The first statements you make to the young person should encompass the spirit of Motivational Interviewing (MI). The core principles of MI need to be borne in mind at all times, communicated to the client at the outset, and demonstrated consistently throughout your conversations (Naar-King & Suarez, 2011; p23).
Central to the spirit of MI is respect for client autonomy.
The assumption is that all people have the wisdom and capacity to develop in a positive direction given proper conditions of support (Miller & Moyers, 2006).
MI is a strengths-based approach.
Practitioners who view clients from a deficit-based perspective may have difficulty embracing the spirit of MI and learning (Miller & Moyers, 2006; p6). Following from this, the role of the practitioner is to support the client to identify, develop, and commit to their own agenda.
The relationship is collaborative, not directive.
You, the practitioner, are not the expert on what is best for the client. These principles are highly consistent with core values of most youth AOD services, and they guide our interactions with young people regardless of what therapeutic interventions are being used.
The spirit of MI is also captured in the difference between ‘guiding’ and ‘directing’.
The key is to convey the idea that you will support the changes that the young person wants to make (guide), rather than decide which changes will be made and push those (direct).
Clarifying the nature of the guiding relationship is particularly important for adolescents whose previous experience has involved being subject to directed change (e.g. court orders) (Naar-King & Suarez, 2011; p23).
You may experience a reaction of cynicism or disbelief (e.g. ‘I know you have to do your job and make me stop using’). Do not take these statements personally. Provide a forthright response that allows the young person to take responsibility for his or her decision to engage or not (e.g. ‘I can’t change what happened that made other people think you need to be here, but I can help you explore what’s going on and how you decide you want to handle it’). You can also ask for clarification to further understand the young person’s point of view (Naar-King & Suarez, 2011; p23).
Many young people will lack experience in setting their own agenda during conversations with adults, and orientation must extend to getting this started. An exercise that can be used to start the interview in the right spirit is to provide a list or menu of topics (e.g. stress, family, drugs, school etc) that could be the focus of the conversation and ask the young person to choose one of these or to suggest another (Miller & Rollnick, 2010)<link to ‘What shall we talk about?’ exercise>.To reinforce your non-judgemental stance avoid using the term ‘problem’ to refer to the behaviours that other people are concerned about.
Avoid focusing on issues that have been raised by others such as parents, teachers or other authorities. Emphasise that the focus will be on what the young person wants to work on. To reinforce the voluntary nature of engagement and your respect for the young person’s autonomy, ask permission to engage in any task or line of questioning (e.g. ‘If its OK with you I would like to find out more about what led to you being referred here’a.
Avoid giving advice unless permission has been granted.
As a general rule MI avoids giving advice. Advice should only be given if the client (i) asks for it directly, or (ii) if you ask permission and it is granted, and (iii) if you qualify the advice to emphasize the clients’ autonomy (Miller & Rollnick, 2010) (e.g. If the client asks ‘What would you do if you were me?’ a qualified answer would be ‘Well it’s entirely up to you of course, but if I was in this situation I might consider …”).
