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Steve Bryson
Nov 10, 2009

Motivational Interviewing to Competence

I just returned from some much appreciated time off. I went into the backcountry of Montana for a week and then went to a conference: "Motivational Interviewing to Competence". Being refreshed and renewed, I found the conference enlightening, instructive and intriguing. As a "seasoned" counselor, I have observed over the decades many new perspectives on the counseliing process. Many of them have made important contributions to a field that some would say is nebulous and indefinable, more akin to art than science. While I adamantly disagree with the view that what we do is fluff, there have been times when the art of counseling took the limelight while the science sat in the background.

The newer fields of CBT, DBT, ACT et al have done much to dispell the notion that we are just "tell me more about it" charlatans. Indeed, evidence based practice has allowed us to gain ground, not just for our clients, but for our standing in the professional helping communities.

At the conference, I learned that Motivational Interviewing (M.I.) has developed much since first introduced in the 90's, including outcome based research that shows effectiveness. The difference I appreciate with M.I. is that it focuses on the process of interacting with the client in such a way as to stimulate internal motivation. Of course Carl Rogers focused on this many decades ago, and it was good to hear the M.I. instructors credit him. But M.I. has scientifically evaluated what the counselor says that motivates, breaking down interactions not regarding the subject matter, but rather how the subject matter is discussed.

This seems to be full circle: process to subject to technique and back to process. While I think we all know we need to be knowledgeable and competent about the latest evidence based interventions most helpful with each identified problem, the fundamental truth is that without an effective relationship we cannot be helpful with anyone. And the beauty of M.I. is that it deconstructs interactions so that we can learn what will get the client in a mind frame to change.

Lets just not forget that without respect, genuineness and unconditional warm positive regard the client will not feel safe enough to be with us in our sophisticated techniques. And competent M.I. does just that. I can't help but think that Carl Rogers would be pleased.

Steve Bryson is a counselor in private practice in Whitefish, Montana and a registered nurse. He works with adolescents and adults, couples and families and has a special interest in eating disorders.

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