Uh, again, I'll get us started then. So good morning, everybody. Um, so we're going to be doing sort of last of the four meetings. We're going to be doing a brief introduction to MI or motivational interviewing. You're going to hear me call it MI. Um, and that's what I'm referring to. Um, it, I'm excited cause it's probably my favorite topic. I like all the topics, but this one I have probably the most, most background in. I've been studying motivational interviewing since 2007. It was actually a wilderness therapist at the time where I was a guide, wilderness guide, assisting therapist at that time. And we had, um, uh, a sheet of paper came across my desk talking about how to craft questions based on stage of change, which we can talk about what that is. And what I, what spoke to me with it was it was the first time I'd ever seen an approach changing how you address someone or work with someone based on where their mental space is at. And that really spoke to me of kind of changing what you do based on where they are at. Um, and so, uh, I went from there. I, um, I actually was able to do a bunch of different trainings. Um, Casey Jackson, who's at a Spokane did a, I did a lot of work with him over the years. And, um, then I actually was able to also take a year long clinical intensive, uh, in motivational interviewing in 2010. And then I've been in the motivational interviewing network of trainers since 2014. Um, and I've been teaching it ever since. So, so a lot of experience. And so part of why I bring that up is if you have questions, because my hunch is, is there's a good chunk of you that probably have had MI training before. Um, and that's fantastic. I love that because we get to have a discussion because every trainer kind of handles it a little bit differently. Um, and if it's your first time coming in, that's great too, because yeah, we're just kind of starting out here and that's the purpose of this training is to give you a basics there. So, um, we've talked about in our other trainings about the, the ORN, um, and how it's kind of set up for, um, and basically if you can sign onto the website, you can get a further, there's a huge orange button that says, uh, request, um, uh, service request. And so, uh, it says this is a grant funded by, uh, SAMHSA that, that funds this. Um, and so, yeah, I'll, I'll move ahead with that because we've talked a lot about that and there's the contact information for the ORN. Of course, the email and the website are probably the best because we don't know exactly where the phone goes, but it might work. So kind of diving in because, um, if you haven't had motivational interviewing training before, um, it's very interactive and that's why I have these goals up here. Um, my first goal is for us to have fun over these two hours. Um, these are kind of awkward skills. Uh, if you haven't worked with them before, they're kind of wonky, um, and we're going to be getting a chance to kind of practice with, and then we're going to be doing some funny stuff. Um, my hope is, is as if we're laughing, we're learning. Um, and the idea of course is to come out of it with some new ideas, some new tools, even out of these two hours of kind of a briefer setup. Um, I hope to give you at least one or two tools to come out of here with. So a part of re of motivational interviewing training is we do something called real play. So real play is, uh, real play is, uh, you using something from your own life that you're thinking about changing, but maybe you haven't changed yet. Um, actually ideally you haven't changed yet. Um, this is different from a role play. So role play is you're thinking about a client or someone that you're working with or a situation that you know about, and then you play that role. You play that, um, when we do a demonstration. Real play, you're actually doing something from your own life. The advantage to this and the reason why we do it this way instead of role play, um, you're going to get a chance to be feeling, to feel what it's like to use the skills with someone that is thinking about a change that is within their own life. So it'll be in, in real time. And the other part of this too, is when you are using your real player, talking about the thing you want to change, and someone is using the skills with you, you'll get a chance to feel what it's like to have the skills used, um, with you. A couple of pieces with this. I want you to pick one thing, because it's only two hours. We're going to maybe have one chance to use this, at most two. Um, and, uh, what I'd like for you to do is to, if we, I want to be trauma-informed here, um, for ourselves, in the sense that we don't want to pick things that are going to run too deep. So great examples. I have a colleague that, um, I worked with for a long time, co-trained with, and when she had gone through and gotten her training, um, her thing that she used was deciding whether to keep cable television. It's a good example. Not going to run too deep. Something you might want to avoid. Whether to get a divorce. Probably going to run a little bit too deep, um, and you might feel a little bit too vulnerable, uh, if you open up about it. Um, so if you can stick with things, a good rule to go with is something you're comfortable talking to your supervisor about, co-workers, or even people that you don't know very well. So take a moment and think of something that you're on the fence about that you haven't changed, and maybe you want to jot it down, um, or somehow just have it on hand, because you're going to need it fairly soon. Hopefully you got that, um, but of course you can keep thinking about that as we go. So this is the reference, um, and so this is, uh, comes out of the, uh, it's the manual for Motivational Interviewing, um, and it's been, it's the two authors William Miller, or Bill Miller, and, uh, Stephen Rolnick are the two co-creators, primary co-creators of Motivational Interviewing. So it's in its fourth edition. It comes out about every 10 years, and so it was in 2023, in August of 2023 was when this one was released. Um, something that's really impressive with this is the fourth edition is actually smaller than the third edition, which is really unusual for what would be, we would call a clinical manual, and because if you're not familiar, clinical manuals, every edition they tend to get thicker and thicker and thicker, and sometimes they split them into volumes because they get so thick, no, what they did here, the reason why it's smaller, what they, they went through and they worked with folks to, um, make MI as accessible as possible, and they really tried to strip all the jargon out of it, and the research, the heavy research, uh, component, and, um, and what, in the end what they did is they carved out a lot of the manual to make it a lot more, uh, efficient and a lot shorter. So what we've got here in the fourth edition is a product that can be used by anyone, and we need it to be because motivational interviewing started as a therapy approach. I teach, uh, I work with early childhood educators a lot with Head Start. I do a lot of work with early Head Start with MI. Um, I've worked with dentists. I've worked with, um, uh, probation officers, uh, teacher, other regular teachers. I've worked with a lot of folks that are not therapy-oriented and a lot of case managers and folks that are not clinical, um, and this manual has made it a lot more accessible. We can actually use that, and anyone can use it. So if you haven't seen it, I highly recommend getting it, um, because it does, uh, it's an easy read, and it's also, um, it's there, uh, it's an easy read, it's a quick read, and it gives you information real quick. Um, one thing for it, if you do want to do a deeper dive, what they've done is they've created little carve-outs where they've got the four therapists. So if you want to go, if you're interested in the deeper clinical stuff, it, there's, there's an avenue to it, but it's, um, but yeah, it doesn't dominate the whole manual. So with, starting with motivational interviewing, um, I'm gonna walk us into a key concept here, and I'm, it's a question to all of you. Like, when you tell people why and how they should change, essentially when you give them advice, what tends to happen, or the flip, you can even also flip this too, when people give you advice that you haven't asked for, how do you respond, and how do you feel? And that's a, please, anyone, there's going to be a range of answers, but I'd love to hear what folks have, other people or yourself, it's, it's a wide open here. Um, okay. I was, so more often than not, no matter what side of the coin I'm on, I think the general response is to, to give a justification for the thing that they're giving me advice for, right? So I can explain why it was that I did it, even if I agree. I usually find myself, right, like, it's just, no, no, no, no, no, but, no, no, no. Exactly. Yeah. You start to want to defend that thing. Yeah. Even though you may be like, what am I doing? I feel a need to defend it. Yeah. Great. Yeah. Thanks, Calvin. Definitely. Others. Reactions that either you have, or you've seen other people have, when advice is given that hasn't been asked for. anyone with the just smile and nod mm-hmm and just let it kind of