Paul Burke Training Group
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Beyond training: Looking at learning MI in a whole new light!
Thoughts on Improved Practice (TIP) #1511
People who understand the MI way of having helpful conversations know that “Listening” is NOT the same thing as “hearing”. Listening to what people are meaning – and beyond just what they are saying is an important part of the MI conversation. So how does one train oneself to really listen to and to get a sense of where a conversation is headed?
Almost every time I facilitate an introductory workshop, several people comment on how surprised they are at how much effort is involved in listening in the MI way. In the closing round of training, many say that “I never realized how much reflection I need to do before I decide on what to reflect back to my client!” Others have been heard to say “a major part of learning to listen, for me, seems to be about learning to listen to what I’m saying to myself while the client is speaking!” Still others have commented on how it is that “in order to listen well, I’ve learned that I have to shut off the noise in my own head so that I can just be with the client for a while before I start worrying about how to get them to listen to me!”
It’s one of those “strange-but-true facts that it’s often very difficult to quiet what I call the “response talk” that chatters away while we try to hear the words of our client. It’s so easy to focus on how we want to respond to what the client is saying, and to what we think about what the client is saying, that it can seem almost impossible, at times, to simply listen! Creating an internal space within oneself so that there is room for the client’s point of view is an essential piece of the preparation work that is necessary to listen well. These are fundamental motivational interviewing skills that professionals must master.
The Four Process of MI: Focusing = “Get rid of the Blur!”
Engaging with your client; with their logic; with their way of understanding things and their situation, is a first and necessary step in constructing an MI conversation. Once engaged however, it’s crucial to bring an “issue” into focus. The issue or topic-of-focus within the dialogue aids both the helper and the client by ensuring that they are both working on, or toward, the same purpose in the conversation. An “issue” can only be worked on, or worked toward, or worked around – if both parties are clear about “what’s in focus”. Similarly, only when both the MI helper and the client find a mutual focal point can directionality be established or measured in an MI interview. If you can’t see what’s in focus, how will you know that you are moving in that direction? Assessment interviewing may be part of the focusing process. In my experience, so long as some skillful work with reflective listening and open-questioning has been done to facilitate the process of engaging with the client (and engaging the client in the MI conversation at hand), assessment interviewing can be a useful asset to bringing sharper focus to what needs to be discussed and worked on in an MI session. Of course, like the engaging process, and like assessment itself, focusing never stops! In MI, bringing focus to a conversation, sharpening that focus, and modifying it over time is the way that we know a conversation is moving in a planned (specified) direction – and in a helpful and strategic direction! Without knowledge of the focus for a conversation, you and your client may well end up chatting away, in a highly engaged manner, but with very little “collaboration”, or “partnership” focus. Partnership and collaboration involve two people moving forward, together, in the same general direction. Focus is what provides the all-important “general direction” that is, by definition, an essential part of motivational interviewing courses.
Much of the process that drives successful MI conversations is allowing our clients to use us as a mirror – so that they can better hear (and sort out) their thinking. It requires that we help clients hear themselves (including the quiet and suppressed voices within that often speak only in whispers with statements like “I wish things were different” and “I need this to change”. Listening work in MI involves listening to what clients say and then reflecting on what that means (relative to the change target). It requires that we reflect on what would be helpful for the client to hear again (Content? Meaning? Intent? The “other side” of what they are saying? The hope inside of their words? Change Talk? Reasons for change that may be implied, or hidden inside statements made by the client?). Then we:
- Compose a reflection that represents what we have reflected upon
- Reflect our reflection
- Allow the client to reflect on our reflection
- Invite a client response to the reflection we have made after they’ve had time to reflect on it a little.
Attending motivational interviewing workshops can help professionals refine these techniques and build their ability to listen deeply.
