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There is Help to Address that “Stuck” Feeling: An Introduction to Motivational Interviewing

There is Help to Address that “Stuck” Feeling: An Introduction to Motivational Interviewing

by | Counseling, General, Mental Health

The Origins and Principles of Motivational Interviewing

You may have heard the term Motivational Interviewing (MI) making its way in mental health popular language. Motivational Interviewing is an evidence based approach developed in the 1980s by William R. Miller and Stephen Rollnick. Miller was attending substance use disorder workshops when he began to notice confrontational encounters between clients and their therapists. He and Rollnick began to observe patterns of denial and defensive behavior which often interfered with client’s progress. An understanding developed that change is difficult when a person is not self-motivated. Relatable? If we have messaging that we know something is good but we do not feel moved to act of course we focus on something else or stay put. Motivational Interviewing was developed to be a safe non judgmental approach for all kinds of goals and desires to change behaviors, whether it be better sleep hygiene, exercising more, to quitting smoking. It is an approach that supports autonomy and discovering our own sense of empowerment.

Key Concepts of Motivational Interviewing

Collaboration and Partnership

Evocation of Personal Values

Reflective Listening

Goal-Oriented Planning

Identifying Change Talk

Building Client Confidence

Highlighting Inconsistencies

Empathy and Understanding

Client-Centered Approach

Non-Judgmental Communication

Enhancing Self-Motivation

Supporting Autonomy

Therapeutic Relationship Building

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Adaptability Across Contexts

Integration with Other Therapies

What to Expect in a Motivational Interviewing Session

Collaborative and Supportive Environment

Motivational Interviewing sessions are collaborative, meaning that once rapport (a sense of trust is established between therapist and client) client shares thoughts and ideas about how they want to make change and develop plans to achieve goals that are manageable to them based on their discussed values and beliefs. Therapists engage in empathy, active listening/reflecting back to client key points, and open minded questions in order to gain insight as to how to best support their client.

Common Questions About Motivational Interviewing

Motivational Interviewing is a client-centered approach that facilitates change by helping individuals explore and resolve ambivalence. Here are some frequently asked questions to help you understand this method better.

What are the benefits of Motivational Interviewing?

Motivational interviewing is… 

 Client-centered, considering the client’s context and background while maintaining nonjudgment and positive regard.

  • Focused on building confidence, self-advocacy, and intrinsic motivation.
  • Effective in enhancing the therapeutic relationship by fostering nonjudgmental communication.
  • Applicable in individual and family sessions with both teens and adults.
  • Oriented toward promoting success in achieving goals and creating meaningful change.
  • Compassionate in exploring and addressing setbacks during the change process.
  • Compatible with other approaches, such as TTM (Stages of Change), CBT, Solution-Focused Therapy, DBT, ACT, and mindfulness.
Can Motivational Interviewing be used for all types of issues?

While Motivational Interviewing is versatile and can be applied to many behavioral changes, it may not be suitable for all situations, particularly those involving trauma or when individuals feel pressured to change. It’s important to discuss with a therapist if this approach aligns with your needs.

What makes Motivational Interviewing different from other therapies?

Motivational Interviewing is distinct in its focus on collaboration and evocation. Unlike directive therapies, it emphasizes the client’s autonomy and intrinsic motivation, allowing clients to lead the conversation about their goals and desired changes.

Is Motivational Interviewing suitable for teenagers?

Yes, Motivational Interviewing can be effective for teenagers, as it respects their autonomy and encourages self-reflection. It helps them articulate their values and goals, fostering a sense of ownership over their personal growth.

How long does it take to see results with Motivational Interviewing?

The timeline for seeing results with Motivational Interviewing varies depending on individual circumstances and goals. Some clients may notice changes after a few sessions, while others may require a longer engagement to achieve their desired outcomes.

Can Motivational Interviewing be combined with other therapies?

Motivational Interviewing can complement other therapeutic approaches, such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT). It enhances these methods by fostering motivation and readiness for change.

What should I do if Motivational Interviewing isn't working for me?

If you feel that Motivational Interviewing isn’t meeting your needs, it’s important to communicate with your therapist. They can help assess the situation and explore alternative approaches that might be more beneficial for your therapeutic journey.

How does Motivational Interviewing handle setbacks?

Motivational Interviewing views setbacks as opportunities for learning and growth. It encourages clients to explore the reasons behind setbacks without judgment, helping them develop strategies to overcome obstacles and continue progressing towards their goals.

Is Motivational Interviewing a long-term therapy?

Motivational Interviewing is often used as a short-term intervention, focusing on specific goals and changes. However, it can be integrated into longer-term therapy plans if ongoing support and motivation are needed.

