“I live a day at a time. Each day I look for a kernel of excitement. In the morning, I say: 'What is my exciting thing for today?' Then, I do the day. Don't ask me about tomorrow.”

-Barbara Jordan

Let’s start from the top: just what is motivational interviewing? Motivational interviewing (MI) is a style of engaging with someone, often a client, in a way that elicits the client’s motivation to make a change or take positive action. This therapeutic or conversational approach is goal-oriented, and centers the client’s (or other person’s) feelings and perspective (Miller & Rollnick, 2009). Motivational interviewing can help people work through ambivalence (or feelings of being stuck), by focusing on their motivation and drive to change. 

"The overall goal [of motivational interviewing] is to increase the client’s intrinsic motivation so that change arises from within rather than being imposed from without."

-Dr. Sune Rubak

So how do you practice motivational interviewing? Let’s assume that you want to use motivational interviewing with a client. The motivational interviewing approach sees the client-provider relationship fundamentally as a partnership that works by honoring client autonomy (Miller & Rollnick, 2009). In line with this aim, work to be a support for clients, rather than a director. Rely on the client’s expressed goals and values to help them identify changes they want to make in their lives. Practice mirroring language to reflect back the client’s perspective and position. Next, focus on the client’s feelings of ambivalence; what is keeping them from making a change? A large part of MI is helping the client understand and resolve ambivalence. Last, practice empathetic listening throughout the conversation and focus on reinforcing the client’s expressed interests and beliefs (Rollnick et al., 2010).

Research has found that motivational interviewing is an effective tool to help clients make positive change.

In a review of 72 randomized controlled trials that used motivational interviewing, MI “outperform[ed] traditional advice giving in approximately 80% of studies” to effect behavioral change, particularly in smoking cessation, increased physical activity, and addiction treatment (Rubak et al., 2005).

Next month, we’ll continue to dive into motivational interviewing, so send your questions our way via aeinfo@multco.us!

It was psychologist Carl Rogers who inspired MI’s main goal of personal growth. According to Rogers, people need an environment of genuine openness and acceptance so they can self-disclose what is really important to them and what is going on in their lives. Rogers found it effective to have people he was helping to guide their own process. This makes them an active participant, and open ended questions help narrow down the direction the person wants to take. Open-ended questions help us find out about a person’s perspective and desire for change. It is crucial for building a collaboration for change and understanding how to evoke change talk. Change talk is exemplified by the desire for, ability to and reason for making a change in a person’s life.

Open-ended questions keep the conversation going, help us understand what is important to the other person, and what methods of going about change might work for them. It encourages exploration and engagement and allows the other person to go more in depth with their thoughts and feelings. According to crisis negotiator and author Chris Voss, “The real purpose of an open ended question is to give people a chance to think rather than to get an answer. One gets an answer but the main focus is to get the person to think.” If a person identifies problems with their own behavior, this is a good opportunity to ask open ended questions. 

Change is possible when people give voice to their own reasons for wanting things to be different. Get comfortable with silence after an open-ended question. Leave space for the person to think and respond. Some people need more time than others. Listen for need statements which are more emotional statements compared to reasons statements which indicate more cognitive and rational motivations. When a person begins using verbs in their statements that express an authentic move towards change talk, open ended questions can be used to get them to elaborate on what steps they want to take next.

There are 4 stages of motivational interviewing and open ended questions play a role in each stage. 

• Engage - This involves forming a relationship with the person and finding out what topics the person is interested in exploring. The goal is to ask broad open ended questions to gather enough information to move into stage 2. Start with engagement in mind by building rapport. Allow space for them to express their needs before jumping into an assessment or filling out forms. This enables the person to feel more like an active agent in the process rather than a passive participant. 
• Focus - Narrow down what to focus on during your time together. Open ended questions are to make sure important motivations for the client are focused on. What is important to the client may not be in line with our goals or the goals of a program. Other people’s goals don’t motivate personal change. It has to come from the client and getting clear on what motivates them is the focus. 
• Evoke - Solicit the person’s own words that will help them make positive changes. Aim questions at what might help the person take steps towards change and what supports might be helpful while highlighting their strengths.

This is the stage to implement open ended questions that speak to their DARN CATS – desire, ability, reason, need, as well as commitments, action, and taken steps. DARN indicates the preparation and CAT indicates the implementation.

• Plan - Create an action plan of concrete steps the person can take to effect change and demonstrate personal agency. At this stage open ended questions are more guided and directional. By going through the previous stages it is clear what the client's goals are and now we can offer help. Here open-ended questions in this stage should follow the elicit-provide-elicit (EPE) formula or as it is talked about in AE, Ask-Offer-Ask. Ask for permission to provide advice, provide the advice, and ask if that advice is understood and seems applicable. Giving unsolicited advice can inhibit the client’s sense of agency.



