Motivational Interviewing

Imagine a fantasy scenario where you wanted to be a Navy Seal.

But, instead of their usual methods, they tell you, show up here at 3 am every day and we’ll walk you through what exercises to do during the week and then you can do them on your own and report back.

No one yells at you or watches you. You do it all on your own.  Maybe they use motivational interviewing to get you to do the training.

When you fail to do the exercises, they ask you how you feel.

Well I’m just really tired after the first day…the exercises are very hard and starting at 3 am is too early because we don’t even finish the prior day’s workout until 2:45 am.

Drill Sargent:  How could we modify the training to make it easier for you?

What if we started at 10 am so I could get some sleep in between workouts?

Drill Sargent:  Sleep is really important for recovery. How confident are you that you could complete the workouts if we let you sleep during the week?

I’m moderately confident.

Drill Sargent:  Ok, well let’s try that. You come in at 10 am and that will give you enough time to rest up for the following day’s workouts.

You fail to do the exercises again.

Drill Sargent:  So how are the workouts going?

These workouts are really hard. You guys want me to jump in this super cold water and just keep swimming until I actually drown.

Drill Sargent:  So the drowning makes you uncomfortable?

Yes.

Drill Sargent:  Here in your Self Reported Navy Seal Training Log, it says that you didn’t quite finish on Wednesday.

I wasn’t able to stay late on Wednesday because I had this dinner with my friends. It was Shannon’s birthday.

Drill Sargent:  Many people have a hard time managing Navy Seal training while also maintaining relationships with friends. Do you feel like these friends have a negative influence on your seal training?

Yes, it’s just really hard to do these workouts and still keep a personal life you know?

Drill Sargent:  Is there a positive activity that you could do with your non-military friends that might also help you become a Navy Seal?

I could ask them if they want to overhead press inflatable boats on the beach together at 1 am.

Drill Sargent:  How confident are you that you could convince your friends to overhead press boats with you?

Hmm…not really that confident.

Drill Sargent:  Well, we want to choose activities that you can be successful at…

 

If the Navy followed this process, would you expect them to have a bunch of stone cold killers, prepared and willing to do whatever is necessary to succeed?

The right answers often exist on a spectrum

We fall into this trap of believing that one strategy is the right strategy. Some clinician did a study and they found that this or that works 1% more effectively in a lab environment. We read a book about it, and we start applying it.  This is now our answer to a problem.

It doesn’t work all the time. It doesn’t even work most of the time. Yet we still do it because we read that it works. We see it work occasionally.

The reality is that strategy exists on a spectrum.

One end of the spectrum can be vastly different than the other.  Sometimes one strategy is the exact opposite of another.

In this example, on one end we have this passive method of Motivational Interviewing, which works well with some people in particular situations. We make small changes one at a time. We let the person making that change steer the process.

On the other end of the spectrum we have drill sergeants screaming in your face, pushing you off the side of a boat with your hands tied behind your back. You must either swim or drown.

Which answer is right?

Both are right.  Both of these strategies, however different, work some of the time, but only in a particular situation. The people involved, the environment, the change we’re making, must all dictate the strategy. The answer to your situation may exist somewhere along this spectrum or may even exist outside it.

There are no universal rules that work in all situations.

Sometimes you can wait until people are ready to make a change.  Sometimes people need to be pushed into the water.

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