Ready to Explore Motivational Interviewing?

If you’re interested in learning more about how Motivational Interviewing can support your journey towards change, we invite you to reach out. Our team is here to provide more information and help you schedule a session tailored to your needs. Take the first step towards a more empowered future today.

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A Guide to Self-Advocacy in Therapy

A Guide to Self-Advocacy in Therapy

by | Counseling, General, Mental Health

If you have been in therapy before or are currently looking for a counselor, know you are not alone if it feels like an intimidating process. The therapy world comes with many acronyms (CBT, DBT, EMDR, ACT, etc.) and it can be daunting to identify what it is you look for in a therapist. Research over the past 50 years has shown that the quality of the relationship between therapist and client, known as the ‘therapeutic alliance’, is the strongest predictor of successful outcomes in treatment. Given the importance of the therapeutic alliance, it is important that you feel seen, heard, and respected by any clinician you work with.
 
 
When meeting with a therapist, whether entering treatment or after care is established, you reserve the right to ask questions. Here are some you might ask to help yourself identify if they are a good fit for you:
 
  1. Do you have experience providing therapy to people with similar issues as mine?
  2. What are the different therapy approaches you practice, and which do you think will work best in our work together?
  3. How do you collaborate with your clients throughout the therapy process?
  4. How do you collaborate with other treatment team members (medication providers, case managers, etc.) when appropriate?
  5. Which types of coping skills do you normally help your clients learn and practice?
  6. How do you measure progress?
  7. What can I do if I feel the treatment isn’t working for me?
  8. How will I know when to stop or pause therapy if I am doing well?
  9. What is your training (what certifications or degrees do you hold)?
  10. Based on what you know about me so far, do you believe we’re a good fit? Why or why not?

 

 

 

Asking your therapist questions about their work to ensure goodness of fit empowers you to make an informed choice about your mental health needs. Not only does this help you decide if a therapist is right for you, you are already taking a step toward autonomy and practicing empowerment. What matters most in your mental healthcare is ensuring you feel seen and heard.
 
 
Some self-reflection in identifying if your therapist is a good fit:
  1. Do I feel respected by my therapist?
  2. Do I resonate with my therapist’s approach to treatment?
  3. Does my therapist listen attentively to me?
  4. Do I feel validated by my therapist?
  5. Is my therapist transparent with me about their treatment approach, and do I understand it?
  6. Does my therapist check in with me about progress and my experiences in treatment?
  7. Is my therapist an ally to me?
  8. Is my therapist open to my feedback about what works and what doesn’t?
  9. Is my therapist a safe person for all pieces of my identity?
  10. How am I feeling about working with my therapist so far?

 

Remember, you are the expert in how you feel. Check in with yourself often about what is going well, and what is not as helpful, as you progress in therapy.

 

Get Outside For Your Brain

Get Outside For Your Brain

by | Anxiety, Coping, General

When I am among the trees,

Especially the willows and the honey locust,

Equally the beech, the oaks and the pines,

They give off such hints of gladness

I would almost say they save me, and daily.

Excerpt, “When I Am Among The Trees” by Mary Oliver

We live in a world that allows us immediate, constant access to Internet spaces. This offers us accessibility, economic opportunity, entertainment, cultural exchange, education, and productivity. However, for as many benefits as there are, we’re also presented with challenges – Cognitive overwhelm, social isolation, distraction. Worldwide, we spend an average of six hours and 40 minutes per day on screens, and we average five or fewer hours in nature per week.

 

Research shares with us a wealth of information about how nature is beneficial for our emotional and cognitive health. When we disconnect and get ourselves into nature, we are happier, perform better on tasks, feel more energized, and experience real-time, literal connection to the world around us. The biophilia hypothesis (“biophilia” literally means love of life or love of living systems) suggests that humans have an innate tendency to seek connection with nature and other forms of life. This hypothesis states that spending time in nature triggers a physiological response that lowers stress levels. We have many studies that show humans perform better on cognitive tasks while listening to nature audio, pausing to view nature scenes, and green spaces adjacent to schools boost cognitive development in children. We know that adults perform better on work-related tasks when they, too, have access to green spaces.

 

Nature helps us feel joy, we become more creative, and moving our bodies further supports the metabolization of emotion. Neuroimaging studies have shown that being in nature activates regions of the brain associated with empathy and emotion regulation.

 

Back to social media for a sec – It’s important to acknowledge that we often see posts in the Internet space about folks who mountain climb, backpack across countries, and live on sailboats. It’s easy to engage in comparison and think of ourselves as not doing enough when we aren’t able to participate in viral-video-worthy feats. But, the nervous system doesn’t discriminate between the leaf on the tree at the top of the mountain and the leaf on the tree outside of your home.