Oddly, what often gets in the way of skillful listening for many of us is our experience in the field! The more experience we have in working with our previous clients and in helping them find solutions to problems, the more likely we are to use past experience as a substitute for listening to this client. It is very important to keep in mind that much of the value of reflective listening work in MI stems from the client “listening back” to what you are hearing! If you are listening only to your own past experience, or to a summary of all the memories you carry from previous client conversations, it’s entirely possible to make the mistake of buying into one of the following three myths that get in the way of effective listening:
- MYTH #1: I have heard this same story several times before
- MYTH #2: I don’t need to hear this story, because I know the plot and I can see where it is heading
- MYTH #3: I know exactly what to recommend, based on the stories of others, so as to create a different (and more positive) ending
Now, here are the facts!
- FACT #1: You have NOT heard this same story ever before. Not even once. This story belongs to this client and her interpretation of it, and the meaning that she gives to it is what is most important. The experiences and stories of each client are unique (and important) to them.
- FACT #2: While it may be true that you don’t need to hear this story, your client does! In MI it’s often the case that it’s not so much what the helper is hearing that matters. MI works by helping the client to hear important elements of what they are saying – and of what they are not saying. We listen to clients so that we know what meanings, and values, and wishes, and hopes, and concerns need to be heard by the client. We need to be clear headed enough to be able to discern what it is from within the client’s speech that they we need to “listen back” to them.
- FACT #3: MI is not about prescribing alternate endings to client stories. Rather, MI involves helping clients to hear themselves in ways that invite collaborative planning and solution- seeking. The idea that we have to listen only until we can “figure out” how to prescribe a solution is very problematic when trying to foster the collaborative, evocative, and autonomy- supporting spirit that drives the MI bus.
Many professionals turn to experts like Paul Burke motivational interviewing to enhance their approach and ensure they apply these principles effectively.
This week, my invitation is to think a little about what you have to do to prepare yourself for hearing – beyond just “listening”. Here are a few things you might try:
- Before you begin a new MI conversation, take a minute to have a brief conversation with your own thoughts. See if you can find a way to remind yourself of your intention to make the upcoming conversation more about the client – and less about you. Is there a gentle way that you can make a wish for the conversation?
- My wish for this next conversation is to be open and receptive to the concerns, and worries, and hopes, and wants, and needs of my client.
- I wish to turn down the volume of the noise in my head enough that I can hear change talk when it enters into the conversation – even when it only whispers!
- I wish to be totally present for this client. I wish to hear his words, and his meaning, and to give attention to the important things he says and means that he may be missing.
2. Before you begin each new conversation, take a few moments to “empty yourself” so as to create space for the client’s thoughts, feelings, ideas, hopes, worries, and needs. Some people find it helpful to close their eyes and do a minute or two of deep breathing. Others initiate a self-directed visualization of some kind that facilitates the evaporation of thoughts and worries
and ideas that would otherwise crowd out what the client means. Imagine placing your inner self-oriented conversation in a balloon and let it drift up to the ceiling – just until you and your client find your focus.
3. Learn to activate a “Beginner’s Mind”. This approach involves letting go of your “social and professional biography” for a while. It involves learning to set your ideas, theories, opinions, logic and beliefs about change on a shelf for a little while – on purpose! Yielding to a fresh, beginner’s mind means allowing yourself to “not know” for a while. It means allowing yourself to get genuinely curious about what the client is thinking; how she sees the situation; what she wishes and hopes for. It means shifting the focus from your thoughts about her experience to simply yielding to understanding her experience.
Activating your beginner’s mind recognizes that our thoughts often distort and manipulate what the client is saying and meaning. Thus, instead of assuming that we know what the client is thinking and experiences, we assume the dual positions of “I don’t know” – and “I want to know” – all at the same time.
To truly master MI, many professionals choose to learn motivational interviewing through structured training and ongoing practice.
Some people argue that “listening deeply” is an advanced MI skill. I disagree. I think that listening with deep interest, deep curiosity and deep compassion is the very essence of good MI conversations. It doesn’t take much skill to hear the words that someone speaks. To hone the ability to get ourselves out of the way so that we can listen for what the client wants, for what they need, for the reasons that support positive change, and for the voice of hope that fuels their willingness to talk with us – is a sign that you are present in the conversation. Being present is an art. It is also an honor. And a gift.
See you next week …
Paul Burke Training & Consulting Group (www.paulburketraining.com)