In this episode Steve, Joel and Ange are joined by our good friends Allan Zuckoff and Chris Wagner to explore MI and Person Centered Counselling. Where do these approaches converge and diverge. We did the best we could to explore what Carl Rogers might think about MI if he was alive today. Happy Holidays and we will see next year!
In this episode Steve, Joel and Ange are joined by our good friends Allan Zuckoff and Chris Wagner to explore MI and Person Centered Counselling. Where do these approaches converge and diverge. We did the best we could to explore what Carl Rogers might think about MI if he was alive today. Happy Holidays and we will see next year!
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Chris might be willing.
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Maybe you could just get us started. I'm sure we all have plenty to say once the wheels get turning.
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I tell you what Chris, since Why don't I try with motivational interviewing? And you try with Klein centered counseling.
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But we just pause between them in case any of the others want to add anything to what I say or you know and then to what do you say?
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Yep.
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How's that? Okay. So motivational interviewing is a style of conversation.
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In which you
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Adopt an attitude.
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Of curiosity. Driven by compassion and acceptance of this person in front of you or group.
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In which you Clarify a direction of travel in the conversation or what we call a focus.
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And then proceed on the assumption that most of the wisdom is inside. And therefore, evoke from them.
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How they feel about this change. Acutely aware that They often feel ambivalent.
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And then if and when they seem ready to talk about doing something about it. You might join them in a process of Planning that change.
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And offering up information and advice. If that's something that they would appreciate.
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How's that? Okay, I tried.
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Okay.
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I like your description of Li.
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I'm not sure if it covers all of what other people call am I?
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So what if I tried this? If I try, try to boil it all the way down.
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I. Allows us to sidestep or defuse the cycle of pressure and resistance.
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When talking with people who are ambivalent about change. And helps them resolve their own ambivalence in the direction of change.
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Through focusing on and drawing out their own values, goals, and strengths.
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Love it.
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That's as succinct as I've been able to get about what I actually think MI is.
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I love that.
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You're also pointing to That whole issue of pressure and bypassing that issued pressure.
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Okay.
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I wonder if we might. I don't know if you want to quickly do base versions of these or if we might elaborate, expand this a little bit.
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Stick with MI for a little bit.
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I don't mind. I'm wondering.
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Love to hear your thoughts, Chris.
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So yeah, so I have a couple of questions.
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One is we say in the direction of change.
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But somehow, what changes has to be established? And. My sense is different people have different senses of how that comes about.
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So that's one question. And.
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Well, we'll stick with that one for the moment.
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If it's in the direction of change. How is change defined? What direction is that?
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And I could respond with one word. Which is focusing.
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Which is an activity or a task.
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Okay.
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Where you try and reach agreement with the person about what that. Changes.
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I think, I think. Kind of historically. Motivational interviewing would focus on what the person wants to change.
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How they want to do it, when they want to do it, and even if they want to do it.
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And that's where and. Supporting autonomy has always been a big part of motivational interviewing for me.
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And the very appealing part of it.
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So in some ways, motivational interviewing to me is, is
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Providing an opportunity. For the person.
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To
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Just decide what it is they wanted. Change or have different in their life.
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And come up with their own arguments and reasons to do that. Based on what's important to them.
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Not me. Coming in. And trying to install these arguments and reasons. On why they should change.
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Because of what's important to me.
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They they awesome.
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Or the feeling the need. Or feeling the need that it's my job to fix somebody.
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Absolutely. And there are these ethical Challenges in the process of focusing.
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That can't. Often can't be avoided because I might sit with somebody in feel. This is probably a worthy direction of travel.
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I can't honestly say that It's always about only what they think. Is an appropriate direction of travel.
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There can sometimes be potential for disagreement and the skill of focusing. Is precisely the ability to form. A good connection and engagement with somebody such that you can raise a possible direction of travel.
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Eventually agree. Okay, and once and then if there is that sense of agreement then you can proceed with mining their wisdom so to speak about it.
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Okay.
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So the
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I love that and I think we're already. Bordering on the topic. Of contrast. Between MI and client senator person centered.
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Counseling because I think the process you just just described Steve. Is quite different from the way a person centered counselor.
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Would conceptualize. Their way of starting and joining and moving forward with with a new client.
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And doesn't that invite us now to try and capture what blind centered counseling is?
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Let me just make a mark about the one part of that I want to come back to a little bit later then.
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Yeah.
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Cause what I'm hearing you say is Focusing involves developing a collaborative partnership. To move toward a particular in a particular direction, either toward a goal or toward an outcome or just forward movement in a direction even if there's not an end goal to find.
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And it's an active partnership of both people then working together and you said some of the skill is negotiating finding what is this thing that we both feel we can work together.
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Toward. Is that correct? Okay.
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And it sometimes starts off. A little bit vague. But there's agreement and then it can get a little bit more specific as the conversation unfolds.
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Black and white, we have a goal to work towards. It's often an unfolding like a flower opening.
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If you like.
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Yeah.
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But I would also underline that word negotiating. Because again, I think as we're thinking about.
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The. The. Overlaps and contrasts between MI. And person centered counseling and, purely, sort of method, I think that word negotiation really is a, I would see it as a dividing line.
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As a just as distinguish between the 2 methods.
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That's very helpful. A fella came.
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I think it's one of the most distinguishments for sure.
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Yeah, yeah, I know. Yeah.
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Hey, how is he the only one? But A, Yeah, yeah.
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I mean, someone got referred to me today with a specific problem and walked in with that specific problem. And in the focusing process.
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Hmm.
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We adjusted what that if she was and talked about something completely different and I think more fundamental but it was negotiated.
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It was negotiated with sincerity or authenticity, compassion. Kindness. But it was completely different to the reason why he walked in and why he was referred.
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Sure.
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So it's a continuum. There's a sticking point. I'm gonna name what I think the sticking point I'm gonna name what I think the sticking point is and then we can decide whether we want to hold that one for later.
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Okay.
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The sticking point being.
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Programs having a goal. Existing before people have even walked in the door, right? Other people walking before a given client walks in the door.
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And a kind of sticky point being.
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What if we see something that seems beneficial for the client and they're not really so up to focusing on that now.
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And I, I don't know this is Stephen any of your work with MI, but I hear people talk about am I sometimes as I use MI when I want to try to convince the client to do something that I think they should do or we think they should do or is better for them.
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And maybe there's still a negotiation of then do we do am I but the impulse of direction is coming in.
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That's what
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Okay.
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Yeah.
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Will swing back. So Alan, you're gonna really have to help me with this or join anybody else, but so client center counseling.
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Classic client center counseling. First of all, I think was different things at different points, right?
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So it had a Under Carl Rogers had about a 50 to a 40 year development period, 30 to 40 year development period and it unfolded in time.
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So we can maybe talk about some of the differences over time, but the essence of it was As I understand it.
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Each person is. A master of themselves or of their own life. And when we meet people, they're not yet able to fully use that power.
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To be themselves fully, deeply. And congruently. Because along the way. They have met with conditional regard, things that.
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They've been shamed for scolded for, etc, that created a sense of internal tension and, a process of people kind of Having an outward face and an inward experience that are always congruent with each other.
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Saying things that they think others want to hear. For you know forbidding themselves from saying things that they, you know.
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Maybe have gotten trouble to with before. In the process of client center counts as I understand it.
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Is to meet somebody.
