The interest in MI as a central (not ‘specialist’ or ‘fringe’) skill for health practitioners is growing fast. I was recently approached by Allied Magazine to pen a brief article on MI in progressive allied health practice. What evolved from this invitation is reproduced and extended in this issue featuring Five Pearls for you MI practice. I do hope you find it a supportive recap of many of the explorations in your MI learning so far, or a stimulating intro for those of you coming along new to these concepts.

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In this issue I am extending on the beautiful Parker Palmer poem shared in Issue 48. If you missed it or would like a refresh you can take a peep in the blog listing below. In this ‘poem’ Palmer encourages us to work with presence rather than intervention, to be truly helpful when someone is stuck or struggling. This encouragement is deeply resonant with the spirit of MI and in this issue I thought it may be useful to bring this encouragement to life and offer a sample of what this may actually sound like in session with a client. This sample dialogue feature a practitioner working within the HAES ® approach to health. Read on for more…….

Download Issue 49

#active listening #haes #oars

For this issue of Practice Pavestones I am sharing a beautiful piece of writing from activist, author and teacher Parker Palmer, for our reflective practice. Palmer invites us to consider the option of ‘letting go’ as practitioners when we may typically experience the urge to grasp tightly and push for more in search of an outcome for the clients we work with. I do hope you enjoy it.

Download Issue 48

#autonomy #listen #presence

When working in an MI framework we are actively steering a conversation towards the strengthening of a client’s own motivations for change …..from within them. Rather than instilling motivation via our knowledge and enthusiasm, we are evoking it or drawing it out of the client. One way we can do this is by listening for and responding to change talk. In recent issues we have looked at responding to change talk by inviting our clients to ‘say more please’ by elaborating or giving examples (more in Issue 46). This issue will feature a quick look at responding to change talk by affirming it. When practicing affirming, rather than looking for problems and finding solutions we are ‘looking for the good’ and handing it back to the client – after all it is their resource!

Download Issue 47

#afformations #change talk #oars

An expression amongst MI practitioners, that some of you may have heard at a Pavestone training, goes something like this: ‘When you hear change talk don’t just sit there! DO SOMETHING!’. This is an evidence informed call to action for the practitioner. How WE respond to what we hear our clients say about change directly influences the appearance of more change talk, the strength of it and what a client may then do after session in the direction of change. It is amazing how often we miss opportunities to dig deeper and draw forth from the client. In this issue I will be introducing a fine tuning of the elaborative ‘tell me more’ question: asking your client for examples that may build towards the direction of change. Taking the time to do this can be a very efficient investment.

Download Issue 46

I’ve planned a fun edition this issue, the last for 2017. It’s all about saying thank you – such an important expression of this festive season. At the end of every MI 2 workshop, attendees are invited to write a thank you note to MI ‘as if they met MI in the street, like an old friend’. It is a playful way to round off the days learning and always heart warming. For this issue I have selected some letter highlights to affirm and encourage your own work towards continuing to develop in a client centred direction. I really hope you enjoy it.

Download Issue 45

This Issue is taking time out from our current exploration of the methodology or ‘mind-set’ of Motivational Interviewing. Inspired by recent discussions with colleagues in Ireland, this editorial offers some thoughts about the ‘heart-set’ of MI. In particular our practice of acceptance of our client’s autonomy: why respecting this is vital and challenging and what it can feel like when we lose our way with embodying this attribute. I hope you find this month’s editorial supportive and thought provoking.

Download Issue 44

#autonomy #spirit

Over recent issues (41 and 42) we have been exploring conversation options available to us within Motivational Interviewing when assisting clients expressing low confidence in their ability to change. In this issue we will be looking more closely at the challenge we may face if confidence building work is outside of our scope of practice. This may be particularly true when the behaviors our clients are trying to change are functional. In this challenge, our MI Spirit and framework can be a wonderful asset. Finding our client’s own reason for attending therapy through a respectful, values based conversation can help a sometimes risky discussion flow with empathy and connection. Read on for more about understating functional behaviours in a super soundtrack for this month.

Download Issue 43

Motivational Interviewing invites us as practitioners to have a deep belief in our client’s capacity to do well in their lives, if they so choose. In MI the therapist will put this belief into action and to go looking, with the client, for their resources and beliefs that would be an asset for the difficult task of behaviour change. This aspect of MI practice is highly relevant to our current exploration of the importance of confidence in our client’s ability to change and the role we play as practitioners in optimising its development. Last Issue 41 we took a look at skillful conversational options available to us when a client expresses low confidence in their ability to change. In this issue, I will be introducing a beautiful practice written by Bill Miller which you may find useful when helping your clients to develop confidence in their own ability to get some traction with important self-care behaviours.

Read on for more….

Download Issue 42

If you have been reading in sequence from Issue 39 you will be familiar with the skill of using scaling questions in MI to identify our clients’ own thoughts about the importance of change in their lives and confidence for making that change. In Issue 40 we focused particularly on working with low importance for change. The challenge this issue’s editorial will feature is: how do we work effectively with our client who believes strongly it is important to change but they are held back by a lack of confidence? Read on to explore some ideas of what MI might encourage us to do (and NOT do!) when this challenging scenario presents.

Download Issue 41

#confidence #scaling questions