Motivational Interviewing: Affirm Autonomy

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

1 comment

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: