How To Use Motivational Interviewing to Be a Better Mentor

2021-03-08
Zachary
Zachary Walston
Community Voice

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Leadership and management books make it sound so easy with their 7-step processes. They layer on their personal experiences to drive home the ease of use. Unfortunately, individual experiences can rarely be universally applied to all situations.

When starting out as a manager of a physical therapy clinic, I applied many of the management rules found in popular leadership books.

I took concepts from Starts With Why, Leaders Eat Last, The Five Dysfunctions of a Team, and Good to Great

While these books include some helpful anecdotes, many are specific to the author's experience.

As a novice leader, I needed strategies with more teeth and greater applicability.

Leadership and management strategies often fail to consider basic psychological principles. It is often assumed that persuasion can easily be achieved through sound reasoning. The combination of authority with well-structured arguments theoretically will lead to behavior change.

This is not a universal truth.

If someone is not seeking change, it does not matter how your argument is structured, it will fall short. I have experienced this both as a manager and an educator. Mentoring won’t be successful if the employee doesn’t want to be coached.

You have likely experienced this yourself. Even the initial steps of accepting information and advice fall short if you have no desire to obtain it. In rare circumstances, the information you initially had no desire to hear may strike a chord and pique your interest, but in most cases, the information travels through your brain unfiltered and uncaptured.

I stumbled upon the mentoring solution when researching ways to improve giving advice and foster behavior change in my patients.

The five techniques I am outlining fall under the overarching tool known as Motivational Interviewing. While they have been designed for patient care, primarily in psychology, they can be helpful for managing. I refined these tools with patients but found them equally helpful in management.

Giving Advice Starts with Listening

Motivational interviewing is a “person-centered method of guiding to elicit and strengthen personal motivation for change”. Essentially, it is the art of responding to someone rather than vomiting information. 

The communication is empathic and person-centered with special attention focused on the other person’s own verbalized motivations for change, not yours. 

While I understand there are cases when a manager simply needs an employee to accomplish a task, explaining ‘the why’ improves buy-in and performance. Simon Sinek drives home this point in Start with Why:

“There are only two ways to influence human behavior: you can manipulate it or you can inspire it.” 

Studies have shown motivational interviewing significantly improves retention and motivation for change six months after initial conversations. The improvements have been demonstrated in a variety of settings, and while they are primarily health-related (e.g. problem gambling, smoking, exercise/activity level)l, they can apply to business settings and behaviors as well. 

Here are the 5 specific techniques you can immediately use.

1. Promote Change Talk

The key is to behavior change is having the other person voice the arguments for change rather than the mentor. When done correctly, the results are promising.

This integral component to promoting behavioral change is referred to as “change talk”. Depending on the person and attempted behavior change, the amount, intensity, and sequence of change talk can vary. 

On the flip side, when someone uses “sustain talk” they are strengthening the current behavior. The goal is to increase change talk while minimizing sustain talk. Here is an example:

Sustain talk: Every time I use the new sales strategies I fail to make a connection with the client. I have tried all the recommendations you gave; I’ve heard it all before. These new techniques simply don’t work for me. I’m sticking with what I know.

Change talk: It does seem like John is more efficient using the new process. The current methods are time-consuming, and I would like to have more time for completing my other tasks. Perhaps I can try the new strategies again.

Small wins are still wins; you can build off them.

A mentor's frequency of change talk does not matter. The mentee has to verbalize the change. 

The potential behavior change will be directly related to the person’s change talk during conversations, and inversely related to sustain talk.

In every treatment session, my goal was to maximize change talk.

After all, the primary purpose of providing advice is facilitating behavior change, not providing a list of fun facts.’ 

So how do we enhance change talk?

There are several components of motivation needed for change: desire, ability, reasons, need, and commitment. The strength of these components can reliably predict the strength of the commitment but not the actual change. 

They prime the individual for change. 

Motivational interviewing can extract statements that express desire, ability, reasons, and need for change which in turn strengthens the commitment to change. 

With respect to change-talk, “action-oriented” speech has stronger correlations with follow-through and maintenance of the targeted behavior change.

Providing advice should have a plan and a structure. Frequency, intensity, and mode all vary depending on the readiness of the individual you are educating. It is not a linear progression. If you find someone is using more sustain talk and less “action-oriented” change talk, you may need to take a step back and re-evaluate the situation.

2. Use Open-Ended Questions

“The single biggest problem with communication is the illusion that is has taken place” — George Bernard Shaw

Open-ended questions are one of the most powerful tools at your disposal. It encourages conversation. Closed-ended questions have value but should be limited to situations in which you want a quick and clear answer. 

When taking a patient’s history, I would ask close-ended questions to learn facts (do you have a family history of cancer) and open-ended questions to understand a person's beliefs (what do you think contributed to your low back pain).

You can use the same approach for any profession.

If you are seeking an opportunity for coaching and facilitating behavior change then open-ended questions are needed.

Open-ended questions are the start of the OARS technique: Open questions, affirmation, reflective listening, and summary reflections. 

OARS should be used early and often in conversations by leaders. It invites the individual to open up and express concerns. It allows the leader to validate those concerns. Lastly, and most importantly, it helps the individual work through the problem. It is not a setup for giving advice (more on this later).