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Human human and create a set of conditions in which A process can unfold of that person moving towards creator, genuineness, congruence.
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And what Rogers thought was a fully functioning person or what other people talked about as being actualized.
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The, I'll stop with that. I'm sure you can do much better. So I just.
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So could I if I could just add one? No, no, no, not at all Chris. I think I agree with everything you're saying.
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I would just add a nuance, which is maybe a point of emphasis, which is I think and I think this is again an important.
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Key for distinguishing. Person centered and counseling and MI is Rogers was very explicit that that Lack of genuineness was not Only about, you know, I'm going to sort of be careful about what I say or how I express myself.
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With with intention. That what his view was is that people lost the ability to even be aware of. There what he would have thought is their genuine strivings.
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That the processes of denial and distortion, which are defenses, in the classical sense of a classical meaning.
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You know, psychodynamic sense of things that happen without our full awareness. Who's workings of which we are not fully aware.
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Such that we often believe. We are genuinely the person we present ourselves as. And only the Malays and anxiety.
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And dysfunction and broad sort of sense of stagnation and unhappiness with our life.
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Reveals. That those distortions are that that who I. Believe myself to be. As well as who I present myself as is not.
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Who I genuinely am. What I genuinely want. And I think it's that disjunction, the incongruence in Rogers term, you know, the technical term that that from his perspective leads to suffering and brings people.
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Typically seeking therapy and seeking help because without knowing why things are going so wrong for them.
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Yes, so I just want to let you know my computer locked up as I'm also scrolling through the transcript.
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But the essence, if I if I'm catching this right, Alan is Yeah, the incongruence is both.
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I always say that word. Strangely, but anyway, from inside to outside there is a difference, but also within that people get, I don't know that Rogers use the term compartmentalization, but that there are different parts of Self that people have access to.
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And don't depend, you know, based on these. I don't even know the language interjected kind of values or beliefs or Okay.
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Yeah, yeah, exactly. Conceived values as,
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So, so then as I understand it, Rogers believe that. If you simply set up a condition and a relationship and this is one of the places we're different over the course of his career.
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In which a person feels accepted, valued. Heard and understood. Those walls within and walls between will begin to disintegrate the facade will will go away, etc, and the person will.
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Genuinely inhabit their being. And be more of their true self. So again, different terms over time, but true self.
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And that then out of that they will make choices. Readily that align with who they are and what their values are without needing us to do the work with them.
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That's very good.
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Or for them.
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Or do the work for them.
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That's true.
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Yes. And so as I started thinking about this a few days ago, I was thinking, well, you know, it's the non directive versus all the different words MI has had.
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Directive semi directive, directional with goal orientation. You know, the words keep kind of shifting, I think, trying to find what's the best frame of that.
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And it kind of, my sense after reflecting a little bit was I don't really think that's accurate that I think
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Rogers work is non-directive about choices, you know, what people would do. But he seems very directional to me on how people should be.
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He has a very clear concept of what a fully functioning person is and a number of attributes and processes that go along with that.
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And in his work is That's the direction things are moving. It's not a behavioral thing, but who people are, how people are, I guess, more than who.
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And MI seems to flip that around to me, which is MI is. Really not interested in kinda how you are as a person who, you know, Trying to even look at are there problems with that it kind of accepts at face value what somebody presents is their view of their life.
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And so it's non directive on that part, but more directional on moving toward a goal in helping people define their goals.
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I don't know if that made any sense. But.
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Can I raise a
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We're very interested to. Hey, what Ellen and Chris think about it because
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For me the 2 of you were the inspirations for this. So I've never had the opportunity of actually asking you, which is very arrogant really, but We made a shift.
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Originally, MI was focused on addiction behaviour change. Then it was focused on behavior change.
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And Now change, not necessarily behavior change.
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Doesn't that bring? Am I in much closer alignment with client centered counselling?
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Yeah.
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And even growth now, now tipping that towards growth. In my review of the new version of the MI book.
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Yeah.
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I didn't see a lot of development of that, but the door has been open to consider that as a future direction.
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I think that's a really, yeah, I think the, you know, the additional of that, of that.
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There was
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Of the word growth to the title and sort of the expansion of the purview of in that way was certainly something that I appreciated and was glad to see.
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And I, I think at the same time, if I were to ask myself, when, when am I apt?
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To to do am I with some one? And when would I be apt to do something? Else, which would be.
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Would not be pure person centered counseling, but a much more. Depth-oriented exploratory kind of therapy.
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The answer, the simple answer would probably be If there's something that this person feels stuck in.
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Wants help in changing or is considering changing if there is a target if there is a focus even if they come in.
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We redefine it and I really appreciated Steve your opening example of the way a focus can become be renegotiated that what the person thinks is where they're stuck is not is often not where they're actually stuck.
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And as we talk together with them, they begin to recognize or take. They thought they were looking for help with this, but what's really going on is something like I'm struggling with this.
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But even that I in those scenarios is where I think I'm thinking of MI. And if someone's coming to me with much broader kinds of Again, this sort of a sense of malaise about their life, a sense of I don't know.
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I don't even begin to know what I need to change. I don't even like the idea of change.
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Of thinking about changing something that already feels artificial to me. I just feel like I'm at a loss.
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I'm I'm not doing MI. I'm thinking in that much more, in a much more sort of person centered counseling, exploratory sort of approach.
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And I think that is something more like. What we usually think of is growth in the classical sense of.
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I don't have a particular goal. I just want my life to be better. And I don't know why my life is not good.
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But it's not and I'm I'm lost. So I still think there is a bit of a you know, sort of a natural.
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Shifting back and forth between those those. 2 sorts of They'rerapeutic focuses.
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Yeah, it, oh, see where you talking.
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Go.
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Yeah, so I wanna talk to both pieces of Steve's first question was, am I becoming more like?
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Client centered therapy over time or is it opening up into similar territory? Maybe is a better way to put it And I think it is, you know, I think that from the first edition of the book that was preparing people to change a addictive behavior.
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I don't know the exact subtitle to helping people grow and change is certainly both a broadening and a deepening of the focus.
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MI. And in that way, I think the As MI broadens. You know, there's more it's broadening in a territory that classic clients that are therapy.
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Has been at home in. If, at the same time, I have another part of me another kind of itchy feeling that in some ways MI is moving away from client.
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Okay.
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Centered therapy over time. So I could think of a couple of examples of this, but one is one is simply like the I know we're in insider kind of stuff a little bit, but in the second edition of the on my book there were sections on when I'm when MI is non-directed.
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And in the third edition and after. It was non directive was no longer a part of MI.
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That at some point am I model in compass both. Periods of directional focus and periods of non-directional exploring and it seems to me that that piece has been taken out in favor of this what I call the gear shift model.
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What?
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I don't know if that's what it's called or that's just how it sat in my head that When when we're in gear, gear shift model like when when we're in neutral.
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It's non directive, and then we put it in gear to move forward towards
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Yeah.
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I was like with neutrality versus being in gear. That's that's I like that.
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Yeah. Good. Yeah.
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And I don't know, I, you know, I don't want to say either any is better.
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I just think there are different. Where of focusing and I personally think you could you could do really depth-oriented MI and you just rethink how you define change.
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It doesn't, you know, it isn't just a behavioral goal or even necessarily a change in identity or a change in, you know.
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Yeah.
