Whether the clinician is supporting the client in building confidence or maintaining confidence, it is important to remember to start with having the client look within to find their own strengths and solutions. It can be very easy for a clinician to want to help and offer suggestions, but for more sustainable change to occur, it is best for the client if they are able to bring forth what is already present. The skillfulness of the clinician can create the conditions for the client to do their own work and be reminded of all the resources they have available to them. The process is very collaborative and it can be extremely rewarding to be working with a client as they realize their own abilities to create the change they want in their lives.
In providing an interaction between a clinician and a client, you can see how skillful the clinician is by the way they ask open questions and affirm the responses by the client. This passage hi-lights the many approaches we have discussed in previous blogs about building and maintaining confidence. Miller and Rollnick have offered this example of a client with low confidence being offered opportunities to express the confidence she has available to her:
Clinician: So you have this amazing inner strength, a solid core inside you where you can鈥檛 be hurt.
Client:聽聽聽聽聽聽聽聽聽聽聽聽聽聽 Or don鈥檛 let myself be hurt.
Clinician: Oh, right! It鈥檚 not that you can鈥檛 feel anything, because you do. You have a way of preserving that loving woman inside you, keeping her safe. So one thing you are is strong. How else might you describe yourself? What other qualities do you have that make you a survivor?
Client:聽聽聽聽聽聽聽聽聽聽聽聽聽聽 I think I鈥檓 pretty smart. I mean, you wouldn鈥檛 know it to look at me, but I can see what鈥檚 going on around me, and I don鈥檛 miss much.
Clinician: You鈥檙e a strong and loving woman, and pretty smart. What else?
Client:聽聽聽聽聽聽聽聽聽聽聽聽聽聽 I don鈥檛 know.
Clinician:聽聽聽聽聽聽聽聽聽聽What might someone else say about you, someone who knows you well? What good qualities might they see in you, that could help you make the changes you want?
Client: Persistent. I鈥檓 downright bullheaded when I want something.
Clinician:聽聽聽聽聽聽聽聽聽聽Nothing stops you when you make up your mind, like a bull.
Client: I do keep going when I want something.
Clinician:聽聽聽聽聽聽聽聽聽聽Strong and loving, smart, persistent. Sounds like you have a lot of what it takes to handle tough changes. How about this? Give me an example of a time when you really wanted something and you went after it.
In MI, the approach believes that every client knows themselves better than anyone else. And that nothing needs to be added from the clinician in order for the client to make the changes they want in their lives. The clinician walks along-side the client and facilitates the process of building confidence and reminding the client of all the strengths and resources that they have available to them. In the example above, the questions asked by the clinician allows the client to express their strengths. The conversation will eventually have the client sharing examples of how these strengths have been used to support them in the past and how they can be used to support them moving forward.
Next month, we will end this blog series with a final segment on hope and some additional approaches in MI that acknowledges the strengths of the client. 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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