Welcome to today’s episode of The Communication Solution podcast with Casey Jackson, John Gilbert and Danielle Cantin. We love talking about Motivational Interviewing, and about improving outcomes for individuals, organizations, and the communities that they serve.
In this episode we explore the recent workshop conducted by renowned experts Dr. Bill Miller and Dr. Teresa Moyer, titled “What Makes Helpers More Effective?: 8 Skills That Improve Client Outcomes.” The conversation reveals the groundbreaking insights from this workshop, focusing on the importance of practitioner attributes in achieving positive client results.

• The Power of Compassion: The conversation underscores the profound impact of compassion, highlighting its role in making helpers more effective.
  
• Attributes Over Titles: The participants emphasize the significance of personal attributes in helping professions, advocating for a shift away from rigid role definitions based solely on degrees.
  
• Coaching and Dentistry: The discussion extends to various fields, including coaching and dentistry, where practitioners are reevaluating their approach to insurance-based models.
  
• Desperation and Timely Help: The urgency of mental health support is highlighted, emphasizing the critical need for timely assistance rather than waiting for evidence-based practices.
  
• Individual Trust and Connection: The trust and connection between a helper and their client are explored, illustrating how this bond can outweigh formal credentials.
  
• Assessing Helper Skills: The importance of developing standardized assessments for helper skills is raised, recognizing the need to measure attributes like empathy and active listening.
  
• Efficiency and Effectiveness: The conversation touches on the balance between efficiency and effectiveness in helping professions, suggesting that experience and degrees may impact the efficiency of achieving positive outcomes.
  
• The Conversation Solution’s Mission: The podcast’s mission to facilitate open conversations around effective communication is acknowledged, bridging gaps and breaking down barriers.
  
• Hope and Empathy: The discussion touches on the power of hope and empathy, emphasizing their role in alleviating the feeling of isolation and understanding clients on a deeper level.
  
• Being a Good Person as a Foundation: The conversation concludes with the idea that at its core, being a good person forms the foundation for effective helping, creating positive impacts both personally and professionally.
  
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This has been part one of a two-part podcast. We hope you’ll join us for the second portion. Thank you for listening to the Communication Solution Podcast with Casey Jackson and John Gilbert. As always, this podcast is all about you. If you have questions, thoughts, topic suggestions, or ideas, please send them our way at casey@ifioc.com. For more resources, feel free to check out ifioc.com.

  Hello, and welcome to the communication solution podcast with Casey Jackson and John Gilbert. I’m your host, Danielle Cantin. We love to talk about communication. We love to talk about solutions, and we love to talk about providing measurable results for individuals, organizations, and the communities they serve. Welcome to the communication solution.

Hi, I’m Danielle Cantin, and I am here on the communication solution podcast with Casey Jackson and John Gilbert. We are so excited for another episode, everything about motivational interviewing and on this particular episode, we might even take a little journey, a little bit away from motivational interviewing and always circle it back.

 thank you so much for being here. You guys,  Casey, you just came off of an amazing workshop with the co founder,  Dr. Bill Miller of motivational interviewing and his friend and colleague, Teresa Moyer, Dr. Teresa Moyer.  so they have a new book coming out. And I think you’re pretty energized about what you just experienced and it’s going to be a great podcast.

Yeah, it’s just, it’s, it is,  mind expanding, mind blowing just every time new chunks of data or new perspective comes out and this was just. Packed with, you know, kind of evolved and some new perspectives, what they set out to do. And what I liked about it, John and I have talked about this. It’s fascinating because they did not do this initiative.

through an MI lens, what they really want to do is step back, look at all of the research for the last 70 years of research on what is effective in interventions in clinical interventions,  especially those that are most associated with positive outcomes. So what they did is they just dug through 70 years of research.

And one of the most fascinating things, and this is from, you know, People are highly invested in the work they put into motivational interviewing. The way they said it, that was fascinating to me is it’s going to, it has to move or research will move people away from brand name treatments and therapies.

So because it’s less about the brand name therapy, like cognitive dialectical behavior. Behavioral therapy or,  you know, AC, just all these different therapies out there that what the research is extremely consistent about is that it’s not as much about the brand name. It’s about the actual provider or clinician.

Their attributes and what they find is those attributes have a profound impact on outcomes either positively or negatively. So it’s not about motivation per se. It’s not about CBT per se, but with the components that they found in individual practitioner or clinician embodiment of an approach is the strongest indicator and the top, you know, 7 of the 8.

Indicators are all things that we look at and measure and teach and motivational interviewing. So, so it’s not that it endorses motivation wing per se. It’s more that people that are highly skilled in motivational learning and been trained well at it and develop a level of master of proficiency embody the top, you know, six to seven out of the top eight indicators of what improves outcomes in,  in interventions.