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Relationship or something like that, but just to change can be defined as growing into myself or moving towards piece or like the last decade and a half of a lot of therapies been around acceptance and I think you could say acceptance is a kind of change.
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I wanted to find my change goal as becoming more accepting. With my life as it is. And I've worked out with a number of people with chronic diseases where that's really the focus.
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There really isn't a change to make other than to stop fighting. You know, with acceptance of how things are now.
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Move to that, be at peace, and then live a life that is more what I want.
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I think.
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Oh, I gotta hear that, please.
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Okay. I could ask you the maddest question of the evening. Yeah, and then it will be quite interesting to sort of circle around to the question, which is the title of the seminar.
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What is the What is the difference between clients centered counselling? And existential therapy.
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I'm definitely looking, Allen on that one. You.
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Yeah.
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Oh, that's a that's a whole other Yeah So I think exist, yeah, try to be really brief.
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Existential therapy really does start. From a certain set of premises about existence and about and and assumes that you know, when you, when you sort of get to the heart of things.
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It, it, the existential realities of death and our knowledge that our lives will end. Finitude and and limitation.
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Is about here are the causes of suffering. And here are the solution. Here are the ways to help people.
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Okay.
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You know, transmit that. Suffering, of course, like Freud, the existentialists start from the assumption that you can the best you can do with Freud said you want to transform neurotic suffering.
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Neurotic, pathology into everyday suffering. He thought that was about as good as you could get.
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I think the existentialists are not quite that primitive, pessimistic, but I think there is a kind of pessimism and existentialism.
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Nothing.
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Okay.
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Not present at all in Rogers much more. hopeful I think and positive. Vision of, of human being.
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One of the connecting threads. To existential psychotherapy. Client centered therapy and motivational interview and therapy has to do with personal values.
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Has to do has to do with values and how you make meaning of your life. Based on your values.
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That are going to inform the choices that you make. Which are incredibly important to be able to take responsibility for.
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And so you're looking at the, you know, how do I make meaning in my life? Not what is the meaning of life.
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As Franco would say, that's too abstract. You know, but, but if I look at the meaning of my life, then I can start to break it down in the way you were talking, Alan.
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Start looking at what it is that I'm struggling with and you know and all of that and that's where I think the sort of humanistic existential connection came because that was during the the the human growth movement.
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And you know like minds just kind of Get associated together. Even though you said, Alan, there's nuances.
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And significant differences. Between exited.
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Okay.
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I think your I think your point about responsibility is an important one Joel that in existential therapy that, There is a sense of.
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An effort that we all tempted to try to deny. The car own responsibility for our own choices because because they are so fraught and and and we, so often make mistakes and don't know we've made them until after.
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We've acted, and so the goal of helping people take responsibility for their choices except the responsibility for their own lives.
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And then see that as a result that they also have a kind of agency. To make choices.
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Okay.
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Dark side as well as a positive side.
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Okay, okay, look, I'm sorry, I took a software.
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That's all right. That's all right.
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You got us off on that tangent. Let's bring it back. Let's bring it back.
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Get back.
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Can I say something about, back on, on our focus, which that which came up as, as I was listening, to Chris.
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Earlier I think and in this this conversation about growth and MI and growth. I think
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What you call the gear shift model Chris I've I've I've been referring to as the standard model.
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Of the which really is focused very much on cultivating change talk and you know in the context of an accepting a relationship and you know in the context of an accepting relationship a relationship of safety where and having a direction and having directionality, knowing where you're going and and facilitating that and an avoidance of Cultivating Sustain Talk.
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And, caution about what would have been seen as the dangers. Of drawing out sustained talk as having, to keep people stuck.
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And there is this other model that has been proposed and it's kind of popped up here and there.
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It was, laid out by, in the MI and psychological problems books. Which he and in his book on resolving ambivalence that he calls the conflict resolution.
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Model of MI. That Henny Westra and her research has. Has really drawn from and using MI with people with anxiety disorders.
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That makes the argument that exploring both sides of the ambivalence. Can be a crucial part of.
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Effective motivational interviewing. I think the conflict resolution model. You know, if you ask what would Rogers think of MI, I think he would like the conflict resolution.
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Model or understanding of how MI works much better than what I've referred to as the standard model.
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With the idea of If you give people the opportunity to explore their ambivalence in particular ways and I think they I think it's the in particular ways that's what that M.
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That's Embi's contribution and and advance over. Person centered counseling. But that exploring ambivalence in that way.
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Provides the kind of trust in the person's natural tendency towards growth towards being able to find their own way.
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And at the same time helps. Resolve and ambivalence more more effectively than other kinds of conversation.
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Nice. So what you've done is you've You've pinpointed an area for develop for real development and which I'm sure will all agree.
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The best guidelines will emerge inductively from people's experience of actual Conversations and ever process research on these conversations.
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I think this I feel this just personal I mean it's it's been too much premature closure.
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On how to explore. Ambivalence. And I was with somebody today, you and I just let him go.
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And he just, I mean the sustained talk was like. An incredible shower. And I waited until he'd finished and summarized it for him and I said, what next?
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Did I freeze?
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And the conversation moved off in a positive direction. So I think there's lots to explore there, but.
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What would Rogers. Feel about am I now.
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Somebody threads that I keep on this to come back to you, but.
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So it depends to me a little bit if we're taking Rogers from a time capsule from when he was alive to now and when.
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You know, for, you know, if he were living human being yet, he'd have 35 more years of Seeing the world develop and seeing helping systems develop.
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And I think in some ways.
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Looking these in looking am I and classic person center therapy in the context of their times and of the Focus and of the goals and the way services were delivered and organized.
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Is different from just kind of talking about them as abstract things. And so I, you know, my sense with Rogers is He was a radical.
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From the beginning. I mean, he He started psychotherapy research after being told only psychiatrists could do therapy psychologists don't know how to do it.
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And he's like, well, I'll show you basically, and you know, started that.
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And I, you know, it seemed to me he He kept unfolding over the course of his life to You know a model where it's about I don't know if empowering people in to use MI language, but is about more egalitarianism and less hierarchy, less people.
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Standing outside of others and being experts on them. And I think Rogers would love that about, am I, and love that MI has helped advance that particularly.
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In medical settings, criminal justice settings, places where the hierarchies traditionally were very strong. The the people at the top had the power for decision making.
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As a psychiatrist classically did with people with mental illnesses and obviously is the case in the criminal justice system.
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I think Rogers would really like that. That MI has been among You know, in medical, their shared decision making, there's other, you know, other models that have tried to do a similar thing but the idea bringing people.
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Allowing people to have more of their own power and incorporating their voice. And whatever is going on, I think you would really like.
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And then
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And Gary, Suffolk points out, I think very nicely. And, in a comment to us that, Bill and Steve were also radicals.
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In in your time. I mean what what was being proposed as a way of working with people with addictions.
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The idea that, you know, people with addictions could be treated as human beings. And and that confronting and so on and was was not only not not the way to work but actually harmful.
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You know in their in your quiet ways this was also a radical stance. And I and I think I like very much the idea of that.
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That sort of confluence between Rogers radicalism. And the radicalism that MI really represented when it was first articulated.
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In the contrast of these models that were very different. We're not about empowering that we're not about.
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You know, evoking people's voices.
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I got an email this afternoon from Bill saying I've got a very serious regret about what we put in this fourth edition of the book, which is Just one way of describing in my it's not the only way.