Open-ended questions serve the purpose of avoiding the question-answer trap where the person gives very short responses often in the form of “yes” or “no.” By engaging with open-ended questions, it allows the person to explore and better understand their ambivalence to change. They get to examine what about change is advantageous and what about not changing holds an appeal. Open-ended questions usually start with words like “how,” ‘what,” ‘describe,” and “tell me more about…” They usually start off broad and then narrow down as general content information is given to clarify and focus on key issues. 

With a little creativity closed-ended questions can be turned into open-ended questions. Closed-ended questions are like filling out a form where very simplistic answers are provided. Example: Are you feeling anxious? vs. What is causing you to feel anxious? By giving the person space to describe what is going on, they can provide context to their feelings or situation. Whenever applying motivational interviewing to an interaction, keep in mind that the undercurrent is always compassion and empathy. We are co-collaborators seeking to create a non-judgmental environment of openness and acceptance to explore motivating and meaningful change.

“What you do for yourself depends on what you think of yourself. What you think of yourself depends on what you know of yourself. What you know of yourself depends on what you've been told. It's time to change the narrative on what you've been told."

-Elizabeth Leiba, I'm Not Yelling

Full disclosure, my therapist recommended this book to me years ago...but I ignored it.

I stumbled upon this treasure in a book search on my beloved Libby app. I'm not Yelling: A Black Women's Guide to Navigating the Workplace by Elizabeth Leiba found me when I truly needed it.

Leiba shares her story of growing up the daughter of Jamaican immigrants to America and the nearly insatiable need she felt to “belong” somewhere. She shares complex and thought provoking stories about her experiences and the experiences of thousands of Black and BIPOC women across the country who are navigating corporate and government spaces. She offers practical tools, data, and a critical compassionate eye to the pattern that many women of color experience in these spaces with the affirmation that “you are not alone.”

She traces the origins of her internalized feelings of being “the other” and “not enough” back to school days. The culture of her high school years was one of acceptance in an environment where teachers nurtured authenticity and students’ unique voices. She recounts stories of teachers in those formative years who taught her how to look at her African ancestry with pride and understand the intersections of her African history and that of the Black American experience. This culturally responsive investment by teachers that looked like her in high school was in stark contrast to her college experience. She often went unseen and unheard in college by her peers and by professors, in a school where (statistically) most of the students in orientation wouldn’t make it to graduation. This was not just accepted by professors, the Dean announced it during the first week at an orientation assembly. In AE, we talk about holding hope for and with clients and how this can support in expanding a clients’ “vision of possibility” for the future. In the author’s lived experience and in the lived experiences of many others, one’s vision of what is possible can be limited by teachers who simply are unaware of the unique challenges and experiences that students with marginalized identities often face in academic environments.

This unfortunate data point stuck with Leiba. She started internalizing the statistics that she was learning about pay inequities, graduation rates and racial disparities. She became very aware of the barriers to access for many immigrants, disabled students, and students of certain socioeconomic backgrounds. It was in college that she began code switching and cultivating an entirely new persona for herself. Later this persona would be nicknamed “Angela” by her husband and close friends; the persona was nothing like Leiba. Angela was always amicable, didn't stand out too much, very quiet, reserved, and ultimately she could survive in a culture where Leiba’s authentic self was unwelcomed and often unsafe. The author mentioned shirking away from any opportunity that put her in the center of attention; she didn't want to be seen or noticed for anything at all and mentions that she felt “safer” that way.

As a County, we are looking to recommit to the WESP (Workforce Equity Strategic Plan) and moving forward with workforce initiatives that foster the safety, trust, and belonging that lead to better retention rates and a healthier organization.

Lets all consider:

• "How do you use your voice in the spaces you navigate daily?"
• "Is that voice different from the one you use at home?"
• "How would you describe the differences in these voices to others?"

If you’re feeling like sharing, even anonymously, we would love to hear from you! Send any comments and reflections to aeinfo@multco.us. 

The author gifts us several powerful affirmations, which I’ve included for you below! Feel free to recite one or all of them on a regular basis to foster self compassion and resource yourself to continue on whatever journey you choose.

Positive Affirmations

• My experiences have uniquely qualified me for everything I will accomplish today.
• I am releasing myself from old limiting beliefs about who I am now and who I have the potential to be.
• I am happy and content at this moment.
• I lean confidently into my most valuable traits and talents.
• I am capable of successfully learning anything I don't have the knowledge to accomplish now.
• I can accomplish anything I can dream of without a fear of failure.
• I will overcome my fears today.
• I am proud of the person I am today and the person I will be tomorrow.
• I have the power to change my life. 
• I am attracting infinite abundance today and everyday. 

The book is available in print and audiobook by our friends at Multnomah County Library here.

Saturday,

March 30

11:00 am - 3:00 pm

Affirmations are a way of reflecting back something positive that someone says or thinks about what they are doing. Think of someone in your life that could use a positive reflection. Which of these could you say to them?

https://www.multco.us/assertive-engagement