So it just, it was just a fascinating,  way that they’ve, they’ve looked at it. The, the analogy they use that I thought was just brilliant was,  is the car or the driver, the thing that wins the race. Is it the ingredients or the chef that makes a meal phenomenal?  so yes, there’s some combination of the two, but a car cannot win a race if there’s not a great, it doesn’t matter how great the car is, if the driver is not great.

And it doesn’t matter how great the ingredients are if the chef does not know how to cook them. So it’s the same thing. It doesn’t matter the mode of treatment you’re using. If the actual one using it is not skilled. So that was just for me, that analogy just was a whole cascade effect in my brain in terms of like, wow, that is just.

Really fast and it makes sense when you hear it that way, but I think as a, you know, somebody is a social worker clinician for the last 30, almost 35 years. Now, it’s always been about going to more trainings on more models and having more tools at your disposable and more tools in your toolbox and the tools in the toolbox matter.

But you also need to be a phenomenal handyman,  or technician, you know, and the better tools you have, the better the technician can be. But if you’re not a good technician, you can have all the tools you want to at your disposal and not know how to, you know, change the light socket. So. You know, you know, what’s coming up for me on this is something that we’ve been talking about and working on for a while, because you teach and train so many organizations and motivational interviewing in a really special way.

 but our latest endeavor that really has peaked the interest of so many people who have gone through your trainings as individuals is that be the change it’s like instinctually. You’re wanting to take care of and lift up all of the individuals who are actually the ones having to implement this, this tool, this solution.

And so as you’re speaking, I’m just going, Oh my gosh, you were, you were already tapping into the importance of this in the development of the program. It is. I agree. And, and the thing that’s so interesting to me about this as well, too, is just more organically and probably the last. Year really heavily in the last six months, but in my trainings, my brain has just been so much more cognizant in being able to articulate that being skilled at M.

I. is as much or more about mindset as it is about skill set. And we just tend to teach skill set because it’s so much easier to measure at face value. It’s easier to measure if it was a question or reflection that is so much easier to measure than is somebody operating from a place of genuineness.  or positive regard.

I mean, that’s just becomes extremely complex to measure and teach. And then how much bias is put into those definitions. And so those were some of the aspects that, that,  doctors Miller and Moyers tried to tease out based on, you know, meta analysis in terms of, okay, what are. How do we get to a common definition of accurate empathy?

How do we get to a common,  definition of, you know, positive regard? How do we get to a common definition of evocation that that’s there? And why is it? Because it’s one of our, when we’ve talked about businesses before, because the reality is this. There’s also people want to be able to brand something and sell it because you can do the training market and you can do the speakers market and you can, you know, produce a workbook.

And so there’s money to be made if you can slap your brand on it. So I think in some ways it’s, it makes me a little giddy to think that while the research is showing is, it doesn’t really matter. The brand, it really matters. You know, who’s actually applying that and, and if that’s where things are going, I think motivation thing is in a phenomenally well positioned because like I said, half the things on there are things that we measure, like at the Micah, some of the things specifically like with the evocation, with focus, with accurate empathy, those are things we specifically measure and give people feedback.

And I’ve been doing it for at the mighty in there, the motivation and treatment integrity skill too. These are things we’ve been looking at measuring for decades and decades now. So that’s, that’s what’s fascinating to me. You know, I’m super curious on so many things and so many levels right now.  from the, in my geek side of it to thinking from the listener’s perspective and all sorts of things, I’m,  much more on the, the nitty gritty right now than the organizational part of it.

And,   but it is interesting to me to look at it from so many angles, but Casey. I’m really curious about this piece that we talk about that we want to be genuine and accurate about. That MI is a particular kind of conversation. Yes. And that it’s not a panacea, it’s not a silver bullet yet. Somehow we are because we like this stuff and we like the way it treats people.

Getting excited that MI is aligning with what it means to be effective overall or whatever that means. Whatever these definitions are. So part of me wants to kind of talk about, well, what’s that eighth part rather than the sixth or the ones that,  don’t align with mi? And what are the pieces of MI that transcend mi and when does it not become mi?

So these are some of the things that are going like. If it’s not a panacea, there seems to be a lot of things that are really interesting here. Yes.  and it is a particular conversation, but where’s the limitations and what does that mean for what am I is and is not. So I don’t know if you have any thoughts, but that’s kind of where my gucci doll is right now.

Yeah. So one of the thoughts I’m one of the eight, like the eighth one, they actually listed, which I can appreciate because it was the lowest. Effect,  variable is offering information or advice and so that is a factor. It was the lowest effect potency and I just always own the bias that I have in the way that I conceptualize and teach motivational interviewing, you know, very invested in the fidelity base, but there’s people that say, well, the mighty looks at, you know, persuading with permission.

