motivation for change

At my work, we have annual meetings with each client and their team to review their progress for the past year and make goals for the next year. I've done so many of these meetings that it's ridiculous but I've never really felt that they were that effective. It's similar to my evaluation at work. The day to day criticism means more to me than a 30 minute summary of how my bosses think I've been doing. Normally, I conduct these annual meetings in a very formulaic manner. I care what the clients think and I almost always focus on their successes. However, it's still my evaluation of them and my plan for their future. Sometimes that works because the client simply does not know that the next step is and needs the reinforcement. However, most of the time I feel that I'm being condescending.

When we did our motivational interviewing exercise in yesterday's class, I initially believed that this form of intervention wouldn't work for my clients because of the high suggestibility among people with developmental disabilities and also the lack of self-determination. But that is even more of a reason to use it. During class, I kept thinking about the meeting I had scheduled today for my most challenging client. This client has had competitive jobs in the past but has failed at them because he lacks ambition and focus. I can relate. Anyway, I was going to go into the meeting today with a set of goals that I had constructed for him at the request of his supervisor. One goal was to only use the bathroom once between breaks because this guy will spend more than half of his day in the bathroom using his cellphone or just avoiding work. Given this client's potential, I knew that this goal would upset him and I was having a hard time justifying it.

First thing this morning, I took my list of motivational interviewing questions to this guy's work site and began to interview him. I didn't offer up any criticism or suggestions. I simply asked questions like, "What do you feel you need to be working on in this program?" "Why do you want to change this aspect of your vocational training?" "How important is it to you to change?" "What are the top three reasons for change?" Basically, he came up with a short list of issues that he sees he has and potential ways to turn them around. It was WONDERFUL! This was by far the best meeting we have ever had and he opened up about some light personal stuff and we found common ground.

It's nice to know that school isn't just about getting a piece of paper or three letters behind my name. I give my professor a lot of credit for making these concepts into interventions we can work into our practice. I know that motivational interviewing won't work for all of my clients but it is so simple that I think I will most likely try it with everyone and I told my boss that I want to train all of my co-workers on it!

What else?
Andrew and I went to Apizza Scholls tonight and split a pizza there. We had the New York White with half red and half white sauce. It was good but not as good as the Tartufo Bianco.