 

Nature is everywhere, and can be free or low-cost to access. Some ideas, just to name a few:

  1. Sitting next to an open window
  2. Reading a book outside
  3. Picnicking with a loved one or friend
  4. Water balloon fight!
  5. Birding
  6. Journaling outside
  7. Hopscotch
  8. Disc golfing
  9. Running and/or walking
  10. Stargazing
  11. Laying in the grass and watching the clouds
  12. Gardening
 
Consider setting a goal of increasing your time spent outside by ten minutes per week, and notice what shifts. Do you have more brain space? More space in your body for your breath? Slow down and see what happens.
 
 
Climate Anxiety

Climate Anxiety

by | Sep 10, 2024 |

Hope, Action, and Climate Advocacy “I thought I couldn’t make a difference because I was too small.” -Greta Thunberg   We live in the age of information, which means it is increasingly difficult to limit one’s access to breaking news. More and more we are seeing...

Get Outside For Your Brain

Get Outside For Your Brain

by | May 10, 2024 | , ,

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Journaling and Mental Health

Journaling and Mental Health

by | Coping, Counseling, General, Mental Health

If you have ever had a conversation with your therapist about coping skill development, you have probably received a recommendation to begin a journaling practice. Understandably, sometimes journaling is met with skepticism – What does writing about my emotions solve, and why is writing so widely recommended?

 

Processing Emotions

  • Putting emotion on paper engages the prefrontal cortex – the part of the brain which puts language to emotion, grounds us in the present moment, and assists in regulating emotion.

Memory Consolidation

  • Put simply, memory consolidation is a process by which information in short-term memory is transferred to long-term memory. Writing about your experiences – positive or negative – strengthens the parts of the brain associated with this consolidation. What this means is that, over time, we become better at accessing various parts of a memory (sound, taste, touch, smell, thought, etc.) and this allows us to better make sense of memories that may be difficult or traumatic in nature.

Stress Reduction

  • Journaling has been found to activate the parasympathetic nervous system (the “rest and digest” response/the antithesis of fight/flight/freeze). Cortisol levels drop, breath deepens, heart rate begins to slow. Suddenly, the writer is able to be more present with themselves as they process.

 

More than what researchers have shared with us about how journaling impacts the brain (as noted above), put simply – writing with and for ourselves fosters an internal relationship. We are in relation with ourselves more often than we are anyone else, yet rarely are we taught what it means to interact with self or how to do so in a compassionate way.

 

If you are interested in exploring journaling but are unsure where to start, here are some prompts to explore:

  1. I feel __________ about journaling because…
  2. My relationship with myself could be described as…
  3. I want my relationship with myself to be more…

 

Remember, journaling is as individual as you are. Let there be spelling mistakes, run-on sentences, scribbles, and even drawings. Humans are gritty and messy; let the way you cope be gritty and messy, too.

Get Outside For Your Brain

Get Outside For Your Brain

by | May 10, 2024 | , ,

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Empowering the Self: An Introduction to Internal Family Systems Therapy

Empowering the Self: An Introduction to Internal Family Systems Therapy

by | Counseling, General, PTSD

Understanding the Internal Family Systems Model

 

Developed by Dr. Richard C. Schwartz in the 1980s, Internal Family Systems Therapy draws on a unique perspective that views the human psyche as a family system. Just as a family consists of different members with their own roles and characteristics, our internal system comprises various “parts.” These parts can be categorized into three main types:

 

  1. Exiles: These are wounded parts within us that carry unresolved traumas, pain, or memories from the past. Exiles often hold intense emotions and vulnerability.
  2. Managers: These parts take charge and work diligently to keep the exiles suppressed. They strive to maintain control, avoid triggers, and ensure our daily functioning remains intact.
  3. Firefighters: When the managers are overwhelmed or fail to protect us, the firefighters step in to manage crises. They adopt impulsive coping mechanisms such as substance abuse, disordered eating, self-harm, or other destructive behaviors to numb or distract us from the pain.

The goal of IFS therapy is to foster harmony and integration within this internal family system. By establishing a compassionate and safe space, individuals can develop a relationship with each part, understand its role, and ultimately foster healing and transformation.

