Sometimes Figuring Out Our Client’s Target For Change Isn’t Easy! Target Behaviors in Motivational Interviewing

There are four processes in Motivational Interviewing:

 
1. Engaging is about establishing rapport, connecting, ensuring that your client feels heard and understood.

2. Focusing is about determining the target behavior, what is the topic of change. 

3. Evoking process is about drawing out the client’s reasons for change. Then, if that client is ready, we move to the

4. Planning process, ending with an action plan to support change.
 
Today, I wanted to talk about the Focusing process, because sometimes figuring out the target for change isn’t so easy!

During one of my training sessions last year, I offered an opportunity to the group to practice a role-play where I was the motivational interviewer and one of the participants played the role of a client.

 
The training participant explained that she had a client whose adult son lived with her, and her client had much to complain about. Her son wasn’t helping around the house. He wasn’t looking for a job. He ate too much food. (And so on…) 
 

Her client was very stressed by the situation, and the caseworker wanted to role play an MI conversation in order to help her client figure out a plan to get the son relocated. This was her focus for the client.

 
We began the role play, and the caseworker acted out scenes from previous client conversations as I demonstrated MI skills.
 

I wasn’t getting any change talk from this client regarding the case worker’s target behavior for her client- to get the son out of the house.

 
The client had a lot to complain about, but it became clear that even though her son was a huge source of stress in her life, she actually didn’t want him to leave.
 

The caseworker had misread her client’s focus.

 
When this happens, we must shift the focus of change, and see how the client responds.

In this demo, the focus of behavior change shifted to managing the stress that was caused by her son living with her. Then, we could elicit her motivation around coping better with a situation she wasn’t (yet) ready to change!
 
 
MI Tip of the Week: Sometimes we can believe our client’s focus is on one change, but it’s really something else. When we are not getting any Change Talk specific to a change target, consider that you may be off-base about the goal of the conversation. What are the client’s values? What are you hearing that they want? Try shifting to a different change target and see where that goes! 

Watch my full video here!