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And guess what it was? It, I, I, I, I see, Johannes is from Germany is here, apparently in Germany, MI has been defined as a form of CBT.
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And within the reimbursement system you can't. Kit, am I? Unless it's defined as a form of CBT and this has been brought to Bill's attention.
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And he and I in the last 3 days have been exchanging. A document about the origins and essence of MI as being client centered and now this often he wrote saying I just wish when we wrote this latest book that we hadn't emphasized that more.
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Interesting.
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So.
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I was thinking about in my head, If we, maybe we ought to do this, get some audio of Rogers or.
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You know, an expert in person center counseling encoding. You know, cause there'd be loads of reflections that below, really a low and softening sustained talk.
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Pro, an almost neutral and cultivating change talk if not low. Hi in empathy and partnership would probably be you know because because of the stamps of the person centered therapist they're not trying to create a partnership where to engage the person.
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And they're thinking about how they're going to do this. Is not an active process. I think, I think person centered therapy would not.
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By the current metrics we have in assessing MI proficiency wouldn't come close. Sure being motivational interviewing.
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Well, I think it depends on, yeah, it depends on which variables you focus on. So we did this. We did study.
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Yeah, yeah, yeah, yeah, I just, I just meant the standard.
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We didn't publish it. Probably should but anyway looking at a number of approaches. By video demonstrations.
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Yeah.
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Rogers and Miller came out really quite close in their style, certainly the reflection to question ratio, the biggest differences.
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Or amount of speaking time. Bill was higher than Rogers. So it was more involved, which I think is what we were talking about, not so much a companion as much as a collaborative partner.
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There was, more focus on change talk. Not surprisingly, when we coded that and there was a future versus present focus, which I think also helps.
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Differentiate. Am I from client centered, classic client center therapy?
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But I mean, there's an overlap is. Sort of the, the spirit of MI meets the 6 necessary and sufficient.
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Just through a blank.
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Conditions.
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Conditions. Thank you, Chris. Conditions, right? And, and, and But all of that is how you are with the person and what you're trying to create.
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Or the person to be able to do some self exploration.
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Yeah, I think, you know, just on the context piece, that we live in a different world where the amount of time.
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Is less, we're pressed for more efficiency for more. Demonstrable outcomes. In more structured settings that are often you know specific to a problem or a change or a way of organizing work in individuals couples groups etc. then when Rogers was practicing when it was kind of
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Figured out as you go along. You know, to pick up with the rest of the Rogers threat just so we don't lose that.
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What would you think of MI? I think he would really like The empirical. Basis of MI.
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How much research is done. I mean, he was very committed to that. And I think at the same time, he would.
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Try to find out where this decry is the word that comes to mind. How much the focus is on.
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Outcomes studies and how little focus there is on process and the interpersonal processes. Because I think one of the big overlaps of these 2 approaches is that interpersonal process element.
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And it at least it seems to me he would look at this maybe it's just my own projection and say why aren't we studying what's happening between people why are we studying Like Allen's thesis dissertation, I forget what it was years ago.
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How did the clients perceive an interaction? What did they take away? What stood out for them? You know, the thing I think I got most from MMI is just that sense of really tuning into whoever I'm talking to in the moment.
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And riding the, you know, riding the ride with them and not being up my head deciding what do I need to do to try to influence them but helping find it together.
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And it just seems like we. There isn't funding for that or there is an interest. I don't know.
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We have like 2,000 randomized controlled outcome trials or something. Few dozen several dozen maybe process studies.
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And I would, I completely agree with you on that, Chris. And I guess I, don't want to seem like I'm doing a commercial, but, for any Westra and and her her research and her work.
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Because she is one of the few. Who has alongside her outcome studies? Have also had an ongoing program at her and her colleagues at York University.
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On process research specifically looking at the client experience of MI. And on what's happening when MI is.
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Is happening and I it's not a coincidence because of those who know York University is the center of experience, you know, less Greenberg and experiential therapy, which is part of the what has been called one of the tribes of the person centered.
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World and I think they have that. Culture there to do exactly the kind of exploration that you were just referring to.
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Chris, that that we need so much more of.
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And I think that us in this discussion as well as a lot of the people. I can recognize as participants would agree.
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That this has been a almost like a wave that overcame the field that we feel was unwise.
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And If you ask me what bit of writing I ever did that I'm most happy with, it was a paper called Enthusiasm Quick fixes and premature control trials, which wrote as a commentary in 2,000 or something after the first meta-analysis.
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And I felt then this was what and it's our fault, I feel. Because we had too narrower focus on the purpose of MI is to change behavior.
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And of course, we then reaped. The punishment, not the reward of pursuit of control trial evidence.
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So I think we agree that don't we? I mean.
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It, yeah, I don't know how much the. Is on your shoulders. I mean, that's the zeitgeist.
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That's the times that we've just I think are starting to move out of but we moving through at a minimum.
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Of you know all of the attention going to horse race kind of studies or just demonstrations of you know, can this do something but without really knowing why or how.
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Means we're really lacking and it means as you continue to develop a model, you don't have the data that would really benefit you in continuing to develop the MI model.
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But because it's not there's not enough research going on.
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I do think that we sometimes Don't we get a little too narrow? In our focus and don't pay enough attention to related research that is going on that almost sort of adjacent.
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To what would be in my process research. So Robert Elliott's interpersonal process recall research that he talked about it.
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PC last year, and he has, you know, he's been doing that for decades.
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I came across the study very recently that used a completely different language. To talk about ambivalence markers.
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It was in the CBT context and and and looking at the process of what happens in a therapy session where client either expresses a new, what we would call change talk says something like I really feel like I want to be more assertive is that it was the example they gave.
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I'm really tired of just quieting my own boys. And then in some cases would say, but then I'm going to feel really foolish if I do that.
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And they call that an ambivalence marker. And, and the, the, the other, I can't forget the other turn they used, but for the first kind of language they called something like a.
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Movement marker like a you know innovation marker or something like that and what they found fascinatingly was that And, it's markers meaning sustained talk coming immediately after change talk.
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Is associated with worse outcomes.
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So is that the oscillation that, you know, Bill and Steve were writing about, you know, so decades ago about what you hear.
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When people are ambivalent oscillating between the 2, that that genuinely does seem to be.
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Destructive, you know, sort of keeps people stuck. Versus when they are articulate.
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You know, a moment of innovation and don't immediately follow it with the other side.
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Where that's associated with much better outcomes than a variety of ways in the next session, lower symptoms in the next session and things like that.
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So I think there is some research out there that we could be drawing on. That can help inform our understanding of what we.
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What we are doing. That I think, you know, go back to what would Rogers think.
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I think he, he would say, anyone who's doing any of this kind of process research, you know, this is all valuable.
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It's not, we, we figured out a way to do it, you know, the Q sword and the different methods that he came up with, but certainly that's not the You know, we need lots of ways of understanding what is the clients experience.
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What actually what's happening in the session and how does that then relate to what happens after the session.
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The the other thing that struck me. Kind of as a divergence is. And I shared this in our.
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Email exchange is that Person centered therapy and a brief intervention. Right, people were going to therapy twice a week.
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For 2040, 60 sessions.
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Yeah, yeah.
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Well, but you know, I decided to interrupt, Joel, but you have to remember, you know, talking about context in the context of times of 20 to 40 session therapy was a brief intervention right because the contrast was with psychoanalysis and you know twice a week or more for years.
