What techniques can you use to help clients feel empowered and in control of their change process?

It is tough to get a teenager to trust and open up to you, especially in a clinical setting. I have found that asking open-ended questions about who they are as a person, not just a patient can help expedite building rapport. Talking with a patient about their favorite, music, their talents, and their interests is essential to the point in the clinical process. Then, when we come in with the tough open-ended questions, they are ready and comfortable enough to share.

Open-ended questions are powerful tools for promoting client autonomy. They encourage clients to explore their thoughts, feelings, and motivations freely. Instead of leading clients to a specific answer, open-ended questions allow them to express themselves authentically. For example, you might ask, "What are your thoughts about making this change?" or "How do you envision your life if this change were to happen?"

I empower my client in their change process by orienting to the therapeutic relationship as one of ongoing consent. Here's an example of some consent-oriented questions I might use. I might ask my client, "Did you want me to empathize with how you are feeling, or did you want help to do something different?" Once I know they want to do something different, I might offer options, "Did you want tools for regulating your emotions, scripts for talking with the other person, or changing your behavior?" I also often add, "Or something else?" This keeps it open-ended and makes it clear that the options I've offered are not the only possible options. My clients are empowered to change what is happening by choosing a different option.

I was just speaking about this with a supervisee today. In therapy, asking questions like, "I wonder what would drive that person to behave in that manner. What do you think?" or "What do you notice when you speak about that?" can be helpful to elicit a deeper exploration of something the client is struggling with, or feels ambivalent/conflicted about.

Reflect, reflect, reflect! Be curious and offer those summary bouquets to demonstrate how skilled folks are in their personal change processes!

Reflection and summarization demonstrate active listening and understanding. When you reflect your client's thoughts and feelings, you validate their experiences. Summaries help clients see the big picture of their thoughts and goals. Both techniques can be used to gently point out discrepancies between their current behavior and desired outcomes, which can increase their readiness for change.

"It sounds like you're saying X ... did I get that right?" "Did you notice that when you said X, your shoulders did X. What was that?" "Tell me more about what you meant when you said X."

Reflecting and summarizing do at least two important things: show the client you were listening to what they’re saying; help to clarify the more salient aspects of what they have said; and of course give you the therapist time to digest and process, as well as clarify that you do hear what they are saying. This helps establish the ground that therapy will proceed on and develop rapport which brings therapist and client together in a partnership to facilitate change.

No cerne da medicina, está a rela??o entre médico e paciente. E essa rela??o é fortalecida quando demonstramos que realmente compreendemos o que nossos pacientes est?o compartilhando. Refletir e resumir s?o ferramentas valiosas que nos permitem mergulhar nas narrativas de nossos pacientes, valorizando suas experiências e sentimentos. Ao refletir sobre o que um paciente diz, mostramos uma escuta ativa e sincera. Esta autenticidade constrói uma ponte de confian?a, mostrando aos pacientes que estamos genuinamente interessados em suas histórias e preocupa??es.

As a therapist with a therapist, I can attest to the power of reflection and summary on both sides of the couch! More than anything, people want to be seen, heard, and validated. The two help to demonstrate your investment in the client's experience which can build trust, rapport, and buy in to pursue treatment goals with little resistance to foster change!

Change talk is a significant indicator of a client's motivation for change. Encourage clients to express their desires, abilities, reasons, needs, and commitments related to change. You can do this by actively listening for statements like "I want to..." or "I can see the benefits of..." and then exploring these statements further. By amplifying change talk, you help clients strengthen their motivation and self-efficacy.

"Change talk" is powerful ... especially when the client realizes that this is the first time they've acknowledged being ready to try something new. :)

When working with teenagers with eating disorders, change talk is a precious gem that must be cared for as such. Change talk for teenagers may sound like, "I just want to go back to school" or "I am tired of not feeling well." With teenagers, we have to remember their ability to look into the future is drastically impaired until their frontal lobe is fully developed. So, focusing on things they want that are short-sighted can be beneficial. When you hear change talk, help the patient come up with action points that seem realistic for them.

An example of eliciting change talk is focusing on the goals and values that are important to the client- make it about their hopes and dreams!

Eliciting change talk is a critical skill for behavioral and mental health providers to develop. Engaging in change talk encourages individuals to evaluate potential changes and empowers them to take those challenging first steps towards reaching their goals.

Affirmations and encouragements are essential for boosting clients' self-esteem and resilience. They acknowledge their strengths, efforts, and values. Offering words of support and hope can help clients overcome self-doubt and challenges. You might say, "You've shown great determination in this journey," or "I believe in your ability to overcome this obstacle."

