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Motivational Interviewing - "Helping People Change"

Dr. Mee-Lee explained that he was recently providing training on Motivational Interviewing and explaining a situation in which a person was ambivalent about smoking. He went on to say that he would always encourage people stop smoking, but if they were ambivalent about quitting he would say “continue to smoke if you want.” A trainee challenged him asking, “Isn’t that just being manipulative and using reverse psychology?”

Dr. Mee-Lee then validated the idea that it could sound that way and then emphasized that “intent is everything.” He went on to explain, “My approach with a client is from a place of acceptance of their autonomy to make decisions about his/her own life and health. And anyway, I am truly powerless over making him/her change.”

Dr. Mee-Lee used Miller and Rollnick’s Motivational Interviewing book, “Helping People Change” to define acceptance using these 4 A’s:

Absolute Worth – “full respect for who the person is as a unique individual.”

Accurate Empathy – “ability to understand another’s frame of reference…and that it is worthwhile to do so.”

Autonomy Support – “honoring and respecting each person’s…right and capacity for self-direction.”

Affirmation – “to seek and acknowledge the person’s strengths and efforts.”

He reports having “stolen” a statement from a trainee who had gotten the statement from a professor: “How is what I am doing with this client at this time, helping them to help themselves?”

Dr. Mee-Lee encourages us to see that the work that we are privileged to do is not about how smart we are or how much we confront our client’s actions or beliefs so we can have them do what we believe is best for them. It’s about coming along side our clients as they embark on a “self-change” process while receiving “acceptance, compassion and discovery.”

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