happen yeah that's what I wrote down like acceptance but non-action like give me your advice I'll hear you but I'm not really here yep exactly you get shut off but I've got here on the screen here is the yeah but or like yeah but what Calvin said to of like he'll start to defend it or you might even go further and and like talk about how you agree with it even though you really don't it's just basically to kind of we sometimes might call that people pleasing I don't really actually call it people please it's just kind of coping with the fact that what the other person is doing is annoying and so it's here and this it's really tricky because as case managers your job is to give right advice right is to give resources at least and so it puts us right away in this tricky spot and in fact I would say I call us as case managers as therapists as folks that are in what we the broadly called helping profession work change agents or change hunters really and or because we're constantly or where our mindset is okay something's not going right in this person's life what can we do what advice can we give to help them change the problem is is when we do that if they haven't asked for it or they're not ready we get this response so I actually want to do an example of this so I'm gonna need one of you to talk to me and we're gonna do this in a very specific way so I'll so you know what you're signing up for you're gonna talk to me for one minute about your your real play the thing you're thinking about changing I'm not gonna interrupt you and I'm actually gonna run a clock here on my phone and when you're talking about it what I'd love for you to talk about takes taking the 60 seconds talk about what you want to change what you need to change what you should change what you're thinking about but have not yet changed kind of going into that describing it as best as you can if you can't fill the minute no worries there's I know that can sometimes feel like a lot of pressure for folks so no worries if you just let me know that you're done and I can stop the clock but if the timer goes off we'll just kind of end it there after that I'm gonna take 30 seconds to sell you the change I'm gonna go through this this in a phase here and so kind of working our way through that I'll tell you why you should change how you should change emphasize how important it is so that's what I'm gonna be doing this is not am I I'm just want to note that I'm starting out here who's willing to do the one-minute talk I'll do great thanks Calvin okay let me get a clock going here and again thank you for being so brave okay you ready Calvin yes all right go for it I'm starting the clock all right I would say the thing that I need to change or want to change or whatever is expressing empathy I would like to think that I'm good at being empathetic right just in general but I know that at times when I'm talking to people I've realized that I don't always it doesn't always sound that way I kind of sound more starting with the advice and what you need to do and what's wrong and this and this and that and sometimes I don't realize until after a full conversation that oh I didn't express you know at all that I was like on their side right or or understanding where they were coming from so it's called a lot of issues and and I'm realizing it I just don't fully always recognize it right away like I know I should do it but but it's not something I've been sorry able to put in practice if I'm honest with myself and you know I can't I can't speak to why it is but yeah definitely need to be better at actively expressing empathy and sympathy and things like that or just going into some kind of monologue or what I could you made the minute Calvin okay awesome thank you great job so Calvin um this is really important I mean you really you're sensing that you're feeling that people are looking at you like a jerk and that really they're just you're not getting it you're not understanding it and so it's really kind of slowing down and figuring out how to make sure you catch it and fully listen and I think the thing to do probably is to figure out how to let go what you're thinking about and figure out how to fully listen sorry that's not am I all right thank you Calvin for doing that I'm guessing there are some feelings so let's debrief what we just saw what did it feel like watching that we're gonna let's just talk about what we just watched and Calvin you can chime in to about how it felt for you but other folks especially what I did well it was sobering because you know like I mean there's a way you think about yourself but like when you put it like that yeah I could I could like replay some conversations where I'm pretty sure that was the process you know I mean yeah well I just seen a reaction like oh okay all right so some of it kind of stuck yeah a little bit but you like you said it was sobering I don't know whether that was very pleasant um well it was necessary okay all right how about others yeah thank you Calvin other reactions to kind of watching that go down like it did So, yeah, please go ahead, Dwight. I was like, you just really hopped out of the gate swinging. That was my first thought. I was like, oh. Yeah. Yeah. I was like, hey, look, I was like, I wouldn't listen to somebody who the first thing I hear is being called a jerk, you know? Yeah. Yeah. That brings up a great example, because I put this list up here. And Calvin, you can also chime in here, but some of you also, I mean, like, Dwight, you just said you wouldn't listen. I doubt you would come back if you were on the receiving end of that. This is a list of possible reactions to what I just did. And I know, Calvin, you said it was possibly helpful, and that's important, and we're going to talk about that for a moment, because some people can find this helpful, though I'm imagining there was also a mix of some of these in there as well. Well, yeah. I mean, it was definitely uncomfortable. I mean, I was probably the most, you know, a little ashamed. Yeah. Yeah. I totally understand. I was going to explain that, but. Yeah. No, like I said, it was just, you know, from a who you think you are standpoint sometimes and just the reality of it, right? It was just like, oh, I'm not really what I, or I could be perceived to be different. So there was a little bit of that there. Yep. Generally not, but we want that to happen with the people we're working with, I would assume here. So this was a really extreme example, though we've seen some folks get really confrontational like that. And Calvin, you bringing up that piece of it, even there was some ashamed, but it kind of sobering. It's moving possibly somewhat in a direction, but through shame, and we do, we want to, I don't think we want to do that. No. Yeah. So, and what that's highlighting is what I did there can work with about one in five people. So it actually can work about 20% of the time. The problem is, is it leaves out the other 80%. And I would say, even with that one in five, there's another way that can also probably still work. What the one in five is, and so some background stats, if this is helpful, if folks are familiar, if you're not familiar with drug and alcohol treatment in the 1980s, it was very confrontational. It looked a lot like calling someone a jerk would be, that would be, well, okay, that's just Tuesday. And in fact, the idea there was kind of to break through people's denial and kind of push them through. It wasn't necessarily intentionally shame that they were using, but a lot of it was shame that they were leveraging. It did work with about one in five people. And so it was enough to be like, well, see, look, this is working. We just need to give the rest of the people even more of it. The problem is, is no, that's actually not what was happening. It was like, it was just, it just happened to work with a few people, but the vast majority of the people that turned off in a big way. So that we can get stuck in that trap. And this is one of the big parts where I mentioned with motivational interviewing, we really, we try, we do not confront. I know some folks will ask, say like, well, can I tell it like it is? And there are ways to get to giving information, but really, no, it's more of waiting and helping them come to their own realization and not like shoving the realization into their face. The thing with confrontation is it actually comes from a good place, confrontation, advice, even resources. It comes from a good place. And what we call it is the fixing tendency. So you see at the top of the slide here. So what I was doing was a really exaggerated example of the fixing tendency. Dwight, you named it well, I came right out of the gate. I went straight to it and was like, this is what's going to get fixed. But it was very jarring and actually brought up some really negative feelings. And I like that we now call it the fixing tendency because we used to have a different name for it. We used to call it something called the writing reflex. So if you've had MI training and someone's called it the writing reflex, it's now called the fixing tendency. And why a fixing tendency is better is that that part of it's coming from a good place. We're trying to help. It's just the way we're trying to help isn't quite