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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.

 

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...

Be a Better Mental Health Ally: 7 Stigmatizing Phrases and What To Say Instead

Be a Better Mental Health Ally: 7 Stigmatizing Phrases and What To Say Instead

by | General, Mental Health, Relationships

Chances are, you’ve either said or heard each of these phrases. While not typically used with ill-intent, imagine for a moment being someone who experiences the mental health challenges described, and how you might interpret these statements. Small, intentional changes to the words we use can have a huge impact on others, so let’s go through some common phrases, why they might be harmful or contribute to stigma, and an easy alternative for each. 

 

  1. I’m so OCD about _____.

 

We all have things we like a particular way, or feel some level of discomfort with if they are not done “properly”. However, OCD is a debilitating disorder that goes way beyond preferences or a bit of discomfort. While some people with OCD have obsessions and compulsions related to cleanliness and organization, there are many different themes, and reducing OCD to fixations on cleanliness dismisses these. 

 

Instead try: It’s really important to me that the kitchen be clean, I feel uncomfortable when it’s messy!

 

  1. Everyone is a little ADD/ADHD.

 

Everyone is forgetful sometimes, struggles to focus on tasks sometimes, and struggles to find motivation sometimes. However, people with ADHD experience symptoms like these (along with many others) every single day, to a level that interferes with their functioning. Again, saying that “we all” have some level of this downplays the challenges people with ADHD face.  

 

Instead try: Wow, I am so forgetful today!

 

  1. They’re so crazy/psycho!

 

People often use these terms to refer to someone displaying erratic or concerning behavior, whether or not it is related to a mental health diagnosis. It’s even used to refer to behavior we just don’t like, or to discredit someone. It is rarely, if ever, used with compassion, and if we are referring to people who are experiencing psychosis, delusions, mania, etc. it’s dismissive of the very real and terrifying experiences these people are going through. 

Instead try: They seem to be struggling to stay connected to reality, I wonder if we can connect them to support?

 

  1. I also experienced ______ and I’m fine!

Trauma affects everyone differently, and we do not get to decide what is traumatic to someone. Research has shown that two people experiencing the same event (car crash, natural disaster, etc.) can have wildly different responses. Your brain’s response does not negate another brain’s different response.

 

Instead try: That sounds like it was terrifying for you, how can I support you?

 

  1. It’s been _____ months/years, you’re not over that yet?

 

Trauma also has no timeline, and isn’t something we “get over”.  With help from tools like therapy, medication, and peer support many people can make incredible strides in healing from what happened to them, but trauma has lasting effects on the brain and nervous system. 

 

This also applies to knowing someone has been managing a mental health diagnosis (OCD, Depression, Anxiety, etc.) long-term. Many people do experience significant improvements to a level where they no longer meet diagnostic criteria or identify previous challenges as a concern, but many people experience chronic mental health challenges that require lifelong management. 

 

Instead try: I know this has been hard, let’s talk about how we continue supporting you. 

 

  1. That person/the weather here is so bipolar!

 

While there are scientific uses for the term bipolar, most people more commonly use this term to casually refer to something/someone that changes rapidly and without warning. Again, speaking this way is dismissive of the intense and terrifying experience of shifting between manic and depressive episodes. 

 

Instead try: The weather changes so quickly here!

 

  1. Kill me/I wanted to die!

 

For people who have experienced suicidal ideation or attempts, hearing other people casually or jokingly say things like this can contribute to the stigma that often stops people from seeking help. If you are experiencing suicidal thoughts (even passive ones!) it’s important to mention them so you can find help, but if you’re trying to find an impactful way to describe frustration, embarrassment, or shame, there are better options. Suicidal thoughts are more prevalent than you might think, and shouldn’t be the punchline in a joke. 

 

 Instead try: That was so embarrassing I wanted to run out of the room!

Now that you’re aware of the potentially harmful effects of these phrases, you might be surprised to notice how often you hear them used. To be a better mental health ally, first start but just noticing when you use them or when they come up for you, then try to consciously replace or correct yourself with something like the alternatives listed. Small changes make a big impact!

 

 

 

Climate Anxiety

Climate Anxiety

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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...

Deep Breathing: Why Do It?

Deep Breathing: Why Do It?

by | Jul 27, 2021 |

If you have ever felt frustrated by being told to just "take a deep breath" when you are feeling angry or anxious, you aren't alone. It's difficult to heed this advice when, in the moment, the mind and body are distracted or dysregulated. The adage of "just breathe"...