#189 Motivational Interviewing and Prospective Clients

Is a motivational interview an appropriate process to use when talking with a person who is considering using your services and has not yet decided? To answer this question, let’s look carefully at motivational interviewing. MI is a conversation between two people in which one of them is considering making a change. There is an agreed-upon assumption that making the change is a good idea. For example, when a client is talking with a counselor about smoking cessation, both of them assume that giving up smoking is a good idea. The conversation is about what is important to the client about the change and how she might do it.

A good listener is not only popular everywhere,
but after a while, he gets to know something.
Wilson Mizner

Most people do not listen with the intent to understand;
they listen with the intent to reply.
Stephen Covey

When conversing with a prospective client, you could characterize the change as whether or not the client will engage in nutrition counseling with you. Is there an assumption that the client will benefit from the counseling and that you are the best person to help him? In the very first contact, this is often not yet determined. There are parallels between the effective skills and strategies used in MI and the effective skills and strategies in wanting to sell a product or service. However, a sales conversation and a behavior-change conversation are different in one important aspect: MI includes a spirit and assumption that the conversation is client-centered and designed to benefit the client – whether or not the outcome also benefits the counselor. If you very much want to persuade this client to sign up for your program or engage you as his nutritionist, you can see that there may be a conflict.

Let’s look at the first few moments of your contact. When you are well trained in the skills and spirit of MI, you most likely will succeed in engaging with prospective clients. In this case, “engaging” is used in the MI meaning – the process of deeply hearing the person and truly getting on her page about what is important to her and her hoped-for outcomes. By doing this, you may retain the client for ongoing behavior-change counseling because she senses that you are on her side and will collaborate with her. Being deeply heard goes a long way in developing trust and confidence in your skills. There is more on engagement here.

If you are truly listening, however, you will find that for some people, you are not the best nutrition counselor to assist them toward their goals. Your desire to increase your client base can overshadow this awareness. To fulfill both the spirit of MI and your professional ethical standards, begin your initial conversation by holding back your desire to sell this client on your services and instead focus on client-centered engaging. Once you are clear that you can help this person, it is appropriate to use such MI skills as summarizing and posing a key question (Tips #72 and #60)  to wind up the initial contact and move to scheduling an appointment.

When you decide to make a referral to someone else, you might also use a brief summary. You would include what you know about your areas of specialty or skills and end with an offer of some referrals. There is more on making referrals in Tip #98.

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