How can you use MI to work more effectively with ambivalent clients?

Ambivalent clients are my favorite. I love it when people become aware of their contradictions and then solve them. MI can help tremendously with ambivalent clients. It's almost amazing how listening to your own statement, worded a bit differently by your therapist, has an incredibly productive effect on your mind. I believe that even the most ambivalent clients have all the answers within themselves. They just need some support in organizing their thought patterns and conceptual frameworks to come up with a solution to their problem. Reflective listening, decisional balancing, affirmations, and summarising help greatly.

Ambivalence is both wanting something, and not wanting something, at the same time. We can be stuck in this phase (aka contemplation) for a long time, sometimes days,, decades, or forever! It can be between: 1. Two really good things you want (Approach-Approach) 2. Two things that you don’t want (Avoid-Avoid) 3. One thing you want and don’t want, however everytime you move towards the change it highlights the disadvantages of it, so you veer towards staying the same, however everytime you do that it highlights the disadvantages of staying the same, and so the pendulum swings back and forth and the ambivalence persists (Approach-Avoid) 4. Or, finally, it could be a combination of two or more of the above! It’s helpful to know which!

Harnessing MI to navigate client ambivalence is key! In my practice, MI has been a game-changer with ambivalent clients. ????? By fostering an environment of empathy and non-judgment, MI enables clients to explore their motivations and resolve ambivalence. ???? A recent breakthrough was when a client, initially hesitant, found clarity and took proactive steps toward positive change. ??♂??? I was able to use this on many other clients, and I was able to teach my supervises how to do this as well. #MIinAction #ClientCenteredCare #SocialWork #EmpathyFirst ????

Ambivalence is “on the one hand” and “on the other hand.” It is reasons both for and against something - often a behavior change.

As a clinical psychologist, I've noticed ambivalence shows up for my clients within the form of conflicting emotions and uncertainty about change. They may express simultaneous desires for improvement, however become stuck and unable to move forward out of fear of making the wrong decision.

“MI does not try to persuade, confront, or argue with the client” is a very important point. This conversation is entirely about the person sitting in front of the practitioner. Inserting an opinion is not in service to the client, who may choose a path to avoid disappointing their practitioner, rather than one that truly meets their needs. Approaching ambivalence with openness and curiosity creates a space where the client can safely explore their feelings without fear of judgment.

Motivational Interviewing is powerful in working with client ambivalence, especially within the mental health setting. It's a tool which directly addresses the clients concerns, values, and goals, through open-ended questions and reflective listening. At this point, the client explores and recognises the discrepancy between their current situation and desired outcomes, which motivates them to consider a new way forward. Whereas previously, they remained 'stuck' in their position and unable to have hope for their future. MI is such a gift.

Our tendency is to succumb to the “Fixing Reflex” and try and fix someone’s ambivalence. The truth is, we can’t fix someone’s ambivalence, only they can. Instead of trying to fix it, ask questions about both sides of the ambivalence, perhaps focusing a little more of the side of change to help them explore this in more detail. This may result in the person not only considering change, but moving towards it. —— John Whitson-Russell

As well as using MI to address a clients mental health presentation, it's also crucial to consider their unique cultural background and past experiences.