What is precious to you?
This question opened our recent workshop, Start from the Heart: Incorporating Motivational Interviewing in Intake Assessment. Discussed in pairs, the answers were diverse: “my family,” “my sleep,” “my mental health.” When the chime sounded to close this activity, the room buzzed with energy, as if a light had turned on inside hearts and minds. That energy never left the room.
“Start from the Heart” was attended by staff of grantees of the DANY Criminal Justice Investment Initiative, which was “designed to invest funds in impactful projects that will improve public safety, develop broad crime prevention efforts, and promote a fair and efficient justice system.” In true collaborative form, MindOpen’s principal consultant, Dr. Elizabeth Speck, invited Dr. Bukky Kolawole, member of the Motivational Interviewing Network of Trainers (MINT) and licensed clinical psychologist, to help us think differently about starting the professional helping relationship.
Understanding intake
We asked participants to help us break down what the intake process involves. They said intake:
(1) introduces a client to an agency and its services
(2) allows an agency to determine if an individual is eligible for its services
(3) gathers information from the client to aid in referring that client to the correct services.
Clients appear for intake appointments in a moment of vulnerability. They might have been building up the courage to come to this meeting for a while. They might be fearing the consequences of being there. They might be fearing judgment or rejection. Intake often occurs in the absence of a relationship - two humans meeting at what is a crossroads in life for at least one of them, a moment of risk and bravery.
But we know as professionals that we cannot be wholly responsible for changing someone’s circumstances. Change is a choice. Our role is to be present if and when people are ready to change their lives. It is to offer the right support - or help that person find the right support - needed to transform their lives.
Enter motivational interviewing.
Motivational interviewing (MI) is “a counseling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior.” The spirit of MI is grounded in partnership, acceptance, compassion, and evocation. At its core, MI believes that we can help one another change through meaningful connection, built on empathy for one another and a willingness to let go of our “righting reflex.” This reflex is our inclination to fix situations through our own expertise. MI encourages us instead to spend our energy deeply listening and drawing out the expertise that is inside every individual - no matter their formal titles or social identities.
Participants in “Start from the Heart” were given the chance to practice MI techniques, including reflective listening and asking open-ended questions. Dr. Bukky emphasized that these were in “real-play” format, meaning that participants used real-life examples from their day-to-day lives. The results were open, vulnerable, and courageous - not unlike how we ask clients to be when they step into an intake meeting.
Learnings
Many participants left the workshop hungry for more MI training. But they also asked the tough question: how do we incorporate MI when there are systemic barriers, like a lack of time and resources? Underneath this question is a subtext of despair - “I want to help, but I don’t know if I can.”
Put next to the intake process - one that can feel so cut and dry - motivational interviewing feels messy, powerful, and drenched in feeling. This workshop wasn’t intended to have participants revamp their entire intake process, but simply to shift the way we think about that process. What can happen when we focus on creating connection in that brief interaction? How can we listen more deeply, and calm our “righting reflexes”? What questions might unlock a program participant’s sense of power?
The answers to these questions will only become apparent when we create the conditions that allow us to start from the heart.
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