Guest Blog Post by Dr. Melinda Hohman, Ph.D.
Did you ever dance with someone who stepped on your toes? Ouch! What do you do when that happens? Some people back up, giving themselves some space from their partner. Others fumble a bit, losing their rhythm. Others might let out a loud yelp and get upset with their partner and maybe say something that isn’t so nice. Or they leave the dance floor altogether.
Using MI with our clients has been compared to dancing with them. There is a give and take and a nice, steady flow. And sometimes we inadvertently step on their toes whereby they respond as in the examples above, by distancing themselves, by losing their engagement or focus in the conversation, or by telling us in no uncertain terms that they aren’t too happy with us. The dance has lost its flow and rhythm.
What just happened? In MI when we get discord like this with clients, we need to stop and ask ourselves what we just did to cause this reaction. One way to think about this process is from concepts of self-determination theory (Miller & Rollnick, 2012; Ryan & Deci, 2002) which helps explain a bit why MI works the way it does. According to the authors of this theory, humans need three things to thrive: to be autonomous, to be seen as competent, and to be in relationships with others. Perhaps when we have “stepped on the toes” of clients, we have done so by not meeting these needs.
Stepping on the autonomy toes: Supporting clients’ autonomy is important in MI. Stepping on their toes in this area happens when we don’t ask clients what they think or how they view their problem or its solution. We make assumptions about their lives, their character, or their abilities and feel we have to help or direct them. Threatening or warning clients about what can happen if they don’t do certain things is certain to prompt them to leave the dance floor. People need to feel that they are in charge of their own lives and decisions.
Stepping on the competency toes: Offending clients can happen when we give them advice without their permission. Or we launch into providing information on a specific topic without asking them what they already know. Doing this gives the message to clients that we think they don’t know these things and they have to hear them from us. So what happens? Again, they check out. They argue. Or, they just say, “Whatever”. As we take an expert stance, we are not honoring their own expertise about their lives.
Stepping on relatedness toes: Most counseling methods will tell us that relationships with clients are key to the change process. Sometimes we damage our relationships by again assuming the expert stance, by not listening to what our clients have to say, or thinking we know best. We spend a lot of energy trying to get our point across. No collaboration here! When clients feel less than autonomous and not very competent due to our interactions, the relationship suffers.
We all want the dance to continue and feel badly when we make missteps. Even professional ballroom dancers misstep from time to time. When it happens and we see clients react, think about how well you are supporting their autonomy and competence and the relationship with you. Self-correct, come alongside, apologize if need be, and you will be off waltzing again.
Miller, W. R., & Rollnick, S. (2012). Meeting in the middle: motivational interviewing and self-determination theory. Journal of Behavioral Nutrition and Physical Activity, 9 (25).
Ryan, R. M., & Deci, E. L. (2002). Overview of self-determination theory: An organismic-dialectical perspective. In E. L. Deci & R. M. Ryan (Eds.), Handbook of self-determination research (pp. 3-33). Rochester, NY: University of Rochester Press