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So Rogers as it worked was actually known as being much briefer, but what we would now look at it and say, 20 to 40 sessions is almost interminable versus you know the 3 to 5 session interventions that we're doing now.
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So if.
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Sure, sure. Sure. I don't, I don't know you could do, well, maybe you could.
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I've never tried. I'd be interested to see like person-centered therapy done in 15 min.
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You know, I don't think given where. Where Rogers was going with the approach of what what where they were aiming for in terms of becoming a fully functioning human, it would take a while.
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Okay.
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But that's a very Yeah, they're it's a very non
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One of the difference.
363
00:55:55,000 --> 00:55:58,000
There's a focus there, but it's not specific. Where, SMI is a very specific.
364
00:55:58,000 --> 00:55:59,000
Go ahead, Chris.
365
00:55:59,000 --> 00:56:08,000
Yeah, one of the in our context again is that I know and I know M is broader than psychotherapy, but therapy and counseling.
366
00:56:08,000 --> 00:56:14,000
Used to be intact, conceived of as an intact journey. There's a beginning, a middle, and an end.
367
00:56:14,000 --> 00:56:27,000
Or we're much more in an episodic care. Era now or come in and let's deal with this part of it you're gonna go have your life you may come back to me, you may go somebody else when you want to kind of take the next step.
368
00:56:27,000 --> 00:56:36,000
As opposed to there's a start a middle and an end. And so I do think, you know, MI provides the tools to be much more efficient.
369
00:56:36,000 --> 00:56:42,000
By narrowing the focus to what's most important to the person seeking help or being sent for help right now.
370
00:56:42,000 --> 00:56:43,000
Yep.
371
00:56:43,000 --> 00:56:52,000
And that that can then open up or unfold. Either by extending our time together or by, you know, over multiple episodes.
372
00:56:52,000 --> 00:57:02,000
And I think this is where another place where am I. Is kind of moved away from what Rogers was moving toward, which is around techniques.
373
00:57:02,000 --> 00:57:25,000
So or the other way around. You know, Rogers that really got to the point where he's so dislike the cop even the idea of techniques, the idea of a reflection as a technique or an open question is a technique just were anathema to him toward the end of his life and am I come in and really embraced these as saying you know.
374
00:57:25,000 --> 00:57:42,000
You could, you know, the way I hear am I is that you it may you may be sufficient to have conditions where you're sitting with somebody and being part-to-heart with them, but actually if you use these techniques you can move things along quicker to an end that they desire and that that is better.
375
00:57:42,000 --> 00:58:01,000
And I think, you know, It, it would seem. Absurd to me if somebody was wanting to Quick smoking or came in and said, I just can't go on drinking like this, you know, to do person Santa therapy with them.
376
00:58:01,000 --> 00:58:02,000
It's not what it's designed for.
377
00:58:02,000 --> 00:58:07,000
It's not what it's designed for and I think we have pretty good evidence that it doesn't work.
378
00:58:07,000 --> 00:58:14,000
When you've got, you know, especially the things that MI was originally designed for habit change.
379
00:58:14,000 --> 00:58:21,000
Essentially, whether you call think of drinking and drug use or or smoking or health behavior, other kinds of health behavior changes.
380
00:58:21,000 --> 00:58:32,000
I think in, in those kinds of areas, the efficiency, the focus. The the the the specification of technique.
381
00:58:32,000 --> 00:58:53,000
Just results in a much more effective way of helping people. And I say that as somebody who, you know, still very much loves person centered and exploratory therapies, but I think the great advantage of the advance of MI is that we have different tools for different kinds of problems.
382
00:58:53,000 --> 00:59:03,000
Whereas before it was it was really the old you know you've got a hammer so everything looks like a nail sort of approach.
383
00:59:03,000 --> 00:59:12,000
I was just looking at Gary's question. Around the therapist factors such as empathy, acceptance and congruence and how there's overlap.
384
00:59:12,000 --> 00:59:18,000
And that's, and that's something that. I'm glad you brought that up, Gary, because that That's stands out to me.
385
00:59:18,000 --> 00:59:25,000
So when you read about what Rogers would talk about about on becoming a client centered therapist. It was a real process.
386
00:59:25,000 --> 00:59:33,000
Where in order to do this you had to kind of put yourself through. Through it to find your own internal congruence.
387
00:59:33,000 --> 00:59:43,000
So then you could create the space. To to work with the person and you you're you wouldn't get and your stuff wouldn't get meddled up with their stuff.
388
00:59:43,000 --> 00:59:54,000
But particularly in the way he understood. What actually being empathic was and getting into the Clients frame of reference and they're phenomenological world.
389
00:59:54,000 --> 01:00:01,000
And you're there as a visitor, you're not there as a participant. Or there to to move things around.
390
01:00:01,000 --> 01:00:08,000
And I go out and teach motivational interviewing in 2 days of people that don't have counseling backgrounds.
391
01:00:08,000 --> 01:00:13,000
And so, where I think we're taking, we're talking about 2 different things around things like.
392
01:00:13,000 --> 01:00:21,000
Genuineness and acceptance. And even expressing of empathy. From a from a regerian perspective.
393
01:00:21,000 --> 01:00:28,000
To to a bill and Steve perspective. They're they're the same thing, but there's a little more.
394
01:00:28,000 --> 01:00:33,000
Emphasis put on on the helpers. Personal development.
395
01:00:33,000 --> 01:00:41,000
Well, I think what's really cool, one of the really cool things about MI is that you can do a workshop, teach people.
396
01:00:41,000 --> 01:00:47,000
And hopefully some follow ups, some coaching, some opportunity for integrating what you what they've learned.
397
01:00:47,000 --> 01:00:56,000
And set them loose. On you know in doing the work and they can be more helpful than they would have been prior.
398
01:00:56,000 --> 01:00:58,000
Yeah.
399
01:00:58,000 --> 01:01:09,000
To that. I, at the same time I would say, you know, when I've done, you know, in the coaching in in supervision.
400
01:01:09,000 --> 01:01:18,000
And guidance that I've done for for MI practitioners over the past, you know, decade or 2.
401
01:01:18,000 --> 01:01:28,000
Where, you know, that's a starting point, right? And if you want to be really good at am I.
402
01:01:28,000 --> 01:01:36,000
I think what it takes to be really good at MI. It begins to converge with what you would just describing, Joel.
403
01:01:36,000 --> 01:02:02,000
Which is developing your. Capacity for deeper level of empathy. A deeper, a deeper ability. To to maintain a pricing Gays the term that Rogers used alternatively to unconditional positive regard that I that I love best because I think It's that it's that gaze that.
404
01:02:02,000 --> 01:02:08,000
We look at when we're looking at someone we love and we're seeing through the eyes of love.
405
01:02:08,000 --> 01:02:17,000
Which is what I think fundamentally unconditional positive regard is and what I think. An affirming presence really is and I think it's what we need to do in MI as well.
406
01:02:17,000 --> 01:02:31,000
And to be able to do that. And to be genuinely have the genuine level of equanimity of acceptance that the person may choose not to do the things that you might think would be in their best interest.
407
01:02:31,000 --> 01:02:38,000
And that you can be fully okay with that. Even if you believe in your heart, they might have.
408
01:02:38,000 --> 01:02:46,000
Done better had they made a different choice. I think it takes a long time to be able to do MI in that way, but when you develop yourself in that way.
