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What are some ways to adapt Motivational Interviewing for adolescents or older adults?

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Motivational Interviewing (MI) is a skillful way of helping people explore and resolve their ambivalence about changing their behavior. It is based on four principles: expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. MI can be adapted for different populations and settings, such as adolescents or older adults, who may have specific needs and preferences. Here are some ways to tailor MI for these groups.

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Rohit Jain

Solution Designer at McKinsey & Company | Ex IGI, Aon, Genpact
David Kruse
Erin N.

1 Understand developmental stages

Adolescents and older adults are at different stages of their lifespan, and they may face different challenges and opportunities for change. Adolescents are undergoing rapid physical, cognitive, emotional, and social changes, and they may value autonomy, peer influence, and identity formation. Older adults may experience changes in their health, roles, relationships, and life satisfaction, and they may value wisdom, legacy, and meaning. When applying MI, it is important to understand the developmental context of your clients and how it affects their motivation and goals.

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Rohit Jain

Solution Designer at McKinsey & Company | Ex IGI, Aon, Genpact
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I've noticed that teenagers go through lots of changes. I've found it helpful to understand how they want more independence and are influenced by their friends. How do you think your friends and independence play a role in your goals? From what I've seen, older folks have their unique struggles and things they value. They often really value their life experiences and the legacy they leave behind. How do your goals connect with those important parts of your life? I remember working with a young person who was trying to figure out who they are. We talked about how their goals could help them understand themselves better. Have you thought about how your goals relate to your own identity and growth?

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David Kruse
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Give strength to the child by encouraging them, listen, positive advice, and share Bible advice. What skills have God given you! He created you to be special. Remember that.

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2 Build rapport and trust

Both adolescents and older adults may have some barriers to engaging in MI, such as mistrust, stigma, or resistance. Therefore, it is crucial to establish rapport and trust with your clients by using a respectful, collaborative, and non-judgmental approach. You can use open-ended questions, reflections, affirmations, and summaries to show interest, curiosity, and appreciation for your clients' perspectives and experiences. You can also use humor, storytelling, metaphors, and cultural references to connect with your clients and enhance their engagement.

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3 Elicit and reinforce change talk

Change talk is any statement that expresses a desire, ability, reason, need, or commitment to change. It is a key indicator of motivation and readiness for change. Both adolescents and older adults may have different sources and types of change talk, depending on their values, beliefs, and goals. For example, adolescents may emphasize their personal interests, aspirations, and autonomy, while older adults may focus on their health, relationships, and legacy. You can elicit and reinforce change talk by using strategic questions, reflections, and feedback that highlight the discrepancy between your clients' current behavior and their desired outcomes.

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4 Collaborate on goal setting and planning

One of the main goals of MI is to help your clients move from contemplation to action by setting realistic and achievable goals and planning specific steps to achieve them. Both adolescents and older adults may benefit from a collaborative and flexible approach to goal setting and planning, where you support their autonomy and self-efficacy. You can use scaling questions, decisional balance exercises, pros and cons lists, action plans, and follow-up sessions to help your clients explore their options, weigh their consequences, and commit to their choices.

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Erin N.
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I’m reminded of my mothers, best friend, who is kind of like a second mom to me, Rebecca. When I was struggling as a teenager learning about my gift of vision and prophecy, and also learning about the struggle of having depression in a depressed household without any mental health supportive services, and not a lot of talking as a household, Rebecca handed me the book called seven habits of highly effective teens. I recommend it to all high-level readers under the age of 18. It’s got simple exercises to help with goalsetting and teaching young people how to write their vision statements and learn about their values.

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5 Adapt to communication styles and preferences

Both adolescents and older adults may have different communication styles and preferences that affect how they respond to MI. Adolescents may prefer shorter sessions, more interactive activities, visual aids, and technology-based tools, such as apps, games, or videos. Older adults may prefer longer sessions, more verbal discussions, written materials, and face-to-face or phone-based interactions. You can adapt your MI style and methods to suit your clients' communication needs and preferences, and ask for their feedback and suggestions.

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6 Address co-occurring issues and challenges

Both adolescents and older adults may face co-occurring issues and challenges that influence their motivation and behavior change, such as mental health problems, substance use, trauma, family conflicts, social isolation, or cognitive decline. You can address these issues and challenges by using a holistic and integrated approach, where you acknowledge and validate your clients' difficulties, explore their impact and coping strategies, and refer them to appropriate resources and support. You can also use MI to enhance your clients' adherence and engagement with other interventions and services.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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What are some ways to adapt Motivational Interviewing for adolescents or older adults?

1

2

3

4

5

6

7

1 Understand developmental stages

2 Build rapport and trust

3 Elicit and reinforce change talk

4 Collaborate on goal setting and planning

5 Adapt to communication styles and preferences

6 Address co-occurring issues and challenges

7 Here’s what else to consider

Motivational Interviewing

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What are some ways to adapt Motivational Interviewing for adolescents or older adults?

1

2

3

4

5

6

7

1 Understand developmental stages

2 Build rapport and trust

3 Elicit and reinforce change talk

4 Collaborate on goal setting and planning

5 Adapt to communication styles and preferences

6 Address co-occurring issues and challenges

7 Here’s what else to consider

Motivational Interviewing

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