And I just know my own writing reflex to that concept in and of itself of persuading with permission, what, what, what came out of that as well, too. So that’s, that’s my, when you’re saying, okay, we can focus on the ones we know are good. But what are those outliers that are interesting that the data came up and popped up?

And the eighth one was offering information and advice, which aligns so much with Western medical model. And so many of the things that we’re talking about are the antithesis of Western medical model and some of the research that we’re learning. I mean, that’s, that’s kind of the language that I’ve been using for quite a while now is just moving to that humanistic perspective and away from that kind of colonialization, you know, doing things to people versus with them and for them kind of on a larger scale.

But that’s what I, that was the one outlier or not the outlier, but the one that is the one that I was thinking, you know, we, we don’t you and I. As trainers, that is not part of our curriculum. It comes up because people ask those questions. Well, how do we give advice? How do we give suggestions? So you and I do address that in training, but it’s not an explicit thing that we train the closest thing that I think we do train is partnership as it relates to the mica as well in the way we defined it in the motivation and competency assessment because partnership is a time where you can share.

 yeah. You know, information or insights in a way that advances the client’s outcomes. And that’s pretty much what they were saying. You know, that was where the potency was coming from. If you share the right amount of information, the right dose at the right time, that can help advance outcomes. And you’re like, well, that, that makes sense because there’s certain information that experts have that the individual may or may not have.

So that, that was the one outlier when you’re going, yeah, okay. I want to know the things that we know, but what are those things that they’re bringing into the mix that may not have been at the forefront of an MI based conversation? Which again, to that last point you made, I’m more biased towards that point because of healthcare settings where there’s so much misinformation by influencers and all this stuff out there that then people might believe a lot of things and you’re using a humanistic approach and that might make their LDL or APOB worse.

That doesn’t have controversy, you know, over it or something like that. So, you know, That it goes to show that though, it’s a, it’s a minor part compared to all these other big things. So now I’m curious in with our, in my passion and enthusiasm,  how do we think about what they’re presenting then that M I isn’t a panacea, or are they?

Kind of alluding, are we hoping that it becomes a panacea or what is it? What does this mean that M. I. is separate than these other interventions? Yet M. I. has so much overlap. Does that mean these other interventions are going to get superseded? Or I don’t know. I’m just kind of curious your thoughts on that of like, where’s the limitation of this then?

I think what the expansion is, here’s a way that I would sort that out. Is. Like I said, most of the constructs that they found through research show improved outcomes. The majority of those are things that are foundations in learning motivational interviewing. Because again, it goes back to the person and not the MI.

 it goes back to the professional and not the, you know, that aspect of it as much. It just happens. To be that motivation thing is based off this because that’s what, you know, everyone who gets obsessed with them. I, there’s so many people that lean into the research side of it. I mean, you look at Dr.

Miller, you look at more. It’s just the amount of research they’ve done roll neck. Stephen is just all the people that you and I know that have done massive research on M I. Well, that’s evolved it. I don’t train. Am I the way that I did 20 years ago and so much that is dictated by what we’ve learned research things we’ve jettisoned from the curriculum have been things that research didn’t hold true on you and I have had countless conversations about, you know, when you and I wrestle through curriculum development over, do we leave it or do we get rid of it?

And you’re like, you know, the data just doesn’t show that. So are we articulating it effectively anymore if we keep Saying these certain things a certain way when we train, that’s, that is healthy growth and innovation,  and moving to that level. So, so that’s what I’d go back to is I think it will continue to evolve MI as data has always evolved MI.

So, and then I’m putting M. I. Is just another brand name of all these interventions. And for me, why am I slides to the top is because it embodies those, you know, some of those core constructs. Daniel, just for your sake, I know John has touched on some of this before, but just to say them and it’s, we’re not doing a training or a power point on it.

But,  the number one indicator and research is the strongest around is accurate empathy. Number one, without, without, and there’s no even contention. The data is profoundly strong that accurate empathy has a significant impact on people’s perception of their improvement,  or being able to move forward and the data shows that they move forward more effectively when people feel deeply heard and understood.

Then they’ve talked about positive regard,  which is very much Dr. Miller spent a lot of time in the workshop referencing Dr, the worker, Dr. Carl Rogers, and that was unconditional positive regard. And teasing out the difference in an, in a practitioner, the difference between accurate empathy and being able to express positive regard and then being able to do that in a genuine way.

So genuineness was one of the top three,  acceptance. So then you think, well, what’s the difference between acceptance and positive regard? You know, so it’s just, there’s all these components that the research is, is based on, Is pretty robust around each of these concepts. What I appreciated about it is it helps clean up semantics where we tend to squish words together a lot and say they kind of mean the same thing.