409
01:02:46,000 --> 01:02:53,000
You can be much more powerful as an MI practitioner. More effective and move faster, interestingly.
410
01:02:53,000 --> 01:02:54,000
And
411
01:02:54,000 --> 01:02:56,000
You become more efficient as well as more impactful.
412
01:02:56,000 --> 01:03:11,000
Yeah, I found it incredibly helpful a couple of years ago when You highlighted the surprising element. And you talked about in a way offering up rather than handing down.
413
01:03:11,000 --> 01:03:18,000
And I've noticed with schoolteachers and sports coaches, you know, it's in my last 10 years.
414
01:03:18,000 --> 01:03:23,000
How incredibly valuable is that distinction.
415
01:03:23,000 --> 01:03:33,000
In the delivery of an affirmation or in the offering of information and advice that's you know, I wanted to thank you for that.
416
01:03:33,000 --> 01:03:37,000
And, and I just found it so helpful.
417
01:03:37,000 --> 01:03:38,000
And crouchers.
418
01:03:38,000 --> 01:03:52,000
You know, you know, one of the, one of the things. That I think. Wonder about is is how the phrase person centered has become so big.
419
01:03:52,000 --> 01:04:02,000
Right, we have person centered services. We have person centered that. And and they're they're not even talking about Rajarian psychotherapy or or anything about it.
420
01:04:02,000 --> 01:04:11,000
They're just talking about we listen to our patients or clients. And we think about them versus, you know, It's something very specific.
421
01:04:11,000 --> 01:04:16,000
And, and I think for a lot of people and maybe, maybe it's just because I'm getting.
422
01:04:16,000 --> 01:04:23,000
I'm getting older, a lot of that is getting lost. In terms of what actually is, what it mean.
423
01:04:23,000 --> 01:04:28,000
From a regerian perspective. To be person centered. Kind of like strength based. Right?
424
01:04:28,000 --> 01:04:35,000
And it's, it's really changed a lot from its inception back in the 70, Si believe.
425
01:04:35,000 --> 01:04:51,000
In terms of what it is. And as Steve, you just said, you know, motivational interviewing gets spread pretty thin sometimes as to what exactly it is.
426
01:04:51,000 --> 01:04:57,000
That's what I was just wondering, what are you thinking about? Walk around the person centered world.
427
01:04:57,000 --> 01:04:58,000
Maybe you'd be happy.
428
01:04:58,000 --> 01:05:09,000
There's certainly You know, I think to some degree the history of Almost anything that has a starting point is it starts narrow and then it broadens.
429
01:05:09,000 --> 01:05:17,000
And certainly the person centered tribes as they call themselves Allen referred to earlier. Or strike me as very different from one another.
430
01:05:17,000 --> 01:05:24,000
I think Rogers would like some of those better than others, some are closer to what he did and some are really very different interpretations.
431
01:05:24,000 --> 01:05:33,000
But I think the thing he would support and that I hope we all support is that. We stay open and we keep changing and we keep trying to find.
432
01:05:33,000 --> 01:05:34,000
Absolutely.
433
01:05:34,000 --> 01:05:47,000
Something that captures it a little bit better. You know, I We still use the terms that Rogers assured toward the end, right?
434
01:05:47,000 --> 01:06:02,000
The reflection, open question. Thinking about. Using these as techniques teaching them as techniques. But hopefully, we, you know, am I captures that sense that he ended up with of We're, how do you put it?
435
01:06:02,000 --> 01:06:08,000
We're verbalizing provisional understandings or we're testing our perceptions with people.
436
01:06:08,000 --> 01:06:23,000
As we do this, we're not. Reflecting something strictly in a mechanical strategic way to try to influence the person's, where they're at in their ambivalence, but we're really trying to understand where they're coming from.
437
01:06:23,000 --> 01:06:29,000
Even if we're sometimes putting things into words that they haven't yet put into words. That we're not crossing that line.
438
01:06:29,000 --> 01:06:39,000
I think Allen's. Just share this, we're not crossing that line into interpretation where we're trying to plant an idea of how they should see things.
439
01:06:39,000 --> 01:06:46,000
We're just trying to reflect something that is their experience, whether they've come to that verbalization yet or not.
440
01:06:46,000 --> 01:06:47,000
Yeah, and I think that what you just described Chris is something that I think we've all seen.
441
01:06:47,000 --> 01:06:59,000
I'm assuming we've all had it's had seen some trainees, a new learning of MI struggle with.
442
01:06:59,000 --> 01:07:06,000
This sense of I don't want to be putting words into somebody else's mouth and my being intrusive if I go beyond.
443
01:07:06,000 --> 01:07:21,000
The things they say. But I think this is very much a place of confluence between Rogers and what he described and and what we how we think in MI the language we use is a little bit different.
444
01:07:21,000 --> 01:07:38,000
That idea you you referenced the the construct of the internal frame of reference, Joel, this idea that Our goal is to imagine ourselves into the world and the experience of the other person as if we were sort of walking around within it.
445
01:07:38,000 --> 01:07:53,000
And What Rogers thought was that part of what that allows you to do is to see and articulate things of which the person is only partially aware.
446
01:07:53,000 --> 01:08:05,000
Is aware of but is avoiding articulating. For the reasons we talked about earlier because it because conditions are worth I mitigate against it.
447
01:08:05,000 --> 01:08:21,000
And that we can sometimes express things. That the client will recognize. As theirs. That they have not been able to find the words for or haven't quite formulated yet.
448
01:08:21,000 --> 01:08:32,000
And I think that depth of empathy. Is powerful in MI and in person-centered counseling.
449
01:08:32,000 --> 01:08:33,000
Now look, Steve.
450
01:08:33,000 --> 01:08:46,000
Yeah, and I, I have a guess about where Steve's gonna go with this, but I'm gonna wait and see if I'm going to go with this, but I'm gonna wait and see if I'm right.
451
01:08:46,000 --> 01:08:50,000
I confronted Bill about this issue.
452
01:08:50,000 --> 01:08:57,000
How could I clarify what it might be a point of difference between MI and Kline centered counseling this?
453
01:08:57,000 --> 01:09:06,000
That certainly in the form of therapy that you are describing, Alan. There's great integrity and coherence.
454
01:09:06,000 --> 01:09:15,000
To how you describe the place of impactic listening. And empathy.
455
01:09:15,000 --> 01:09:23,000
Then if you fast forward into the hurried world of am I in healthcare in all sorts of environments.
456
01:09:23,000 --> 01:09:29,000
What if and I just leave MI out of it? I'll come back to, in, in a moment.
457
01:09:29,000 --> 01:09:50,000
A young doctor. Last couple of months came to me and said, look. There's no way in the context in which I'm working that I can really enter the world of all these people who dying in front of me and I'm telling them they've got poor prognosis and I'm dealing with distressed weeping relatives.
458
01:09:50,000 --> 01:10:02,000
I would burn out. I can't cope like that and can you help me and the way We, the way I feel we resolve this, if I could return to MI.
459
01:10:02,000 --> 01:10:16,000
Is more or less to distinguish between cognitive and emotional empathy. And then I checked it out with bull who says, No, you don't have to enter into someone's world in order to empathize with them.
460
01:10:16,000 --> 01:10:23,000
Is basically stating what I suppose you could call cognitive empathy.
