Motivational interviewing practice model: cultivating change talk

3rd August 2020

The technique of motivational interviewing (MI) encourages our participants to explore an individual’s readiness to change and the process needed to facilitate this. It offers the families we work with the space to explore the benefits and challenges of change, for them and those close to them. Principle Practice Tutor Tessa explores what MI as a practice model looks like at Frontline.  

How do we help people to achieve change? MI supports our participants in answering this question. In social work, we are often wanting people to change something and this sometimes feels challenging for families who may not initially want to work with us. In this situation if you start to give advice or tell someone what to do, you can get a lot of push back from families. MI avoids this situation it says that if someone asks for advice then that is okay, but if they don’t want advice, don’t give it to them. Instead, motivational interviewing encourages social workers to enhance their listening skills and to pick up on when people are making arguments for change. It also focuses in on and amplifies change talk to take the focus away from the areas where a person is arguing to stay the same.  

There will be times when a social worker has to tell a family what to do in order to keep a child or young person safe. In these situations, MI would say you can still respect people’s autonomy; for example, you can tell a family that it is against the law to hit their child with an object and leave a markbut within this you can respect the parent’s autonomy and ask for their ideas on alternative ways to discipline their child. It also emphasises the support role a social worker plays – what can we come up with together to think about that?  

There are a few key ways social workers can use MI to best support families, often using the acronym OARS.

Open QuestionsMI encourages social workers to use open questions, rather than closed ones. This is because open questions elicit the persons own ideas rather than your ideas as the social worker. For example:  

  • Closed question: do you think it is a good idea to go to the park and get some exercise? This would receive a yes or no answer. 
  • Open question: what are your ideas about getting exercise? Receiving a number of different replies. This ties in with systemic ideas around curiosity. 

Affirmations: Recognising the qualities or the strengths a person has to make a change. Listening out for or noticing things a person is saying that are going to help them make changes in their life. For example: you didn’t smoke for four days this weekRecognising this affirms the persons efforts and strengths in this situation 

ReflectionsReflecting back what a person has said. There are two types of reflections, simple and complex. Simple reflections involve repeating back what someone has said. This can be really reaffirming for someone because it shows that you have listened really carefully and you are hearing what they say. A complex reflection is where you are reflecting back what the person has said but you are adding a little bit more to it based on what the person may be thinking but has not yet said. Here is where you are likely to be cultivating change talk. 

Summariesgathering together of reflectionsSummarising what the person has said and handing it back to them. This again can be affirming and skillful in terms of bringing together all those things which might be helping that person towards change.  

MI is a really practical approach that our participants use to be able to facilitate conversations about change with families. By using this approach families feel listened to and not judged, allowing our participants to build strong relationships and work towards the best outcomes for children.  

Throughout our summer institute, we’re taking a closer look at the practice models our participants learn on the Frontline programme. Learn more about our systemic practice model here and parenting interventions here.