This has been a great conversation on building confidence with our clients and numerous approaches have been discussed. And one experience clients can have is feeling like they are 鈥渇ailing鈥� in their attempts to change and they can get very discouraged. One strategy to work with clients who feel this way can be to reframe the 鈥渇ailure鈥� attempt in order to encourage and support more future attempts. Perhaps reframing the 鈥渇ailure鈥� as more of a 鈥渢ry鈥� can be helpful since we know that making a change is usually never accomplished on the first 鈥渢ry.鈥� If some examples are beneficial, the experience of a smoker attempting to quit can be mentioned because, on average, it takes them three or four serious attempts to succeed. So each 鈥渢ry鈥� by our clients can be seen as moving one step closer to changing a behavior as well as building confidence through their perseverance and commitment.
If a client is having difficulties with the details of implementing change, one approach may be to consider thinking about change in hypothetical terms. For example, some questions that may be asked to the client offered by Miller and Rollnick include:
Suppose that you did succeed, and were looking back on it now. What most likely is it that worked? How did it happen?
Suppose that this one big obstacle weren鈥檛 there. If that obstacle were removed, then how might you go about making this change?
Clearly, you are feeling very discouraged, even demoralized about this. So use your imagination: if you were to try again, what might be the best way to try?
By asking these types of questions, the client is able to explore why previous attempts may not have worked and speak out loud what may work moving forward. In MI, it is always about trusting that the client knows what is best for them and that they know themselves better than anyone else. We are also reminded that there is nothing that needs to be added by the clinician and that the client possesses all of the wisdom needed to make changes in their life.聽聽
Reframing 鈥渇ailures鈥� as attempts by the client can be an effective way to encourage and support our clients in continuing to pursue change. And by providing research or examples of the number of attempts needed to be successful can be helpful. Also, thinking in hypothetical terms can be helpful if the client is having challenges in coming up with a way to make change happen. By asking some open ended questions, clients can hear themselves speak about what strategies may work best for them.
Next month, we will focus on how to respond to a client when they are expressing some confidence towards change. There will be several suggestions offered in order to support and strengthen this confidence talk. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing. Take good care!
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
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