461
01:10:23,000 --> 01:10:30,000
So this. This doctor found it extremely useful and has written up this little paper which I'm helping her write and stuff like that.
462
01:10:30,000 --> 01:10:45,000
And she's described a scenario in which she's capable of Cognitively empathizing with these people, but keeping her distance so to speak so that she can manage other aspects of her the work that she has to do.
463
01:10:45,000 --> 01:10:55,000
And is this perhaps a point of difference because And I'm not saying Bill Miller's view is the only view or characterizes MI.
464
01:10:55,000 --> 01:10:58,000
I'm just saying in his view.
465
01:10:58,000 --> 01:11:07,000
You don't need to enter a person's world in order to empathize with them. I've noticed inside myself.
466
01:11:07,000 --> 01:11:16,000
That I feel protected by that awareness. I'm worried about getting burnt and I have been burnt out 2030 years ago.
467
01:11:16,000 --> 01:11:41,000
And I think this was one of the reasons. So. I'm worried about not in a form of therapy, but I'm worried outside of therapy of this concept of empathy being People worshiping on the altar of this concept of empathy as if it's you know, the magic ingredients and solution, even to kind of resolving international conflict.
468
01:11:41,000 --> 01:11:55,000
When it's a little bit more complex. And not so easy for people not necessarily so functional and in the case of wider geopolitical conflicts people over empathize with their own people and fail to empathize with others.
469
01:11:55,000 --> 01:11:57,000
You know, you can
470
01:11:57,000 --> 01:11:58,000
Right.
471
01:11:58,000 --> 01:12:07,000
So I'm worried about oversimplifying empathy and I'm suggesting that This is a point of contrast between client centered counselling and M.
472
01:12:07,000 --> 01:12:08,000
Yeah.
473
01:12:08,000 --> 01:12:14,000
So, it might be, but I think it's also a point of contrast just within the umbrella of MI.
474
01:12:14,000 --> 01:12:22,000
Depending on what role you're in, what setting, the amount of time you have with the specific goals that you're using MI for.
475
01:12:22,000 --> 01:12:33,000
Right, because we know the at the very from the very outside. MI was used as an engagement tool into other therapies as well as to then helping.
476
01:12:33,000 --> 01:12:47,000
But even if you're using MI as a in a helping model, if you're physicians, you know, circulating on awards dealing with people or being you know, told their condition is terminal.
477
01:12:47,000 --> 01:13:06,000
And you've got to keep moving. You know, what am I is to you and how the the goal that you would be using it for the purpose you'd be using it for are different than if you are doing outpatient on going psychotherapy or you're working, you know, doing residential work with somebody.
478
01:13:06,000 --> 01:13:07,000
Yes.
479
01:13:07,000 --> 01:13:13,000
Yeah, I, I agree completely, Chris. I think. I don't think, and this is a discussion that goes also back a couple of decades, right?
480
01:13:13,000 --> 01:13:24,000
I don't think everything we call MI is the same. I don't think what I do when I'm doing MI in the context in the psychotherapy context.
481
01:13:24,000 --> 01:13:32,000
Is the same thing as what people do when they are doing MI in a busy hospital setting. And I don't think it's the same thing that I do.
482
01:13:32,000 --> 01:13:43,000
When I'm, in my current work, having conversations with people to help who are ill to help them do advanced care planning.
483
01:13:43,000 --> 01:14:04,000
I think Not, and certainly not what a dentist would do with, with, with the patient when they're talking about, you know, tooth care and not not only is it what for the reasons that you described Steve on the on the provider side, but on the patient or client side, you know, if you walk into a doctor's office.
484
01:14:04,000 --> 01:14:11,000
And the doctor is doing deep empathy with you, you're going to probably be weirded out.
485
01:14:11,000 --> 01:14:12,000
Yeah.
486
01:14:12,000 --> 01:14:18,000
It's not what you're looking for. From that in that setting. You know, you didn't go in there expecting somebody to be seeing into the depths of your soul.
487
01:14:18,000 --> 01:14:24,000
You, in there because you know you were feeling sick or you had a, you know, and you wanted help from them.
488
01:14:24,000 --> 01:14:39,000
With that. So I think whether we say it's different ways of doing MI or whether we should be making distinctions between what MI is in these different contexts.
489
01:14:39,000 --> 01:14:40,000
Not very
490
01:14:40,000 --> 01:14:56,000
I think MI is actually a very broad umbrella. And what it looks like in different contexts and there's a comment about, you know, in the criminal justice system, I would push back a little bit and I can't help myself from saying that you can't empathize with people who are engaging in criminal behavior in the in the full sense of empathy.
491
01:14:56,000 --> 01:15:08,000
And I think I, there's a paper that you wrote, Steve, decades ago about that I still love about working with with a person who had engaged in It's like abusive behavior.
492
01:15:08,000 --> 01:15:19,000
And, and the empathy of, and the power of MI in that context. But I do think.
493
01:15:19,000 --> 01:15:26,000
You're, you're not going to do empathy in the same way or at the same level in all contexts and nor should you.
494
01:15:26,000 --> 01:15:35,000
Yeah, and I've got it, you know, one of my sons a police officer and just earlier on this evening right he's looking at a video and then comes up on the video screen.
495
01:15:35,000 --> 01:15:40,000
2020. And so I walked into prepare food and I said, what's that? 2,020?
496
01:15:40,000 --> 01:15:46,000
He said, that's a signal on the video for me to take 20 min break before I look at the next frame.
497
01:15:46,000 --> 01:15:54,000
So distressing. Was the next frame going to be? Okay, so you forget about, you know.
498
01:15:54,000 --> 01:15:59,000
Yeah, I think you can finish my sentence.
499
01:15:59,000 --> 01:16:07,000
Yeah, and I think it's extremely useful what you're saying about the both of you, Ellen and Chris, that they're different settings in which you use MI.
500
01:16:07,000 --> 01:16:17,000
And different ways in which that happens and different Rolls for the use of empathic listening.
501
01:16:17,000 --> 01:16:18,000
Yeah.
502
01:16:18,000 --> 01:16:28,000
Yeah, so. Good context, different mechanisms, different goals, different focus. And it's where, I mean, 2 things come to mind.
503
01:16:28,000 --> 01:16:35,000
One is, MI is kind of what we would call a night name brand therapy at this point. And I think it's outgrown that.
504
01:16:35,000 --> 01:16:44,000
I think MI is. Maybe the name is not appropriate for this, but it's something more akin to cognitive behavioral therapy.
505
01:16:44,000 --> 01:16:59,000
A broad umbrella. In which the you know used in different settings in different ways but with kind of a general understanding of what the focus is in the general ways that we relate to people and kind of a set of tools that you can but don't have to use.
506
01:16:59,000 --> 01:17:09,000
Right in any given interaction. The to flip it around them to think about what is the other person experiencing is still work that I really hope that we do.
507
01:17:09,000 --> 01:17:28,000
More and more of going forward. Because you're you and Alan and and Steve you're contrasting different provider experiences of what empathy is, but if you flip it around to the patient or the client or the person on the receiving end.
508
01:17:28,000 --> 01:17:48,000
It may not really matter that they hear someone attempting to understand them and you're getting reasonably close and you want to get closer maybe the important things regardless of whether in your experience you're just cognitively identifying some things or emotionally alighting.