working. So oops, why did that? Oh, so actually, wait, I get my slides out of whack here. Okay. So actually, I'm going to stop that share before that. So Calvin, can I get a redo? Of course. Okay. Thank you. I really appreciate it, especially considering what I did to you just a few moments ago. So we're going to have a completely different conversation here. If we can talk about the same topic. I'm going to try to use motivational interviewing this time to the best of my ability. So it's going to be a regular conversation where you'll say some stuff, I'll ask questions. There's going to be some back and forth. It won't be the minute and then 30 seconds. And we'll go for as long as it makes sense, maybe five minutes or so, however long makes sense. Okay. Okay, so I'm going to start here. So Calvin, you've mentioned, I've heard a little bit from what we've talked about so far that you're really wanting to focus on building empathy and getting better at that skill. Tell me more about what you're thinking about. I'm thinking about being able to actually show or express empathy better than just it being, you know, me being empathetic in my head towards people. Got it. So it's happening. It's just being able to communicate it. Yes. Okay. You've thought about this. I'm wondering, it's wondering kind of different things you've either tried or wanted to try to try to make this work. What are your thoughts at this point? You know, I've at least given thought to, you know, being more mindful and have an active listening to try and really understand what people are saying so that I can respond in the right way. I think that in the moment though, I tend to go straight to the, this is wrong and fix it more than understanding, you know, the actual like emotions and all the other things that people might be feeling. Got it. So you were like, there's all this thought about how I'm going to do it, but then it comes out the old way and then afterwards you're like, ah, dang it. I wish I had done it a better way. Okay. So it's, you're already aware of it and really making an effort. It's just turning that thought into actual skill and being able to use it. Yes. Got it. So it seems like there's been like something tripping you up. What are your thoughts on, because you've got the thought, it's there, you want to do it this way. And then unfortunately it flips over. What are your thoughts on what's happening? I think sometimes it's a wrestle between probably what I believe somebody should be doing and I guess wanting to see more immediate results. So it's your hope to think you want them to get better. You want them to do better. And that's hard to watch as they're maybe making decisions that don't sound like they're going to go actually help them. Yeah. Yeah. I feel like I give more advice to like cram it all into one, right? So like, it's almost like we had this conversation now be better. Well, okay. Yeah. That makes a lot of sense. Yeah. Because it is that it's hard to watch them make these decisions. And when you really, really want the best for them and you'd really love to see, because you've seen other people turn things around and how good it can be for them. And you want that for them as well. Yes. So, again, you've thought about kind of different pieces here about how to have empathy, how to kind of hear where they're at. What do you think would help you move ahead with this a little bit? But what's like one thing? Um, that is a very good question. Not quite sure yet. Not really sure. I mean, probably some kind of skill or something to help me remember, you know, that I guess that I'm talking to the person and not the problem. Yeah. Okay. Hey, that's a great realization there. Recognizing, yeah, there's the problem, but that's separate from the person and to really address the person. Almost like the problems outside. It's like a third, third party. Yeah. Okay. Great. So we've got that. So you've got some ideas of possibly figuring out how to might call that externalize the problem where they're, yeah, it's basically almost look at it as a third party there. So you can really connect with that person. And it's also sounds like kind of remembering what you appreciate about the person and what you hope for the person to yes, got it. And also recognizing that there's the problem. And then there's the person really does actually want to get past the problem. It's just the problems tripping them up. Yes. Here. As I say, this is this sounds like the stuff that's kind of going through your mind. Where's this? Oh, yeah. Different. Yeah. I thought you was actually have a brain. Yeah. I said, I said, it almost felt like you have a brain open. It was just picking stuff up. Oh, I'm sorry. It could be the area that I'm in too, sorry. No worries. So you really do. You really want the best for folks, you really want to do this job well and have it and not only do the job well, but know that you're helping people and make sure that your skills are being put to good use. Sounds like you've got some ideas of how to externalize this and kind of look at how to separate the person from the problem, and that will help you then be able to have empathy for the person, even though the problem might be frustrating you. So you've got a first step. It sounds like also possibly working on some of the skills that we're going to talk about today might help too. We're going to close down here for a moment. Any last thoughts or anything that you'd want to add to this? No, not from my end, but this is very, very helpful. Good. Okay. Hopefully a little better than the first round, right? Yeah, no, yeah, absolutely. Thank you again, Calvin. So let's all debrief this. How was this for folks? And compare and contrast. What was different? I'd say, right off the bat, you know, there wasn't any... They didn't call him a jerk. Yeah, right off the bat, there was no shock value. Yeah, there was no shock value. And I would also add that you were very encouraging, you know? You had a more sense of willing to assist him. And I'd even also say... Oh, you're still muted. There you go. Sorry about that. I would say I also felt like you were more like helping them try to find the answer versus you telling them the answer. Yeah, I brought that up on Mina. Did I give him any advice? No, I don't think so. It was very much like, what happened? And like, how did we get here? And what do you think leads here? Hopefully, I was trying to get it to be Calvin's ideas. Well, I can say also, well, obviously being a part of the other part of it, it genuinely felt more conversational the second time, right? In the midst of just having a conversation, it was easier to bring forth things. Yeah. Thank you for that, Calvin, because really we're going to... Because we can get... We were talking a little bit about trainings. I mean, we can get really into the weeds with MI. And I mean, it's usually like a two-day intro, a two-day advance. That's like four days of training. And then we sometimes can go into coding. I did a year-long and clinical intensive. But what we forget at the end of the day is what you just said, Calvin. It's a conversation. It's just a conversation. And that's one of the things I hope we... And in a moment, you're going to see the definition for MI. And it's just a conversation about change. So expanding on what we're talking about here, this slide, I flipped to before, but I want to focus. This is different than the one we saw. And this is here. It's a little bit of a better list, isn't it? Especially with the likely to return. And what we're looking at here, and hopefully what we saw in the example that I just gave with Calvin, is it's instead of the fixing tendency, it was the making sure that Calvin felt heard. And so starting out, I mentioned that motivational interviewing is just a conversation about change. If you take nothing else away from today, if you could take away this piece here, is that the goal of motivational interviewing, above all else, is to make sure the person you're talking to feels heard by you. Feels like you're hearing them and that you're doing your best to understand them. And so that's... It's really at the core of it, when we strip away all of the major pieces of it, the goal really is to make sure they feel heard. Now, we can add things in and talk about how it's helping people move towards change. And yes, there's a lot of strategic things that we're going to do. But even before we get to any of that, we want to make sure they feel heard. Because just feeling heard, which is empathy, is an evidence-based practice in and of itself. So just making sure that people can feel like someone understands why they feel the way that they do, can actually help people move towards change on their own. This is hard to do. And Calvin, you brought up great examples of this. Because so often, the decisions of the people that are making, that we're working with, we know they're not going to turn out well. And so you gave that great example of separating the person from the problem, of how do we connect with the person, even though the decisions that they're making, you know, are potentially going to be problematic. One other tool here that I'll add in is what we did before, if you noticed, the slides were called the persuasion