This lesson will explore the root causes for a clients deception and discord. It will also provide various skills to help us navigate the relationship during these tough times. Multiple opportunities are provided for you to test your understanding of the causes and responses to deception.
- Duration: 1 hour
- Credit Hours: MCBAP-R (0.0) MCBAP-S (1.0) Mi-CEC (1.0) Nursing (0.0)
MI Style and Strategy
The Motivational Interviewing style is fundamentally Client-Centered, and two strategies of MI are to Develop Discrepancy and Roll with Resistance. We list the practices of MI that make it Client-Centered and also define Develop Discrepancy and Roll with Resistance. These aspects of the MI style and strategy are relevant when considering working with resistance, deception and sanctions.
Discord vs. Status Quo
Discord is a relationship issue about the “you and me” part of our work. Status Quo is about the client’s support or defense for the problem. Motivational Interviewing says that Status Quo talk is a byproduct of ambivalence, not a form of resistance. Definitions for the terms Discord and Status Quo are provided and the difference between them is further explored.
Deception is a normal human behavior, and we can expect it in many of our clients for pretty ordinary reasons. It is important to remember not to take it personally, but instead, work in a way that fosters a positive relationship and helps the client Develop Discrepancy. We explore reasons why a client may choose to lie, and helpful practices that the interviewer can use when facing that situation. Multiple opportunities are provided for you to test your understanding on a clients reasons to lie.
Responding to Deception or Discord in MI
In order to avoid pushing the client into a defensive state, we want to take a step back from arguing or debating and ignore our Righting Reflex. This practice is known as Rolling with Resistance, and is especially important when we are in a dual role of supporting our clients and also reporting their progress to overseeing agencies. Collaboration in these relationships can be greatly enhanced If we are clear about our dual role to the client and also handle our reporting in an MI-consistent way. We provide an example of a staff person explaining their dual role to a client, and also provide you the opportunity to test your knowledge on the Righting Reflex.
Four strategies for responding to sustain talk, deception and discord are: Reflective Responses, Reframing, Coming Alongside, Shifting Focus. Each of these skills are explored in greater detail and an example is provided of a staff person using each skill in a client interaction. We also ask you to write your own response using each skill and compare it to our answers.
Responding to a Clients Denial of a Sanction
It is not uncommon for a client to deny having committed an offense for which they are facing consequences or sanctions. There are three things that can help us navigate these situations
Avoid arguing, maintain “even keel” attitude, emphasize personal choice and control. An example of a dialogue is examined where the client is denying having committed an offense and the staff is using skills and strategies to navigate through it.
Emphasizing Autonomy is a MI strategy for responding to a client’s denial of a sanction and a key skill that will help us navigate the relationship when deception or discord arise. We explore the role it can play when navigating through tough times with a client and explain how to properly use it. An opportunity is provided for you to practice writing your own response using the Emphasizing Autonomy skill and compare it to our answer.
The way a staff person asks a question partially determines what kind of answer the client gives. Some staff can actually encourage lies through the way they ask questions. Closed questions can have the effect of increasing a sense of staff-client discord.
- You will review some basic elements of the style and strategies of MI as they are applied to working with deception, resistance, and discord.
- You will learn why lying and deception can be expected - even a "normal" part of the process of change.
- You will be able to state why utilizing a MI style is more likely to reduce the incidence or duration of client deception.
- You will be able to define specific strategies for responding to deception as well as upholding sanctions without leaving a MI style.
- You will practice using these strategies with case examples and exercises.
- You will understand how to work effectively with clients facing sanctions even if they are denying the problem.