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→ Ali Hall is a member of MINT (Motivational Interviewing Network of Trainers. She trains, teaches, and coaches individuals interested in MI around the world, including being chosen by MINT to lead their Train the Trainers event.
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As part of my preparation to facilitate the CIPC MITI Coding and Coaching Workshop, I was reflecting this week on one of the first conversations I evaluated with the Motivational Interviewing Treatment Integrity (MITI Version 4.2.1).
I had made a recording of myself talking with a patient who was struggling to stop smoking. When I listened through the MITI lens, I could hear some of my own strong patient-centered listening skills—what a relief! Lots of reflections, a few thoughtful questions, an affirmation appropriately here and there. Partnership and Empathy—such important concepts in Motivational Interviewing and the two “all-at-once” measures in the MITI clearly rated high: I had interacted with the patient in ways to show I valued their contributions so that their ideas impacted the session strongly, and I demonstrated I was hearing what they meant at a deep level.
But, something else was not happening in the conversation. And the MITI showed me this too. The more the patient talked, the more they were comfortable with their status quo smoking behavior. In the language of Motivational Interviewing, there was only sustain talk in the conversation. No change talk was happening.
The MITI helped me see that while I was offering deep understanding, it was only one side of the patient’s considerations…I was missing the change side, and the MITI began to give me ideas of how to help the patient shift their ideas about smoking from where there were to where they wanted to go.
But, how do we do this? How does the MITI help us shift our skills to really help patients change?