I encourage my clients to affirm and encourage themselves. While I offer my own support, I model and teach them to provide this for themselves. For example, I offer them a list of affirmations and suggest they choose one daily to say out loud to themselves, looking in the mirror. Since I'm not going to be with them forever, it's essential that they develop an internal locus of control and have the ability to be their own source of affirmation and encouragement.

Affirmations and encouragement are powerful tools that can make a significant impact on the lives of our clients. By providing positive statements that acknowledge their efforts, achievements, values, and strengths, you are not only boosting their confidence but also helping them realize their true potential. As a licensed mental health therapist, it is crucial to incorporate affirmations and encouragement into our practice to create a supportive and empowering environment for our clients. A few kind words can go a long way in inspiring and motivating individuals to strive for greatness.

Encouragement: "You can do it." Affirmation: "I've seen you successfully take risks before." Affirmations, to me, are more powerful. ;-)

The key is having authentic trusted relationships. Collaboration and negotiation are tools to achieve this goal. Takes the element of surprise away from managing your clients and stakeholders. It’s important to sing to your own tune. Corporate corridors have ears and always maintaining a brand that speaks to “easy to work with”, will be plenty mileage for your MO and achievements of outcomes.

Collaboration and negotiation are key to treating clients as partners in their change process. Involve clients in decision-making by seeking their opinions, preferences, and feedback. Offer options and alternatives, discuss pros and cons, and work together to create realistic and acceptable action plans. This collaborative approach enhances client ownership of the change process.

Clients are the experts of themselves. I'm just there to help them gain clarity and self-belief so they decide to take action. We're "think partners." ;-) If by "negotiating" you mean that I invite them into change, then yes, that term applies to coaching. I can't force or bribe them into change ... not even with warm-from-the-oven chocolate chip cookies. ;-D Every person on the planet already has within them the "heroic potential" to continually evolve into the person they'd like to be. Our past only holds the power we give it. (I love that belief!! So empowering.)

It is important to remember that you and the client are building a relationship. Relationships require reciprocity, openness, and empathy. Collaborating with clients establishes an expectation that they play an active role in the partnership which can promote both autonomy and confidence. To add, negotiation helps the provider to meet the client where they are without increasing the chances to retrogress progress. Ensure you are using their words when setting goals, ask before you assume, and inquire how they feel about the dynamic between you two periodically.

Collaboration and negotiation is essential for motivational interviewing. It's important to remember that this journey belongs to the client, we are there to simply guide and support, and challenge bad decisions in a helpful and supportive way, ultimately their choices, successes, and mistakes belong to them.

Motivational Interviewing through a harm reduction perspective is, in my experience, a vital aspect. Allowing the client to be the expert on their own lives and what their goals are while facilitating a place for the client to feel supported without on overarching clinician goal leaking through is what builds relationship and supports change. Utilizing the process of MI only works when we aren't trying to convince a client to buy in to what we think their problem is.

"You can lead a horse to water, but you can't make it drink." We can't force change, but we can help clients find their own motivation and empowerment. We can guide, support and inspire them, but the choice to change must ultimately come from within. One way to help clients change is to use the "empty chair" technique. In this technique, the client imagines that a person or part of themselves is sitting in an empty chair and talks to them. This can help clients to understand their own thoughts, feelings and needs. Change is not always easy, but it is possible for everyone. Our goal should be lasting and meaningful transformation.

One powerful technique that I’ve found helps clients maintain a sense of empowerment during their journey of change is working through achievable milestones. While “where do you see yourself in five years” might be the big goal, I spend most of our time turning that into smaller, manageable steps. By celebrating these mini-victories along the way, clients not only gain a sense of accomplishment but also stay connected to their progress, fueling their motivation and confidence to continue moving forward.

Something I learned in my practicum years from my supervisor was the Colombo method to pointing out and confronting conflicting thoughts. Essentially you elicit the client to explain their line of thinking or behaviors. Yes, as a clinician you're playing dumb, but it starts a discussion on how we protect ourselves while holding 2 different thoughts/justification. I also set a tone of humor and bluntness that worked well for me, I had clients in shock at my interactions with them as I was always just me I thought something "sucked" I said "that sucks." I sort of ran with radical authentic responses to clients and they saw I was able to disagree, confront, and still would walk their mindset a bit.

The system of trust you are developing with these techniques that have been stated will lead to areas where the client will feel safe and challenged. Hopefully the client will take the risk and find the courage to move through the suffering to develop competency. This competency will help them feel more empowered to deal with more areas of difficulty. The one thing that I believe is important for clinicians to consider with the client is helping them understand that there are things they cannot be in control of. This understanding and acceptance can also lead to more empowerment because they can let go of things that take up too much of their energy and refocus this energy to healthier pursuits.