Monthly Archives: November 2014

BG chain link fence



Why is it sometimes so hard to accept the personal agency of others?


Yesterday’s continuing professional education workshop on Motivational Interviewing was an absolute joy. Just me and 10 practitioners in an intensive clinical day of exploration, engaged practice and critical reflection.

One of the ideas that we kept circling back to was autonomy. It can be incredibly challenging for clinicians in the health and counselling fields to sustain absolute, nonjudgemental acceptance and collaboration when individuals engage in damaging or destructive behaviours/choices. And everyone agrees that a fundamental component of any health provider’s role is to facilitate change. So we have a bit of a paradox:

(a) On the one hand, we are here to support and facilitate clients’ change in positive directions.

(b) On the other hand, we come to the interaction with radical acceptance of clients’ autonomy, control and decision-making. This acceptance is integral to the ‘spirit’ of Motivational Interviewing, coupled with a deep compassion for what it is to see the world through another’s eyes.


Simple but not easy, when we care so much. When we want to make it right and lessen the suffering. When we just want to be helpful. If only this person would listen, things would improve!


I have found that the heavy work is generally not related to facilitating change. The really hard part is continuing to come alongside a person when he or she is not ready or willing to change. And hearing ourselves say, out loud, to that individual: “It really is your choice. You are the one who has to decide this.”


People are most able to change when they feel free not to.



Resist the Righting Reflex

sticky buns


One of the axioms about great presentation skills is to “make it sticky”


Sounds good, but how? Here are four of tried-and-true strategies (the “application” part is how I say it – you can adapt to your style!).


1. Get people talking

People remember most of what they say, versus what the presenter says

Application: “Take 3 minutes, turn to the person next to you and share one thing that stands out so far”


2. Evoke disagreement

Critical analysis often means criticism – ideas don’t stick if a person hasn’t had a chance to integrate within existing knowledge, assumptions, worldview

Application: “Write down one concern, question or skeptical comment or idea about what I’ve been saying”


3. Initiate a “Teach Back”

No matter how much knowledge/skills/expertise I might have started with, anything I’ve ever had to teach forced me to learn more deeply.

Application: “Find someone you haven’t spoken to yet and teach them ___ (concept, skill, approach, etc.)


4. Bridge the Gap

Don’t be afraid to assign homework.

Application: “Before you go to sleep tonight, write down three things that you are going to practice or do differently based on the work we’ve done here today…and put them on your computer screen/refrigerator/other.”


Last week I was asked to facilitate a workshop for a diverse group of community health and counselling providers. The organizers asked for an outline of the proposed session as well as an overview of a subsequent follow-up session to help ensure uptake and implementation. In other words, why invest in staff training if there’s no traction over the longer term?


The research/education/practice gap is undeniably tough to bridge, and follow-up coaching and training certainly helps increase adoption and skill development. But in my mind, every presentation is an important opportunity to foster motivation for change – with or without follow-up.

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