exercise. So going back here a bit, I'll back up a little bit here. Yeah, you can see these three slides, all titled persuasion exercise. So something that's important with motivational interviewing is we're very, very aware of persuasion. And we really, really try, as best as we can, to not persuade someone unless we have permission. And as case managers, this comes up a lot. It's really a lot for everybody. But even in you providing resources, just asking, I've got an idea for a resource, would it be okay if I provided it? Just simply asking permission vastly increases the chances that the person is going to hear, at least hear what you're going to say. Because even if they react to it, they'll still be like, well, I told them I was okay. But it also makes it less likely that they're going to react to it negatively. And so when we're, and especially if it's a resource we really believe will be helpful, I really suggest asking permission. And being transparent of, here's a resource. I think it would be a really good idea to use it. Let's see what you think. It's okay. Or feel free, here's an idea. Feel free to do with us whatever you want. But somehow give them permission, get permission to give the advice and also give them permission to disregard it. So that's another add-on here. Any questions on that? So there are three definitions to MI that are actually in the third edition. They don't appear in the fourth edition, but I still find it useful and still work with it. This is the definition I just mentioned to you a few moments ago, which is meant as the definition for lay people, so people that are not affiliated with behavioral health, that don't need any clinical jargon or anything like that in there. And so it quite simply is, motivational interviewing is a style of communication that focuses on change. It's my favorite because it's easy to remember and it strips away all of the extra stuff and gets to the core of it that really, ideally, this is a flowing, easy-moving conversation. The other two definitions, I don't have them written down here. I'll share them with you right now if you're interested, just briefly. The second one is the practitioner's one, which has a lot of jargon in it. So it's motivational interviewing is a person-centered counseling style that focuses on helping people resolve ambivalence about change. All right. That's a whole lot of clinical jargon. If you don't know what person-centered counseling style is, that's no problem, no worries. Ambivalence is actually kind of jargony. We're going to talk about ambivalence, but ambivalence is our natural tendency to think about when we're faced with making a change, to think about making the change and also think about not making the change. But again, that's not all that useful unless you're doing counseling stuff specifically. The third one, which could be useful for y'all, but I think for an intro, we'll just stay with this one, is motivational interviewing is a counseling style that focuses on developing a strong therapeutic relationship through empathy, but it's also strategic in that it focuses on the particular language of change and utilizes skills to help enhance the amount of change language that's happening. Really kind of wonky a lot there. It does describe a lot of it. It touches on how we could go into the weeds with this a lot, but yeah, it does kind of talk about some different components there. So hopefully it's obvious why I've stayed with this one, because it's easier to work with. So that definition also flows into how motivational interviewing, since it's a communication style or just a conversational style, it ideally would flow like a dance versus a wrestling match. So I was a camp counselor many years ago, and I had a great instructor. He wasn't teaching me motivational interviewing, but in the end it really kind of was motivational interviewing for working with the kids. But he was talking about power struggles, and power struggles can be like the fixing tendency, and we can get stuck in them with the adults that we work with, especially around making changes. And so his example was, Paul, how do you know when you're caught in a power struggle? You have the thought that crosses your mind, you little shit. And it's true. It's there. And with adults, we might not think of that, but we might think something different, like what's the matter with you, or what's wrong with you? Why are you thinking this way? But it's close. It's still close to the you little shit. And what was helpful and powerful for me in that moment, and he was like, the moment you have that thought, that thought crosses your mind, you're stuck in a power struggle. And say I'm trying to get them to take a shower, they're not focused on me getting them to take a shower. They're not focused on the shower, they're focused on how much of a jerk I'm being for telling them they need to take a shower. And so the battle's already lost. It's similar with adults. The moment we dig in and we're like, what's wrong? Or other ways I see this, I'm having this conversation, they're having that conversation, what the hell's going on here? We need to recognize, oh, shoot, we're caught in a verbal wrestling match or a power struggle, and we need to fall away from it. How do we get back to the dance? Now, the simple way is to let go of whatever you're fighting for, like when I mentioned that piece of sounds like they're having a different conversation than I am, or they're just digging in. What I need to do is let go of defending my side and figure out where they are at. That will automatically get you back into this dance and hopefully will just flow. Now, with a dance, it's sometimes you lead, sometimes they lead. It's not just meeting them where they're at. There are going to be moments where you do lead, but it's going to flow back and forth. Another way to look at this, because we're looking at motivational interviewing as a communication style, it is aiming to be a guiding communication style. So, it's in the middle here. Now, following. A following communication style, if you've ever heard, meet them where they are at. That's a following communication style because you're trying to find them and then just meeting them where they're at. It's extremely important to do that. You've probably heard that as something that you have to do and it's something that your service is really aimed for, is meeting people where they're at. When we talked about harm reduction, that's what we were doing, is meeting them where they're at. The problem is if we just meet them where they're at, unless they're headed somewhere, you're going to go in circles. And so, it's really important to meet someone where they're at, but then have something to do, and that's where MI can come in. Now, the reverse of this would be directing. And you saw an example of me in my first example with Calvin directing. That was kind of a crude way of doing it, but directing, you've got the judge up there. I would also put a teacher there. So, teachers tend to be very directive because they're telling you how to do it. They're showing you how to do it. They're working with you while they're showing you how to do it. Now, the great part with directing, you never go in circles because you always have a direction. The problem is, unless they're along for the ride, you're going to leave some folks behind. So, following and directing both are really important and also have significant flaws with them. And so, that's why we want to go for a guiding method. So, guiding is a mixture of following and directing. We've got the example there of someone, the two people there, one pointing at the terrain, the other one holding the map up. The person is kind of helping figure out where they are on the map that's kind of following, kind of going along the way, but then the other person is looking at and pointing at different aspects of the terrain and how you can tell what's what on the map. That is ideally collaboratively what you're going to do is you're going to guide someone through the conversation. Which gets us to an important piece here what's called the motivational interviewing spirit or MI spirit. So, MI spirit. It's hard because it's not a hard set of skills. It's a way of thinking. It's a set of beliefs and a way of thinking. And it's really a way of understanding human nature. And some of it that we've already talked about is recognizing that people don't tend to respond well to unsolicited advice. What's also in that too is that the idea that they really have the best ideas in them already and that it's our job really to kind of pull those out. But spirit is broken down into four components. It's partnership, acceptance, compassion, and evocation. What we've got up on the slides here is partnership. It's the first of the four. So, when we talk about motivational interviewing like a dance, it just being a conversation, another way to look at it is it's something that we do with someone, not to them. Sometimes you hear people say, oh, just MI them to that. It's like, that's doing something to them. That's not the hope. The hope is really use your MI skills to see what they think and see whether they're interested in it. That would be the way to approach it because it's just a conversation