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Feature Article: The Four Processes in Motivational Interviewing: Part II
From Dr. Ellen's Blog: Using Motivational Interviewing for Leadership Training
The Changing Times
Motivational Interviewing for Positive Behavior Change
I live in the northeastern US, in the Boston area. About three weeks ago we experienced one of the most violent storms I’ve ever been through, and lost power to our house for four days.
As problems from this storm go, this was mild, but
disturbing to me and my family none-the-less. It’s truly
shocking how dependent we are on our electronic devices! I
had no access to my computer with all of my work stored
there. It always surprises me how dependent I am on my work
to define me, and how I really don’t know what to do with myself
without my electronics, my work and my TV!
The third edition of the Miller and Rollnick text, Motivational Interviewing here was published in October 2012. One important new set of concepts is the Four Processes used in Motivational Interviewing. These refer to the four basic sets of ideas that guide the clinician’s relationship with the client, and dictate how the guiding style of MI is operationalized. In my October newsletter I discussed the first two of the processes, Engaging and Evoking. In this issue I will describe Focusing and Planning.
Focusing in MI refers to a particular agenda, or what the person came to you to talk about. This may also include your agenda for the client, and these may overlap or not. Your job as a clinician using MI is to help the client focus using the guiding style of MI. We avoid telling the client what to do, but rather guide in the direction of positive behavior change by helping the client to focus on behavior change goals. Focusing is the process by which you develop and maintain a specific direction in the conversation.
Planning includes both developing commitment to change and creating a specific plan of action. It is a conversation about action steps that includes the clinician listening carefully for the client’s own solutions to the problem. Again, this is the guiding style of MI; we are not telling the other person what or how to change, but helping them formulate their own plan of action. An important aspect of the planning process is emphasizing the other’s autonomy of decision making. We assume that our clients are experts in their own lives, and we let them know we respect that autonomy.
These four processes are operationalized throughout our relationship with the client. They are not sequential, that is, one does not end when another begins. They flow into each other and overlap, and each later process builds upon the ones before it. They can be visualized as stair steps, as seen below.
I will be writing more about this in the months to come
You are welcome to use Dr. Glovsky's articles in any of your own publications provided you copy the following into the article: "Dr. Ellen Glovsky is a Registered Dietitian and Motivational Interviewing trainer. She is on the faculty of Northeastern University in Boston, MA, where she teaches courses in nutrition, public health and MI. Her website, newsletter, and blog are at Training With Dr. Ellen."
Ellen Glovsky, PhD, RD, LDN 2012. All rights reserved.