.