of how they think, how they feel. You might infuse some information in there and see what they think of it. It's also a collaboration between two experts. So, you all know a lot about what helps a lot of people. You do. You have a lot of expertise. And we're not asking you to let that go. You know how to do your job well and you know a lot about your job. However, you don't know what helps the person in front of you, what they've tried, what works for them, what they prefer, how they've dealt with things, those kinds of. And so, they have expertise on themselves. And the goal here is for you to kind of bring two expertises together, yours and theirs, and see if something comes from that. Doing this requires a profound respect for the other. So, here with the spirit, your purpose with this is we're really aiming to see the world from their eyes and really trying not to superimpose our own vision. This is really, really hard to do. So, be kind to yourself and easy with yourself when you're first trying to do this. The reason why this is hard. Our profession forces us to have a certain view of things. Just being in this job, we have a bias towards health. We have a bias towards maybe reducing substance use. We may have a bias towards, we have all kinds of biases just because we're in the field. And in fact, there, we could even talk, I know there's a bias. One of the clear biases is when we work with someone who's thinking about suicide, our field doesn't allow us to think it's okay that they kill themselves. I know, and that there's a reason for that, but that is actually a specific bias that our field requires of us. I just bring that up as an example, but there's a lot of other ones that are very subtle in there. And so, this is really important and fully, if we can fully let this go, we can, for a moment, see as best as we can how they're seeing it. And why, like, continued use is a good idea for them, or why choosing that for them in this moment looks like a good idea. And really letting ourselves go, even though we might be like, oh, no, that's an awful idea, and that's going to not turn out well, and that's not safe. Okay, let me see why this is really making sense to them. Any questions on that? That's a really key one, and it's a tricky one. It doesn't mean agreeing with them, because that's the other part, too. It just means that you're letting go of your own thoughts or feelings about it, enough to be able to fully see where they're coming from. Okay. I'm imagining there'll be questions as we go, but I'll move ahead a little bit here. So, the second part of spirit is acceptance. So, acceptance here, it's honoring the individual's absolute worth and potential as a human being. So, they always have value. No matter where they've been or what they've done, they always have worth. You hold them in high regard. Of course, you're not, you have boundaries and you're not going to take verbal abuse and things like this, but as long as it's not like at you or something where you're needing to hold a boundary, you're always going to hold them in high regard. And even if you're holding a boundary, you're going to still hold them in high regard. You're just going to be letting them know that they need to change the way that they're talking. We also need to recognize and support their autonomy to make their own choices. So they always have freedom of choice. They, I mean, they can know what the rules are at the house and totally disregard them. Of course, there's consequences, but that's their choice. We can never take that choice away from them and we don't want to. Seeking to understand the other person's perspective through accurate empathy. Now we don't have enough today to go into too much detail on this, but this requires something that we call reflective listening. And reflective listening is in its simplest form, just repeating back what your understanding of what someone's saying is. And why it's called accurate empathy is when you get that playback right and someone says, correct exactly, you're getting it, or they just keep talking about what they were talking about without correcting you. That means you've hit the target that your empathy is accurate. Because it is possible to have inaccurate empathy. And that's where you give that feedback and they correct you that you're getting it wrong. Which actually is okay. It's fine. You're getting the correct information, but you're missing the mark a little bit in the moment. It's going to happen. I have it. I'm working with a few people right now where it's really, really tricky figuring out how to get accuracy with the empathy. But at least it shows that I'm trying to understand. And then affirming the person's strengths and efforts. So this is a big part of acceptance. Always pointing out any strength that you can see in them and any effort they're making to cope. Compassion. So compassion was added in in 2013. Before we added compassion and we had to hold do a whole piece of ethics. The reason is, there's actually a book out there called how to get people to do what you want in seven minutes or less. And they talk about it being science-based. Unfortunately, the science that they're using is actually science that motivational interviewing uses. And so if we do go further and get even deeper into some of the skill set, you'll see it can be manipulative. The piece is, and if you were to use it in that to get people to do what you want or for sales, it would be really effective. But it wouldn't have any compassion in it because you would be using it as a way to manipulate people and to get them to do what you want or what's good for you. So this is why compassion has to be there. As we always have to stop ourselves for a moment and think, wait, okay, am I helping them move towards something that's good for them? Am I helping them move towards something that they've said that they've wanted? Am I helping them move towards something that is in their best interest? Am I helping them move to something that's really for their welfare? And then a tricky one is, am I moving something that's good for them versus me or the program is to really truly be compassionate. And that last one can be a little bit tricky because there's sometimes program requirements that enforce us to kind of nudge someone in a certain direction. It's like, okay, we're losing a little bit of compassion here. It's probably not a big deal because whatever the program compartment is, is still probably good for them in the end. But yeah, making sure everything we're doing is oriented towards them and what works for them. And then evocation. I also like to add empowerment here because there was a brief moment before they released MI3. It was about a year before. So in the end of 2022, there was the MI conference. And at that conference, they mentioned that they were going to possibly replace evocation with empowerment. They didn't end up doing it. I like to still teach it though, because I thought it was a really great idea of recognizing the role that empowerment plays in what we're doing. Because it's a big part of what we're trying to do is help empower people to make the changes that they want to make. Evocation is still there. And these do go hand in hand. So evocation here is the idea there's an implicit message that you have what you need and together we're going to find it. So another way of putting that together is that you have the best tools. You have the best ideas, the best goals, the best things to work on. And really it's my job to help you build that or find that and put that together. So we're really building your ideas. Another part of this, and this is where this is a hallmark of MI, is you always remain curious. Because we never fully know someone. And part of that is because they're constantly changing. And so remember and holding on to that, even though you might have worked with someone for a really long time and you feel like you know them really well, letting go of that of like, I don't know them as well as I think I do. And what's changed? What's new? What's different? What else can we discover in there? That helps us immensely in this process. Because when we're curious, we ask questions. We're trying to find out from them versus if we let go of that curiosity, we start to kind of tell them what we think is best for them. And we can fall into that fixing tendency. And then the last part here, people are more likely to follow through with a plan that came from them than they are to follow through with anything that you bring forward to them. So it's really essential that it be their plan. It's far more likely to happen if it's their plan. So this gets us to MI in a nutshell. I usually like to give folks this slide printed just as a PDF on its own. Because this is a great tool for mapping out pretty much all of motivational interviewing on one sheet of paper. What's nice with it is it is actually a counseling style if you want to use it as such. And so it's rare that we have a counseling style that can be all on one page. But more importantly, why I like to use it is you can use this tool in learning motivational interviewing. Because learning motivational interviewing is similar to learning how to drive a car. So if you can remember back to when you