 

Key Principles of Internal Family Systems Therapy

 

IFS therapy operates on several key principles that guide the therapeutic process:

 

  1. Self-Leadership: The central principle of IFS is the belief that within each person exists a core essence referred to as the Self. The Self embodies qualities such as wisdom, compassion, and curiosity. Through self-leadership, individuals can connect with their Self and guide the internal system towards healing and wholeness.
  2. Non-pathologizing Approach: IFS views all parts of the internal system as valuable and necessary. Instead of pathologizing or attempting to eliminate certain parts, therapists encourage clients to develop a compassionate and non-judgmental attitude towards themselves.
  3. Unburdening Exiles: IFS recognizes that emotional wounds and traumatic experiences can create inner exiles who carry the weight of these experiences. Through empathy and understanding, therapists help clients engage with these exiles, provide them with the support they need, and help them release their burdens.
  4. Healing Inner Conflicts: By facilitating open communication and negotiation between parts, IFS aims to resolve internal conflicts and foster cooperation. This process helps parts recognize their shared goals and enables them to work together harmoniously.

 

Benefits of Internal Family Systems Therapy

 

  1. Emotional Healing: IFS provides a powerful framework for accessing and healing deep emotional wounds. By establishing a compassionate relationship with our exiled parts, we can address unresolved traumas and find emotional resolution.
  2. Increased Self-Awareness: Through IFS therapy, individuals gain a deeper understanding of their internal system and the dynamics between their various parts. This heightened self-awareness allows for greater self-compassion and the ability to make conscious choices aligned with personal values.
  3. Integration and Harmony: The ultimate goal of IFS therapy is to foster integration and harmony within the internal system. By developing a compassionate relationship with each part, individuals can restore balance, facilitate cooperation, and enhance overall well-being.
  4. Long-lasting Transformation

 

Are you interested in working with a therapist that uses parts work? Sherese Cordova, LMHCA is currently taking new clients age 16+. Reach out today to schedule an appointment!

 

Window of Tolerance 101

Window of Tolerance 101

by | Aug 15, 2024 | , ,

Strengthening Coping Strategies Widening the Window of Tolerance The more adept we become at coping with distress, the more we strengthen our ability to experience the here-and-now sense of safety in therapy as we face our pain. When your therapist helps you ground,...

Things You Might Feel Shame For, That Are Actually Very Common!

Things You Might Feel Shame For, That Are Actually Very Common!

by | General, Self Acceptance, Self Worth, Self-Esteem

As therapists, we hear from people in all walks of life. Every client is different and comes to therapy with varied experiences, but one thing remains true; most people hold shame for things they don’t need to. When we feel shame, our brains will often make us think that we’re the only one who could think or feel this way, or that only terrible people would be. Aside from being a horrifically uncomfortable emotion, intense shame is detrimental to our overall mental health, relationships, and long-term self-esteem. 

 

While this is nowhere near a comprehensive list, below is a list of things I often hear in therapy, that are entirely normal. If you’ve ever had these thoughts, you are far from alone!

 

“When ____ died, I felt relieved”

 

What shame tells you this means: I must be a terrible person to feel a positive emotion after a death. Did I wish this upon them? 

 

What it actually means: You’re a human capable of compassion fatigue, empathy for an end to suffering, potential safety benefits to yourself or others, awareness of resource strain, etc. Grief is always complex and there are typically many conflicting emotions that can include relief. 

 

“I lied/cheated/stole in my past”

What shame tells you this means: “I am a liar, cheater, criminal.”

 

What it actually means: Many people hold shame for very minor mistakes or choices from their past. Barring violent or aggressive actions, most of the time there is a reason for these choices, that once understood, lets in compassion instead of shame. 

 

 

“I _____ to cope”

 

What shame thinks this means: I can’t deal with the stress of my life. 

 

What it actually means: Substances, “nervous habits”, and impulse spending are just some of the behaviors people often feel significant shame for engaging in when they are feeling difficult emotions. If your behaviors are causing you harm or aren’t working to reduce your distress as you hoped, all that means is that they aren’t quite the right option for you. There is never shame in trying to feel better, there are only things that serve you and things that don’t. 

 

“I have intrusive thoughts about ________”

 

What shame tells you this means: “My brain is out of control, I’m disgusting/disturbed for thinking that way”

 

What it actually means: You have a normal brain, working exactly how a normal brain should. Intrusive thoughts are so common, that it’s more uncommon to be someone who hasn’t experienced an intrusive thought. To be frank, I’ve never met someone who hasn’t experienced intrusive thoughts, only people who felt strong emotion after them, and people who brushed them off and forgot about them. Having intrusive thoughts (even ones that feel totally out of character!) says nothing about who you are. If these thoughts are causing you intense distress it is certainly worth discussing with a mental health provider, but even then, there is no shame in experiencing them. 

 

 

 

Seasonal Depression and The PNW Rainy Season

Seasonal Depression and The PNW Rainy Season

by | Oct 20, 2022 |

What is SAD? Seasonal Affective Disorder (SAD), often called seasonal depression, is estimated to affect roughly 5% of the population at any given time. Although it can occur with any seasonal change, the predominant timeframe is depressive symptoms starting with a...