What are the most effective MI strategies for online counseling?

Establishing rapport in a virtual counseling envionment is key to client comfort and continuation of care. Clients are less likely to schedule their next session if they do not feel the therapuetic alliance. Clearly articulating that the work to be done in therapy is a collaboration between client and therapist is helpful. Sharing with the client that you believe in their ability to make meaning of their experiences reinforces that they are in control of their journey to wellness. Being present, authentic, and understanding will go a long way in helping the client to feel safe and supported in session. Increased feelings of acceptance lead to increased willingness to be open and vulnerable. Clients grow and change when they are nurtured.

- Display responsiveness and timeliness by promptly addressing client messages or inquiries. - Employ a friendly and professional tone to create a positive impression. - Practice active listening to understand clients' concerns, needs, and goals. - Personalize interactions by addressing clients by name and referring to specific details from previous conversations. - Offer valuable information and insights related to clients' industry or interests to establish expertise and foster trust. - Emphasize transparency and honesty by clearly conveying expectations, limitations, etc. - Utilize video calls or virtual meetings for more personal interaction and observation of visual cues. - Follow up regularly

While some may feel virtual makes it harder to establish rapport, I disagree. With so many modalities now available to connect with therapists, clients have more options to get care that fits their needs and personality and time.

These skills never go away. It doesn’t matter the modality of treatment. Skills are skills and when you are working with a client in a way that works best for them, MI continues to be effective.

Open-ended questions are valuable tools for encouraging clients to express themselves freely and provide detailed responses. This fosters trust and promotes a collaborative conversation. Affirmations play a significant role in acknowledging and validating clients' strengths, efforts, and achievements. Reflective listening is an essential skill to practice. It involves paraphrasing and summarizing clients' statements, showing that you genuinely understand . Summarizing key points and themes discussed during the session is an effective technique. By employing these OARS skills, you can effectively build rapport with clients online via telehealth. This promotes a cohesive and mutually beneficial therapeutic relationship.

MI can be effective via - Phone: Active listening, open-ended questions, and reflective listening can identify ambivalence and explore motivation for change. - Video: Visual cues aid in observing non-verbal communication. Use open-ended questions, affirmations, and reflections to guide clients toward change. - Chat: Utilize concise messages, paraphrasing, and open-ended questions to maintain engagement and build rapport. - Email: Craft empathetic emails with reflective statements, affirmations, and open-ended questions to encourage self-reflection and change. Regardless of the modality, maintain a client-centered approach, respect autonomy, and foster collaboration for effective MI.

My work has been in community based mental health. Sessions are 2+ hours in persons homes. During the COVID lockdown I and my team had to remote for a few years and we adapted in several ways to make the time useful and interesting. Some of which added to my toolbox to this day. 1. Video sessions whenever possible to keep that personal element. The ability to share your screen factors into the next ideas. 2. Using videos for psychoeducational purposes. Very good for generating discussions 3. Use of psychoeducational handouts. They can be reviewed in session and are good conversation generators as well. 4. Emailing psychoeducational handouts ahead of time for them to review and / or as homework when appropriate.

- Online Assessment and Feedback: Use digital tools to gather information, assess behaviors, and provide personalized feedback. - Mobile Apps: Utilize apps for reminders, goal tracking, and interactive exercises to boost motivation and reinforce progress. - Virtual Coaching Platforms: Conduct MI sessions through video calls, chat, or messaging platforms for real-time communication and interaction. - Web-based Resources: Share educational videos, podcasts, and interactive modules to support client learning and understanding of MI concepts. When using digital tools, ensure they align with MI principles, are user-friendly, evidence-based, and prioritize client confidentiality.

To evaluate client growth and follow up effectively: 1. Set clear goals with the client. 2. Regularly assess their progress. 3. Use reflective listening and provide feedback. 4. Adjust goals if needed. 5. Address ambivalence and resistance. 6. Schedule regular follow-up sessions. 7. Collaborate with other professionals for support. By following these steps, you can evaluate client growth and provide ongoing support.

New and emerging modalities allow for different types of follow up and check in’s that best meet the client where they are. Not everyone wants or is comfortable with constant face to face.