first learned to drive a car, and hopefully you have all learned to drive a car or at least can imagine it and maybe something close to it, when you're first driving, it's like, how hard do I push on the gas? Oh, wait, there's the blinkers and then the windshield wipers and the mirrors. There's all this stuff going on. And it's really overwhelming. It's hard to figure out. You start to focus on one thing and you lose sight of another. But now if you've been driving for years, you can drive home and not even remember you did it. It's so ingrained in you. And that's what motivational interviewing is like. It's at first, if you're new to this task, it can be really overwhelming. And like, oh, there's all these things I need to think about. And why I like this form is it's a way to kind of take one thing at a time off the shelf. So just focusing on maybe partnership, let me focus on getting their expertise. Maybe focus on evocation. How do I remain curious? Or any one of these other skills that we have here. So that's why we have this tool here. We've covered spirit and not much else on this form yet. We don't have enough time in the session today to cover each one of these things in depth. But I did want to at least show them to you. So you see the spirit up in the left hand corner. We've discussed that extensively. If you go let's actually go down to change talk because everyone's probably wondering why there's a cat there. So the reason why there's a cat there is the acronym is darn cats. There's a lot of acronyms in MI. So if they work for you, great. If not, that's fine. But darn cats is what it's talking about what change talk looks like. And change talk is someone talking about a desire to make a change, maybe an ability to make the change or a reason to make the change or a need. You're probably already hearing that and cued to it. With motivational interviewing, we can look at this even further and get even a better ear for that. And then there's the cats part of it, which is commitment, activation, and taking steps. So darn is the first part. We call that preparatory change talk where they're kind of getting ready to make the change. And then commitment, activation, and taking steps is where it starts really happening. And so that's a really brief introduction to that. But that's essentially what we're looking for is we're looking to hear some form of change talk. The four tasks are actually come out of research on effective counseling. And so engaging is the first portion, which is probably the most important task. And so that's really where you're working with a person and how comfortable they feel working with you, how much value they see in working with you, and figuring out how to build that trust. Then moving on to focusing, which is choosing a topic and sticking to it as best as you can. And that's something that's when we're looking at effective counseling, which there's when we're looking at effective counseling, which there's crossover to case management, a really effective session will focus on one or two things. It's when you start hopping around a lot, that's like, we're really not being very effective. Because we're not going far enough into anything to actually get any substantial work done. Evoking actually is talking about evoking change talk. But it's more also evoking what their thoughts and feelings are about the change that you're focusing on. And then planning is obviously setting forward a plan. So those are kind of the four tasks that in any meeting that you're having with someone, those are going to be at play. And then on the bottom here, real quick, what we have is it's the ORS, another acronym. And these are the core skills. These are the probably what many of you are familiar with, if you've taken an MI training before. It's looking at open-ended questions, affirmations, reflections, summaries. These are all types of communication that tend to facilitate more communication. And so they're great ways of listening and making someone feel heard. We'll talk a little bit about some of these in the second portion of this. But if we do a bigger training, we definitely go a lot further into it. And then ask, provide, ask. Ask, provide, ask is an alternative to giving advice. And it's quite simply, ask what they know about the resource or the information you're going to give them. So that short circuits that whole problem of, hey, we're not going to give them advice or information that they already have. It also helps you know whether they're interested, too. But just ask them what they know about it, provide the piece of information, and then ask them what they think about the piece of information. Just doing it that way, which is pretty straightforward, can vastly increase your ability to be able to provide resources and have them actually more likely consider them. Not. Let's take a break. So the oars. Let's talk a little bit about these. The oars, the idea here with the oars is they're the engine of MI. So this boat out here, this dinghy, if you will, is floating in the water. It doesn't have any oars. It doesn't have any engine. And so it's just going to float along until the current or the wind or both take it somewhere. And so what we're doing with the oars within motivational interviewing is it's our engine. It's how we get to the things that we're getting to. So open-ended questions, affirmations, reflections, and summaries. Again, I mentioned earlier that these are all types of communication that tend to keep communication going. So open-ended questions. And so open-ended questions are different than closed-ended questions. Closed-ended questions are questions that you can answer with one word, usually yes or no. And if you've ever had people ask you a lot of closed-ended questions, you can probably feel how it kind of closes the conversation down. And sometimes it can even start to feel like an interrogation when you start, especially when there's a lot of closed-ended questions. You probably all have different assessment tools that you need to use, and they all probably all have a lot of closed questions on them. In fact, assessments usually do. And it's one where you'll see it can kind of shut people down a little bit. But in general, we want to try to use more open-ended questions. So where closed-ended questions tend to close conversation down, open-ended questions are not as bad at that. The reason for that is they require more than a simple one-word answer. They allow the person to set the agenda. There's choice. They have choice in how they can answer. And so they're not restricted as much by what you're asking. They gather really broad information. And generally, we'll start with general information and move to more specific over time. The most important part with open-ended questions is how they start. So a closed-ended question tends to start with, can you, will you, could you. You think about it, whatever word it starts with, you could see how it could be answered with a yes or no. Versus an open-ended question starts with how, tell me about, describe, what, walk me through, help me understand. All of those ways of starting, it would be hard to give you a one-word answer. That being said, it would be hard to give you a one-word answer. People sometimes can be very skilled at still doing that. So just a heads up on that. And so when we're using questions, we really want to try to make them more open-ended. A second skill here, what we're going to move into is what we call reflective listening. However, reflections. Purpose of reflections is to help with communication breakdown. So why we've got this slide up here is we're looking at four different places that communication can tend to break down. One, what the speaker means. Now, communication can break down here. It's really someone just formulating what their thoughts are. Now, when you think of it, if you've ever had it where your emotions are running really high, you might even have a hard time figuring out what it is that you actually mean. So we can have a hard time just in this first stage here. Also thinking of the folks that you work with that maybe have severe mental health. Their mental health stuff, and maybe they're hearing some voices and other things that can make it really muddled and hard for them to figure out what they mean. It could also be English as a second language. So they may know what they mean in their original language, the language they're fluent in, but they may not know or there may be no way to say it or communicate it in English. So yeah, you can see a number of ways it can break down just at level one. Level two. So what the speaker says. Well, sarcasm is actually a purposeful break between one and two. So if you think about sarcasm, that's where speaker means something but says something else. So you can see right away why it's thought sarcasm is kind of a dangerous form of communication because it is purposely breaking kind of a link there. It can be fun and hopefully folks will get it. But yeah, there's a danger. However, it can also break down unintentionally. Like sarcasm is intentional, but it can fall apart unintentionally. So I mentioned that English is the second language. Again, they might have a clear way to say it in their native language, and it