If you remember from the last blog, an approach was discussed where the clinician provides a summary of all the change talk the client has expressed. The clinician shares back with the client all the motivations they have verbalized. Then, the clinician asks the key question to the client about what they are thinking and what they might do next. This can be a very powerful experience for the client, and it can often be helpful to give them some additional time to reflect on this key question.
We haven鈥檛 talked much about silence in conversations with our clients. We know that it can feel awkward or uncomfortable if a question has been asked and 5 to 10 seconds has passed without a response. There can be a feeling of needing to 鈥渇ill the space鈥� or to say something to break the silence but it can also be a chance to let this silence exist and see what emerges from the client. If this silence is supported and normalized, it can be a great opportunity for some deeper reflection by the client. The client can also feel less pressure to respond quickly.
If you ask the key question and allow for the pause to be present, the clinician can acknowledge that a big question has been asked and that it can often be helpful to take some time before responding. Some statements that may be made could include:
鈥淭hat鈥檚 a big question, and please take your time to think about how you may want to respond鈥�
鈥淚t is very understandable that this question may require some more time to think about鈥�
鈥淧lease take as much time as you need to think about this question since I know it is a lot to think about鈥�
In this scenario, where the clinician has offered a summary of motivations offered by the client and then asked a key question, offering an extended period of time for the client to reflect can be supportive. This pause for the client, to think about where they may want to go next, is a pivotal point in the conversation. Providing a little more space for the client to let the summary and the key question to be digested can be helpful. And acknowledging that it is encouraged to take some additional time can make a big difference.
Everyone has a different amount of time they take before responding to a question鈥nd perhaps needing even more time to respond to a big question. There is no 鈥渁ppropriate鈥� amount of time someone should respond to a question, but if the client is encouraged to take their time, a thoughtful response will likely come. Trust the process and see what happens and don鈥檛 feel pressured to move things along too quickly. I hope everyone is doing as well as possible and you 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
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