![](https://ayokatheblogger.files.wordpress.com/2021/07/pexels-photo-3793316.jpeg)
While thumbing through the 3rd Edition of Miller and Rollnick’s book on Motivational Interviewing, I came across the concept of heart and mindset. It got me thinking about a few things.
As helping professionals, we have all come across wording that speaks to the client being the expert on their life and lived experiences. It is the practitioner’s job to work with the client as a partner or rather in partnership.
The helping profession has undertones of power dynamics, similar to that of a teacher-student. For example, I might go to the podiatrist for an Achilles Tendon Repair consultation. Or, I might have anxiety and go to a mental health professional to help me gain a deeper understanding of my experiences and triggers. There is a potentiality for all sorts of power dynamics to unfold in these two settings.
Helping professionals rightfully have a wealth of knowledge as per their years of schooling and probably have a great deal of insight. But the lines get crossed when we move away from the principles rooted in the client being the expert. And use our knowledge to coerce clients into seeing things the way we see them or telling them what we think they ought to do. This can be done outright, unintentionally or on a subconscious level. This approach may lead to a breakdown of the relationship and cause resentment on the provider’s side, and breed distrust within the client.
I came across an analogy in Miller and Rollnick’s book that speaks to the client being the expert of their life. The analogy reads, and I am paraphrasing heavily:
‘A partnership is a client and practitioner sitting beside one another as the client opens a photo album of their life. The practitioner’s role is to support the client’s needs through their comments (this may involve the use of open-ended questions, reflections, summaries, affirmations, etc.) and providing advice when the client asks directly.’
Reading that was a lightbulb moment for me. I didn’t have a way to capture the essence of partnership, and boom, there it is staring back at me. What works well about this analogy is that we can all relate to that experience in some way.
So what can we do to ensure that we stay on track? We must have compassion for the client’s humanity and their decisions around what is best for them. This requires us to lean into our client’s autonomy.
We also need to consider our technique. Miller and Rollnick made the distinction between directing, guiding, and following. My interpretation of these distinctions is as followed.
- Directing involves telling the client what we believe is happened or is happening in their photo, even down to their thoughts and feelings.
- While following involves allowing the client to lead the session, and we, as the practitioner, observe without appropriately commenting or leaning on our expertise when applicable.
- Guiding involves being strategic on which photos we comment on and infusing our knowledge when asked.
The ideas presented by Miller and Rollnick may be specific to motivational interviewing, but we can take that knowledge and apply it to many disciplines within the helping profession. In my opinion, it’s a great litmus test to evaluate our approach and assess for behaviors that are not in alignment with the principles of client autonomy.
It’s the practitioner’s job to learn alongside the client: point-blank, period.