comes out and it doesn't quite make sense the way that they say it in English. Maybe there's a heavy accent. There's lots of things that can come break into that middle there. Well, actually the accent is actually really impacts three. So what the listener hears. So now it needs to make it over to the person, and that's where the accent can come in. If it's a really heavy accent, the listener might not be able to fully hear or understand what's actually being said. Is the room quiet enough? Can you actually hear them? Many different things that can get in the way here. And then we get to four. What the listener thinks the speaker means. This is the most common place for communication to break down. And it's because you see that part here, it says that the listener thinks the speaker means, and that's an italics. This is because it doesn't just have to filter through what the speaker means, what the speaker says, what is heard. It also has to filter through how the person is feeling that day, how the person feels about the person that's speaking, how the person, what any bias that the person might have. It really has to filter through a lot of things. To actually get to the understanding. This is why empathy is so hard. It has to crack through so many layers. And so what we really need is a bridge between four and one. Because it's like a game of telephone. If anything goes wrong at one, it's going to get real weird by the time it gets to four. And the way to counteract all of that is to figure out how to make this into a loop, where you can go back from four to one. The way to do that is a reflective statement. So I want to start with here that a reflection is a hypothesis, an educated guess, and it's a guess. And that's a very important part here as we learn how to use reflection. And I'll come back to this. But remember that it's a guess about what the person is saying or what they mean. So the way that we know something is a reflection is that it's a statement, not a question. The way that we know it's a statement and not a question is that our voice drops at the end of it. This is really important. Because our brain registers an up what's called an uplilt. But it's a lifting of our voice at the end of a statement. When we lift our voice at the end of the statement, it becomes a question. It reads as a question versus a statement. So I'm going to give you an example here and go two different ways. So the first one is what I'll have the uplilt. So it's more of a question. Or actually, no. Actually, let me start with the statement first, the reflective statement. So you're angry with your father. You can see that lands OK. That's a statement there versus the second one. You're angry with your father. It's subtle. And I don't know. Hopefully, I picked it up. But that part there of you're angry with your father, really exaggerating it there. The difference between. Yeah, I was wondering, is this universal? I think we talked about this before. Is the uptilt in your voice universal? If I'm speaking from somebody from a different culture where English isn't their first language, is that still common? Or they actually did a lot of research in it. And the Thai language was adamant for years that there was no uplilt. And then they ended up doing a study and they sure enough found that there is actually an uplilt even in Thai. We haven't found a language yet that doesn't have this. It does. Our current understanding is that it is a universal human experience. But the jury is still out. I mean, I don't know that we've tested every single language, but every language, the most common languages have been tested for this and it holds. I can't say every language, but I was going to I was just going to say I've been to Korea extensively and even not knowing the language, I could tell the difference between like when they were talking, how they were asking the question because of that inflection. Yeah, it does. It just rings. And yeah, it's now stepping back for that moment and kind of that difference of you're angry with your father versus you're angry with your father. I'm exaggerating it a little bit, but you can see like with that first one, the person's going to receive it and be like, I am angry with him, huh? Versus the second one. Should I be angry? Are you saying there's something wrong with me being angry with my dad? That's it's so subtle, but it's so powerful of we want someone to sit with what they've said and examine it versus question it. Or worse, make us them think that we're questioning it. And so, again, be kind with yourself. This takes a lot of skill because what's going to happen if you haven't practiced with this before, what happens when we're not confident saying something, we lift our voice. And so, there's going to be a moment where I'm like, I'm going to get a reflection here. And then you do it, but you're a little shaky about it and your voice accidentally rises. It's okay. With practice, it will get better. But it is something that is important to try to focus on as best as you can is to try to, when you do a statement, really try to drop your voice with it. The reason for that is because it's affirming and validating. Because again, back to that, you're angry with your father. It's right, I am. Or someone is really hearing and seeing that I'm angry with my father. And that's validating or it's making sense to that person. If you've ever had it where either you or you've been with someone in a conversation and they're asking that question, does that sound crazy? If someone's really reflecting, well, that question almost never comes up. It doesn't need to because the person is validating and saying, yeah, what you're saying makes sense to me. It makes enough sense for me to be able to say it back to you. Which helps the person keep talking and thinking about what they were thinking about and talking. So, the great value with this too is that it leaves the momentum on their side. And when you're, if you're first trying this out, again, be kind with yourself, they're going to be kind of awkward a little bit at first, but with time they'll shorten and they tend to be more powerful when they're shorter. So we're gonna do an exercise here. This is a taste of MI. I have one, two, three, Mina just stepped out. So Mina will be back shortly. It looks like we're gonna have two groups of two. And then when Mina comes back, we'll put Mina in with one of the groups and it'll be a group of three. What I want you to do, we'll just do five minute rounds here because we don't wanna take up too much time. But I want you to try out what we've talked about today. And I know that this is, we've just scratched the surface with motivational interviewing. So I'm not expecting you to use all these skills. If you've had MI training before, use all the training that you've had. If you haven't had MI training before, no worries. The goal with this exercise is to listen with interest and really do your best to give zero advice. Do your best. If a little advice leaks out, it's not the end of the world, it's happened. But if you can try to get all the way through the five minutes with no advice, great. See what that's like. So I've got a slide up here. Unfortunately, the slide isn't gonna be able to follow you into the room because we're gonna do breakout rooms. So if you want, you could take a picture of this slide so you have access. Because what these questions that we have down here are some suggestions if you would like to have them. Some suggestions of questions that you can use in your practice session. Like what have you been thinking about changing? What are the three best reasons on a scale of one to 10 or zero to 10, how important is it? And then you might follow that up with what makes you a five instead of a zero. If you decided to, how might you make this change? What do you think you might do next? These are just some questions that you can reach for if you're having a hard time thinking about what to say. But the goal with this is really to try to stay with this and try to talk with the person without giving them advice, but making them feel heard. Questions. I put that in the chat. I think that should be viewable in a breakout room but it looks like we lost Madalia. So let me just see three. Okay. So then we might have a room of three. All right. So if that's the case, then yeah. Calvin, you maybe don't need to be the client because you've already done that. So maybe Lavelle and Dwight can work with it or you all can figure it out, but we'll do two rounds. And at least two of you could get a chance to do the MI piece because I don't think we have enough time to do it more than that. So any other questions? So it'll be about 10 minutes. Paul, do you want me to put them in a breakout room? Yeah, if you could, that would be awesome. Yes. Okay, great. Rooms are open, see you all in about 10. It's just Calvin and Dwight. First. I don't know if we need to keep the recording going for I could probably do that. Yep. I just want to let you guys know I'm gonna have you on still but I have to go into the office and grab a thin client. Okay. So I probably won't be responsive for a little bit. Okay. No worries. Thanks for letting us know Calvin. Yep. I will also not be responsible responding for a