Q&A with the Author
Congratulations on the publication of Experiencing Motivational Interviewing from the Inside Out! In her endorsement, Jennifer K. Manuel, PhD, chief of psychology at the San Francisco Veterans Affairs Health Care System, writes that “this book provides the unique opportunity to learn and understand MI from the client perspective.” Can you unpack this for us? What does it mean to view MI through this lens?
Typically, in training we focus on the practitioner. We convey models and concepts, draw connections between ideas, and describe how these fit with things we already know. We also spend time describing the skills that accompany the model – in this case motivational interviewing (MI) – and then provide opportunities to practice and learn the skills. Finally, to become proficient, we go through a process of reflection and refinement, where we deepen, improve, and maintain the skills by reviewing our work both after it’s happened and as we become more proficient, while it’s unfolding. We can use a variety of methods to accomplish these things, including deliberate practice, supervision and mentoring, and more recently interacting with AI learning methods, as well as workbooks. While understanding the client’s experience is central in this process, the learning focus is from the perspective of the practitioner. What does the practitioner understand and do in a particular situation? This book takes a different tack.
In this Inside Out book, we focus on what it’s like to receive these skills when we are the client. That is, how do we experience MI when we are working on a personal issue? The focus is from our personal self, or what Dr. Manuel refers to as the client perspective. We then engage in a reflective process to understand the experience and then intentionally bring those understandings back to our work.
Experiencing Motivational Interviewing from the Inside Out is part of Guilford’s Self-Practice/Self-Reflection Guides for Psychotherapists series. For those who may not know, can you explain what SP/SR is, and why it is beneficial for clinicians?
Self-Practice/Self-Reflection (SP/SR) is an evidence-based training method that grew out of James Bennett-Levy’s desire to and personal experiences of working to understand the use of cognitive-behavioral therapy with clients. It has since spread to areas such as schema therapy, acceptance and commitment therapy, compassion-focused therapy. In all cases it begins with the assumption the practitioner understands the basic knowledge and concepts of the approach, has at least some beginning skills, and wishes to deepen or refine skills in the approach.
There are three basic components to SP/SR: self-practice, self-reflection, and crossing the reflective bridge. To begin, the learner chooses a personal or professional issue in which to change or grow. Then, through a series of modules, they have a personal experience with a particular concept or skill. This can be done in a self-directed manner or with a limited-practice partner who is also going through the SP/SR process. This is the self-practice component. The self-reflection component asks the reader to answer a series of questions designed to assist them in noticing and thinking about that experience from that personal perspective. For example, where did I notice it in my body when I felt deeply understood? What feelings accompanied that? What thoughts stemmed from those things? Finally, the reader intentionally connects these experiences to work with clients by answering a series of questions to cross this reflective bridge.
Much of traditional training focuses on the What and the How of a particular therapy. SP/SR focuses on the Why. This is the question that many practitioners are working to answer when they move beyond introductory coursework. They want to know why I do this at this moment and not something else. This process helps them answer that question.
In 2017, you published Building Motivational Interviewing Skills, Second Edition. Can you compare and contrast that book with Experiencing Motivational Interviewing from the Inside Out? Do you see them as working together?
These two books fit nicely on those dimensions I described. Building MI Skills is a book that introduces the reader to the concepts and skills of MI. It focuses on work from the practitioner perspective and was written in a manner that reflects current science about MI while making the ideas and skills accessible. It helps someone new to MI, as well as more advanced learner deepen their understanding and skills of MI. It allows opportunities for deliberate practice, as well. This book is for someone who wants to understand how to “do” MI.
Experiencing MI from the Inside Out is for the person who knows how to do MI – from either a basic or a more advance perspective – but now wants to understand “why” to do those things in a particular moment. In addition, SP/SR training often employs sharing of process reflections in a group format to layer in more learning from this reflective bridge and this book provides guidance about how to create such a group.
I have come to see learning and training in a therapy as a continuum. There is the knowledge base and beginning skills which can be accomplished a number of ways, including books and workbooks, as well as training. Then we move to refine those skills through additional learning that includes things like scaffolding learning, deliberate practice, and supervision. Finally, there is developing the wisdom of why we do things when and when we choose not to do things. These books fall in different places in that learning process.
You are the president and CEO of the Prevention Research Institute in Lexington, KY, a private nonprofit organization dedicated to helping people reduce the incidence of alcohol and drug-related problems. How did your work at PRI inform your writing of Experiencing Motivational Interviewing from the Inside Out?
Well, this is a very interesting question, and I could get long winded in reply, so I’ll focus on three specific ideas and an example. At PRI, we work with people who don’t want our services, at least initially. So, we work hard to understand what the experience is like from their perspective. We need to understand the attitudes and beliefs and how things help or do not help in that experience. Then we try to construct programs and training, based on what research shows works, not what we like or what we think is a great idea. Finally, we construct a learning experience for the people who will provide our programs in a way that not only conveys the concepts, methods, and skills of the program, but also provide personal experiences that help them understand the Why.
A couple of years ago we began experimenting with a training series that we now call Extraordinary Conversations; it is built on SP/SR principles. It has become one of my and participants favorite training experiences based on attendance and comments. The self-practice exercises and self-reflection questions in the Inside Out book have been informed by those experiences.
Thank you so much! Now that the book is out, is there a project that you are excited to work on next (a presentation, a workshop, writing another book, etc.)?
There are always multiple things that have my interest. Like many folks, I feel most alive when I am learning so I am looking forward to figuring out the next thing. I have several books on my stack that need to be read, including Christina Lee’s new book, Motivation Interviewing Across Cultures, Patterson and Mendoza’s new edition of Clinical Hypnosis for Pain Control, and a book that is a few year’s old by Proffitt and Baer, Perception. How Our Bodies Shape Our Mind. At PRI, we are working on Version 10 of our Prime For Life and that is always an interesting process of asking ourselves questions, “What is the other right way to do something?” Or “What is the research saying about this issue now?” I’m working with Lynne Johnston and Charli Hilton on some training ideas stemming from our book and we hope to have some options for people moving into 2025. Finally, I have a training on hope that is germinating, and I am looking forward to seeing how that grows in 2025. There are lots of things that have me interested and intrigued.
See all titles by and read more about David B. Rosengren on his author page!
