Motivational Interviewing (MI) is a good thing. It’s good for the people who work in Corrections and for the clients we work with. When implemented the right way with coaching, feedback and fidelity, it can be a tremendous asset in our efforts to change behavior and even improve our own work culture. But for several years now I’ve observed problems with how it’s been perceived, implemented on a large scale, and practiced.
Let’s use the initial definition of MI from the article I linked above. It’s listed as a style of communicating that helps people explore and resolve ambivalence about changing specific, maladaptive behaviors. It can technically be defined as an intervention with the specific purpose of increasing motivation to, for instance, engage in treatment. But more commonly I see it applied generally across a variety of interactions, from interviewing for assessments to discussing violations. It’s a great definition for its application within Corrections but it also brings me to my first problem:
I don't actually understand what MI is
This may surprise you, but a lot of the people using MI skills have a fundamental misunderstanding of what MI is and what it’s for. It can lower resistance, it can be used to gather information, it can even be used within case planning to guide your interventions. But it is not change in and of itself. One does not MI another person to change. Although we can consider motivation a prerequisite, change doesn’t occur simply because we want it to.
I confuse skill deficits and barriers for lack of motivation
If someone isn’t changing their behavior, it may be because they don’t want to, but it also may be because they can’t. MI has been woven so thoroughly into the fabric of many of our organizations, it should be no surprise that motivation is typically where our eyes go when we encounter some level of failure. But oftentimes motivation is only half the story.
If I wanted to help change someone’s behavior, to say, improve their jump shot, it’s definitely important they have awareness a problem exists and a desire to improve. But it would be silly to stop at motivation. Maybe they’ve already bought-in and are eager for improvement, but they’ve never received any coaching before and happen to have a broken leg. I sense the motivation so I send them off without accounting for the injury, introducing anything new or even walking them through a practice. When they return, likely no better off than they were before, motivation tends to falter…on both sides.
Motivation is not linear
We’re all familiar with the stage of change as they relate to MI, and we focus on moving individuals through the stages in a linear fashion. But we also know motivation doesn’t always progress in a straight line and for many of the people we work with, it can feel like we are constantly having to rebuild momentum lost between meetings.
The book Tiny Habits by BJ Fogg, does a great job describing this phenomenon as the motivation wave. It rises, it falls, and most importantly, it’s perfectly natural. This isn’t a problem for the justice involved, it’s part of the human condition. When motivation is high we can accomplish difficult tasks, but as motivation naturally wanes, so does our ability to maintain new desired behaviors. When we feel like a failure, our motivation can sink even further. Keeping our interventions and directives at an unattainable level for the individual and only focusing on motivation as a response to failure will not create the momentum and feeling of success needed to build new habits, and it certainly won’t result in sustained behavior change
When something doesn't do what it's supposed to do, I stop using it
What happens when we are asked to use a tool we think doesn’t work? Even though this feeling stems from the misunderstanding of MI I noted above, corrections professionals, like anyone, are much less likely to use a skill if they don’t believe in its efficacy. Even if they were obligated to use it in while being directly observed, it’s unlikely they will continue to practice it once monitoring ends.
Unfortunately, I think this point extends to evidence-based practices in general. Misconceptions on what the term means and a lack of immediate returns based on unrealistic expectations commonly result in frustration and even resentment toward innovations in our field. So where do we go from here?
Think of MI as a language
What if MI was an entirely new language that needed to be learned? We can think about this both from an individual (skill development) and organizational (implementation) perspective.
- Elementary
- Proficient
- Fluent
- Native
For anyone who has attended nothing more than an initial training, I think it’s fair to call that an elementary skill level. That person may retain a basic understanding of concepts and even use a few canned statements, but they would likely struggle to maintain a challenging conversation using MI. A step above would be MI proficient, where the person may be able to use their skills in conversation but it would require a great deal of focus and energy. Using MI can become so exhausting as a result that it’s typically switched off as soon as the interaction ends. Constantly having to translate words and phrases in their minds is not likely to be sustained for an entire work day. The next level would be fluent, where using MI has become relatively easy. The person is consistent and accurate in their delivery and the mental processing has been reduced to a nearly effortless level. Finally, at the native speaker level, MI has become the language the person does their thinking in; they sound like they have been using MI since childhood.
When we consider the amount of practice, feedback, and guidance needed to become proficient in another language, I think leaders can better understand the challenges to implementing evidence-based practices like MI and take a more strategic approach to adopting it. And as individuals, if we re-examine our understanding of it and take it upon ourselves to practice these skills, not just with clients but in our every day interactions, we can become as fluent as we want to be.
I think even at it’s most basic level, using MI forces people to at the very least listen to what the other person is saying.
I’d rather have a field full of people at the basic level than have a lot of people who just DON’T use it.
I guess what I’m trying to say is I think “bad” implementation of MI is better than nothing.