When you really get into semantics and how they research it, it really does start to clarify the dimensionality of what it takes in a human being to create effective outcomes.  so there’s acceptance and focus and I was a little startled by,  hope. In some ways, because so many of our participants and trainings will bring up the concept of hope because there’s so much research and written about it and models that are built around hope,  but they’re talking about hope and self fulfilling prophecy,  from a different perspective, which really helped my brain,  evocation, which is literally something we measure along with accurate empathy,  and, and then the offering information or advice.

So those are the eight. Yeah. components that have data that shows these are all factors in an individual or a practitioner or professional that any combination of those, the stronger they are, the higher the correlation with. Out positive outcome client outcomes. Do you think, this is probably a very interesting question to answer, but did they set out in this research to write this book?

I have a feeling the answer is yes. Of being willing to like just forget all about motivational interviewing. Yes, you’re right. You’re exactly right. They did, and that was the intention because they, they both are, I mean, looking at Dr. Miller, looking at Dr. Morris, they are both researchers first. Neither one of them have a desire to like endorse the brand of motivational interviewing what they want to endorse is positive outcomes and healthy interaction.

And they sat out on this book to just go wherever the data led them. And I think it was more that I think there was probably a warm, fuzzy feeling inside in certain aspects that they uncovered to go, wow, this is what I’ve been training. Miller even commented on that in the training of going, you know, it is a good feeling to look back at trying to do the right thing for the right reasons and let data lead us there, which is how am I evolved.

And then to just step back from all of that and try to be unbiased and just look at other people’s research. You know, all the, all the data out there,  and then just sift it out and see what lands out of that. And it’s like, wow, a lot of things that sift and land out of that align very tightly with what we measure and what we teach and believe in motivational interviewing.

So, so, and they wouldn’t, I mean, they really stayed away a lot from talking specifically about motivational interviewing and just talking more about these,  these clinical skills that improve outcomes. Yeah, I’m really curious how much it kind of got into fidelity with the model. So how much alignment with whatever the model is,  how much discussion was around that your thoughts on that, you know, for example.

You know, I’ve been, you know, a hot topic right now. That’s, I’ve, I heard about a while ago, it’s picking up more and more steam is,  internal family systems therapy. You know, am I, it’s not therapy. So that’s why I’m kind of curious about that discussion too, because effective psychotherapy is therapy. Am I was designed as a pre treatment to engage people in their care,  or comparing it to like therapies.

And we’d like to say. Therapy is different yet. Somehow we’re comparing it, but I’m, I’m simply getting that. There are other therapies that have specific approaches that might embody in my spirited things and certain approaches with therapy that might not, but I’m wondering, no matter what it is, does it matter the fidelity that you have with it or how much you seek fidelity?

Or how much you do that, no matter what it is, or that once you have fidelity, say with AMI, then it makes it even better than a certain kind of therapy,  with compared to fidelity. I don’t know. They, you know, it wasn’t mentioned explicitly that way that you’re framing it, that wasn’t explicitly what came up.

What, what Miller did talk about is that it, which is, it was. It was fun for me to listen and talk about certain things that I’ve been talking about for years, just the way my brain evolves. So there’s so many, there’s just a significant amount of validation of how my brain has evolved around motivation wing to see, wow, this really does align with the trends as they’re, you know, articulated now.

But what he was talking about more is thinking about motivation as a method of communication. Which is like, that’s so much what we lead with, you know, for people that are thinking they’re taking MI as a therapy training is that it’s a method of communication. So the way that I would, the way that my brain would interpret what you’re talking about is it’s the same message again, in terms of when you’re using other evidence based practices to fidelity, your concept is it would, it would seem to be that they will be exponentially more effective if people are using an MI Method of communication when they’re applying a therapy technique, because their whole point was it is about the, the person using the model, what their skills are on these eight levels,  you know, how much they embody those.

So I think that’s where you’re going to see that exponential effect. So if they’re using the model, it’s very effective, but the individual practitioner themselves, if an individual practitioner is doing the model to fidelity and not embodying these, my hypothesis would be they’re not going to have the same outcomes as somebody that’s using that same model.

And all of these,  clinical skills and mindsets in combination, but that would be, I think what Terry would say is that’s something you should write a grant to NIH and get funded for because that’d be fascinating research.

This has been part one of a two-part podcast. We hope you’ll join us for the second portion. Thank you for listening to the communication solution podcast with Casey Jackson and John Gilbert. As always, this podcast is about empowering you on your journey to change the world. So if you have questions, suggestions, or ideas, send them our way at Casey@ifioc.com.

That’s CASEY@ifioc.com. For more information or to schedule training, visit if ioc.com until our next Communication Solution podcast keep changing the world.