Leaders can use open-ended questions and reflective listening to empathize and affirm the individual's strengths, resources, and achievements, which will enhance the belief they can change.

What happens if someone is resistant to the conversation or you there is an endless loop of excuses? Time to roll with resistance.

3. Roll With Resistance

What happens if someone has no interest in changing? How do you increase the odds of change talk occurring? 

Focus on the relationship.

A key to building a relationship is honing a strong empathic thinking skillset. Often times a person may feel judged, frustrated, trapped, or incapable of change. If you bulldoze through a conversation, forcing down education, or ignore the individual concerns of the other person, you will struggle to transfer any knowledge or facilitate behavior change, no matter how sound the reasoning is.

“If you would persuade, appeal to interest and not to reason.” — Benjamin Franklin

If a person is to fully explore the possibility of change and develop sound strategies, they require an atmosphere of safety and acceptance. This is accomplished through accurate empathy, congruence, and positive regard in every conversation.

It is impossible for me to tackle chronic pain and encourage a patient to open up without establishing a relationship. The same is true for any mentoring relationship.

Truthful open-ended questions require psychological safety.

To maintain the relationship and create an atmosphere of safety and acceptance, you may need to use a strategy called rolling with resistance.

Rolling with resistance is when we employ empathy and recognize the validity of another person's argument. This lowers a person's defensive shields and helps build a dialogue. Take smoking as an example. 

There is overwhelming research that smoking is deadly, yet, people continue to smoke. Rolling with resistance would be acknowledging why someone chooses to smoke. You might say the following: “You have a very stressful job and smoking provides you an outlet for stress relief.”

This is not condoning smoking, but it is recognizing the reason for smoking and reflecting without judgment. There are many different responses that can stem from rolling with resistance such as reflecting ambivalence (on the one hand you want a stress reliever but on the other hand you are concerned about the risks of smoking).

The idea is to foster change talk, but that only happens when someone is willing to engage in conversation.

During the rolling with resistance stage, you have several options to build the relationship and foster further discussion. One of the key decisions to make is when to summarize and when to repeat verbatim.

Both have the potential to enhance or torpedo the conversation. Summarizing runs the risk of “putting words in someone’s mouth” or missing the point they were most concerned about. Conversely, repeating verbatim can come across as condescending.

You have to feel out the situation and gauge the response when you choose one. Other strategies you can use include reflecting on the theme of a statement (i.e. “you don’t like this idea” or “you seem to feel hopeless”).

Be willing to shift rapidly and adjust to the person you are speaking with. The goal is to foster conversation and navigate a person to change talk.

4. Use Confidence Rulers

If you want to gauge the individual's progress, you can use a confidence ruler. You are asking them to express their confidence in their ability to execute the discussed change. Here is a simple way of applying the confidence rulers:

  1. “On a scale from zero to ten, with ten being the highest, how important is it to you to change [insert target behavior]?”
  2. “On a scale from zero to ten, with ten being the highest and assuming you want to change this behavior, how confident are you that you could [insert target behavior]?”
  3. “Why did you not choose a lower number, like…?
  4. “What might it take to get you to a higher number, like…?”

This is one of the most effective tools I have used to facilitate open-ended responses and conversations.

Questions 3 and 4 encourage change talk.

The primary objectives include assisting the individual in identifying a goal(s), building an action plan, anticipating barriers, and agreeing on a plan tracking change.

5. Resist the Urge to Give Advice

There are a few ways to torpedo a relationship quicker than failing to listen to someone. 

Your goal as a leader is to elicit change talk through guiding the conversation. A crucial point is to not shame or judge the individual under any circumstance. 

Under no circumstance is shame ok. Shame promotes defensiveness and destroys a relationship.

Another common mistake made is letting the advice monster rear its ugly head.

If you are seeking to effectively employ motivational interviewing as a mentor or manager, then you must master your ability to suppress the instinct to immediately dazzle with your vast knowledge.

Most advice is premature.

Immediate advice and telling someone what to do may lead to resistance or pseudo-commitment. Whenever I jumped to giving advice, patients and employees simply told me what they thought I wanted to hear. They nodded their head with no intention of making a change.

Even if someone is seeking advice, start by diving deeper and ask the individual their thoughts on the question. Have them provide answers and only provide your advice as a last resort, once you can safely weed out the bias and know they have a genuine desire for an answer. 

We retain information better when we come to the conclusion as opposed to the answer being provided to us. Michael Stanier builds centers is coaching strategies around this concept in his book The Coaching Habit.

“With personal insight comes increased growth and capability.” — Michael Stanier

When giving advice, ask yourself who the advice is for. Is it given to genuinely help the other person, or is it given to build your personal self-worth?

Sometimes people simply want to be heard and have no interest in advice. Listen, gather information, and wait to be asked. Taming the advice monster will both improve your relationships and help you learn and personally grow.

The beauty of motivational interviewing is that it places responsibility on the individual you are speaking with to reflect and change their behavior. The simple act of establishing autonomy free of guilt and judgment frees the individual, and significantly increases the likelihood of a joint effort to create change.

Once I added motivational interviewing to my management toolbox, I had a greater engagement with my employees. Our one-on-one conversations were more fruitful.

I became a better mentor.

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Zachary
2k Followers
Zachary Walston
I am a physical therapist, researcher, and educator whose mission is to challenge health misinformation. You will find articles about...