little bit. Okay. Well, that's going to make debriefing a little bit challenging. Yeah. Mina, were you able to see what happened? Yes, I was. I keep getting taken away. But yes, I was able to experience the motivational interviewing that they were doing. Okay. So I think you'll be the one answering the questions as best as you can at this point. Kind of talking about like, well, you can't talk from the client experience, but kind of what you saw like, who did you see both of them do it or just one of them? I mainly saw one, but I can based off that. Did they were they successful and not giving advice? Yes, I would say so. Right. And generally, like, what was your general impression? I can see that during the conversation, they were mainly just focusing on encouraging the other to kind of like, dictate the conversation and see exactly where. So that's what I meant prior when I said encouragement. Yeah. So it's like, they bring in a sense of like, I'm wanting to allow the other person to kind of guide them on themselves through compassion and ensuring that they understand where they can go. You don't want to, you know, put like a particular one sided perspective on it. So you want to make sure that they're taking their own initiative throughout the conversation. So that's what I've looked when I saw it. That's what I saw during the conversation. Yeah. Great. Okay. I don't know that you got a chance. Oh, you're back Calvin. Yeah, I can speak to it. Sorry. I'm just outside. I didn't realize what time it was. I can spend time to debrief. Great. Were you the client or the, or well, you probably got a chance to do both. I was, yeah, I was, I was more the counselor. Got it. What was it like for you as the counselor? Actually it was, I mean, it was easier to do it that way. Right. I mean, it was still a little foreign, but it was a lot easier because I didn't feel like I had to come up with the right thing to say, right. Or, or, or have the sage advice as to why it's a thing. It was just more uncovering. It does let you off the hook. Cause it's like, I don't have to have the answer. In fact, I'm not supposed to. Yeah. Great. I like that. Yeah. It makes it. Yeah. It's nice. It is. And then I'm guessing Dwight's still probably busy. Okay. Okay. Well, unfortunately, I guess the debrief cut shorter than I thought it would be because of the hiccups here. I guess I can speak to it from a client perspective also though. Right. I mean, it, it, it was different because, and just even explaining it out, right. Like even for myself, right. It was a real thing. And it was like the time that I really did get to think about it. Right. So it was like, when you're asked those kinds of questions, it's like, oh, why is that? Yeah. Like, why am I a five and not a, a this, but it was done in such a way where I didn't feel like I had to be defensive about why I was there, but, you know, just able to kind of think to it and just go, oh, okay. This is where I'm at. Funny how it makes you think. Yeah. It makes you look and examine what you're, where you're at. And you said, like you said, without being defensive, you're not needing you, you can be free to go wherever you need to. Yeah. Great. So that's the hope here is it sounds like, yeah, it made sense. And you got a chance to try this out. I know this is kind of a quick training here where we're kind of showing you the basics here. The hope in this is again, trying to reduce the amount of advice that we give is one takeaway potential that you can have remembering if you are giving advice that it's persuasion. And if you can ask permission, that's, that's going to be helpful of just to be transparent that you're trying to persuade them in a certain direction. Also making them feel heard. So that's the goal here is if you can feel heard that's what we're aiming for. And then we've got some extra pieces of open-ended questions and reflections. If you want to take that in that can be great too, but any last questions or comments or anything that anyone has about motivational interviewing? I have so much. Okay, great. Yeah, bring it. First of all, I couldn't say anything, but I heard everything. So for my debrief, I just wanted to say, it felt very fluid, very natural. Me, Calvin and Mina talked about, it felt like something you do naturally when the conversation is flowing good. I talked about like when you're up like late at night with a friend on a phone call or something and it's like feeling like this is probably what's going on, but you don't realize it and then having the skill set outside of that. Yeah. Oh, great. It even felt fluid when it even felt fluid when me and Calvin switched back and forth. I did learning, wanting to go back to school. And then after he asked me questions, he was like, I want to too. And then I started asking him questions. So I thought that was very cool. Cool. Other than that, I would love if there was like, I don't know, like paperwork where we could like go through with staff and stuff and just continue to work on this practice and getting motivational interviews better and better. I know for me, I felt like the prompts being presented were really helpful, but then I wonder when the prompts aren't there, how much you remember. Sure. What he said. Which is a great segue into kind of next steps. So next steps with this, of course, we talked about possibly getting some more training. That's definitely a possibility out there. And even if you don't do the training with us, one of the great parts about Western Washington is it's a very MI rich area. There's a lot of opportunity. And one of the great parts with motivational interviewing is they've really focused on making it accessible. So it's easy to find either free or low cost training options. RN might be able to provide it. There's also the Addiction Technology Transfer Center at the University of Washington. But there's also a lot of things. King County regularly does some things as well through the Behavioral Health and Rehabilitation Department, BEHRD. I know they do a lot. I've done work with them as well. So keeping your eyes peeled for that, you can get more training. But even without training, there's some things you can do. Paperwork. Well, I can get you copies of these slides. If you want, there's some specific things I can go with. There's actually an entire book, if you're interested. There's what's called the Motivational Interviewing Skills Workbook by David Rosengren, which I know is available online. You can get it online. You can get it at the library for free or you can pay for it. There's a 2012 edition that's really cheap. If you can still get a copy of that, that 2012 edition is still really good. However, there's a newer one in 2017 and there might even be a third edition now that's a bit more expensive. But it has a lot of exercises and things you can do to practice MI in there. You also mentioned something, too, of some things you can do to practice. Some things I suggest for folks is find someone who does interviews really well. Not motivational interviewing, just regular interviews. And listen to how they do interviews and pick out how much they're using questions, how much they're using reflections. And that can develop your ear and recognize how late what you're saying, Dwight, is right, that we do this naturally. And folks that are really good at interviews do this a lot and start to kind of build that and recognize and see what you're trying to do there. So those are just some options there. I also, as funny as it sounds, I recommend practicing with family and friends, but let them know what you're doing. Be transparent. But why that's helpful is if you try to do this with clients right away, it's really difficult because it looks really different from what we did today. Part of that is you've thought a lot more about what you want to change and you have a lot more insight into yourself than your clients might, or the folks that you're working with might. And the changes that you're considering are easier for you to look at, whereas there tends to be a lot of shame and guilt around the changes that they're trying to make, which makes it really challenging. Plus, if there's mental health stuff going on, that can add another layer. So practicing with other folks other than clients is actually really helpful because it can show you kind of what it's supposed to look like, as opposed to what when you get in working with clients, it doesn't feel quite right. It's like, okay, wait, this is what's missing. I know what this is supposed to look like, and here's how what I'm going to do with it. It can build your confidence. So lots of ideas there. There's more we can talk about too. Unfortunately, we've lost everyone, and we needed to do the gift wrap. Yeah, I'm wondering if we should send it out. But we have a survey that we have to do for all of our trainings. We do it in the last session in the series, but it is required for our grant funding. So if we continue to receive funding, we need people to fill it out. I can put it in the chat right now if you have time to fill it out, or you can click that link and do it when you have time. Or scan this if you have time right now. There's the QR codes right there too.

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