509
01:17:48,000 --> 01:18:04,000
You know, with things. I think Rogers idea of empathy and being both immersive but also detached, you know, if there's immersion and detachment at the same time, you're fully in but you gotta you know you don't lose yourself in it.
510
01:18:04,000 --> 01:18:05,000
Yes.
511
01:18:05,000 --> 01:18:09,000
Well, you, you never lose the as if quality. That and that was the thing that he was very explicit about that you've got one foot out.
512
01:18:09,000 --> 01:18:10,000
Yeah, yeah.
513
01:18:10,000 --> 01:18:30,000
Me mean something really different if you're doing kind of slow uncovering work of. You know, embedded traumas and how that's impacted people's identity over decades versus if you've got you know, pressing there's a problem right now and somebody needs to solve it.
514
01:18:30,000 --> 01:18:33,000
You know, I think it's just probably a different thing, but.
515
01:18:33,000 --> 01:18:43,000
I do and yet if I could just say one more thing about the cognitive empathy versus you know, something like what I would say the sort of full.
516
01:18:43,000 --> 01:18:52,000
Cognitive affective, which is what I think empathy really is a kind of both the art both I think.
517
01:18:52,000 --> 01:18:55,000
Very often when I have been working with with in supervision and coaching with folks who are struggling with the client and not able to figure out.
518
01:18:55,000 --> 01:19:08,000
And again, this is not in therapy settings. I'm talking about advanced care planning, patient navigation, so medical.
519
01:19:08,000 --> 01:19:21,000
Medical adjacent settings. Where they're feeling like they're just not getting anywhere in the conversation that they're having and the things that the client is saying is sort of that not quite grasping it very often.
520
01:19:21,000 --> 01:19:31,000
It's helping them to slow down. And allow themselves to resonate. With what the client is saying.
521
01:19:31,000 --> 01:19:39,000
And I, and I've adopted this concept of resonance. I found it to be very helpful for myself and for my when I'm doing coaching that.
522
01:19:39,000 --> 01:19:56,000
The metaphor, yeah, I've got my guitar in the background is, you know, when you pluck a guitar string, it's, it's the, the, top of the guitar resonates and, and how it resonates is going to determine the quality of the sound.
523
01:19:56,000 --> 01:20:01,000
If it's too stiff and rigid, you get no sound. If it's too loose, it sounds muddy.
524
01:20:01,000 --> 01:20:12,000
There has to be an ability to resonate with what the other person is saying. Which I think does mean some affective availability.
525
01:20:12,000 --> 01:20:21,000
And particularly when there's discord and when there is stuckness in the work between us.
526
01:20:21,000 --> 01:20:31,000
That will often give us the information, the clues we need to understand why am I not connecting. With this person that I'm trying to help.
527
01:20:31,000 --> 01:20:43,000
What's the unspoken? Between us that is creating a barrier. To them feeling accepted and safe so that we can actually work together.
528
01:20:43,000 --> 01:20:46,000
You know, in the direction of change.
529
01:20:46,000 --> 01:20:53,000
It's just superb. I've been getting emails from people while while we're chatting.
530
01:20:53,000 --> 01:21:07,000
Saying things like I had to knock off but is there some way I can access the recording? And I know from, Because I know Angela Well, she's probably thinking Is only 8 min left.
531
01:21:07,000 --> 01:21:14,000
And I'm wondering whether we should hand over
532
01:21:14,000 --> 01:21:17,000
The next few minutes.
533
01:21:17,000 --> 01:21:18,000
One
534
01:21:18,000 --> 01:21:24,000
Yeah, they'll definitely be. That will definitely be a way to access the recording. I mean, we do the podcast.
535
01:21:24,000 --> 01:21:33,000
And get it up on YouTube. So, you know, I'd love to say in 24 h, but we'll see how it goes.
536
01:21:33,000 --> 01:21:45,000
So, I mean, all of the all of our episodes are on podcasts. And on the YouTube so far.
537
01:21:45,000 --> 01:21:52,000
I don't know, just noticing. Well, I'm wanting to give some of the participants who are in the sidelines.
538
01:21:52,000 --> 01:21:53,000
Some space.
539
01:21:53,000 --> 01:22:03,000
Yes, I think we've been trying to address some of those they come up, but it would be great if people would pop up and share either the next thought or something we missed or.
540
01:22:03,000 --> 01:22:07,000
You know, something else that they would like to have a conversation about.
541
01:22:07,000 --> 01:22:08,000
Have a look.
542
01:22:08,000 --> 01:22:09,000
So what were you thinking we should do, Steve? Kind of watch it down.
543
01:22:09,000 --> 01:22:19,000
I love that last comment, the comment by on it and the last one that kind of came through, you know, it could probably be a whole topic of conversation, you know, you know, is, Is am I more complicated than it needs to be?
544
01:22:19,000 --> 01:22:38,000
I know Steve, you probably love that question because that has spoken to to your commitment to. And Bill's as well to find the simplicity on the other side of complexity in talking about MI and how we understand it.
545
01:22:38,000 --> 01:22:49,000
I do think MI is more than person-centered therapy I don't think any of us would disagree about that and and We can't reduce one to the other.
546
01:22:49,000 --> 01:22:52,000
Both more than and less than, different than, yeah.
547
01:22:52,000 --> 01:22:54,000
More than and less than, yes, different.
548
01:22:54,000 --> 01:23:08,000
I think it's comments got wisdom to it but really I really feel their eyes. Has got quite a purposeful quality.
549
01:23:08,000 --> 01:23:09,000
Yeah.
550
01:23:09,000 --> 01:23:19,000
To it. It's got a directional purpose for quality that's something that's beautiful and
551
01:23:19,000 --> 01:23:20,000
Yeah.
552
01:23:20,000 --> 01:23:23,000
I think what owners describing is an absolutely gorgeous description of engagement. To use to use the MI free framework.
553
01:23:23,000 --> 01:23:28,000
And then owner. Where next?
554
01:23:28,000 --> 01:23:34,000
Yeah, like the on a opened up the flip side of what I'd said earlier what And they said Bill was doing more.
555
01:23:34,000 --> 01:23:46,000
It's now that Rogers was doing more, but that was the receiving. I do think Rogers would think I might more complicated than needs to be, but I challenge him to try to get done in the amount of time what MI gets done.
556
01:23:46,000 --> 01:23:50,000
Without getting things up a little bit.
557
01:23:50,000 --> 01:23:51,000
Exactly. Exactly.
558
01:23:51,000 --> 01:23:55,000
Yeah, a lot of consensus. I wonder if there's.
559
01:23:55,000 --> 01:23:56,000
Hi.
560
01:23:56,000 --> 01:24:05,000
And that sort of comes back around. A little bit to the. Where we started when we started bumping up against the contrast with the negotiating part.
561
01:24:05,000 --> 01:24:13,000
And that's where it gets complicated. That's where, you know, I'm, I'm going, okay, we need to negotiate.
562
01:24:13,000 --> 01:24:26,000
What it is you want to address as opposed to you just. Be yourself and and and as I was reading Clients and in therapy, Roger's original book.
563
01:24:26,000 --> 01:24:48,000
I had this idea in under this maybe just like one of these joel things. Is it all the psychoanalysis and climate therapy are quite different and most most way a lot of well Rogers was influenced by auto rank and and gestalt therapy as well would look very different.
564
01:24:48,000 --> 01:25:00,000
But the therapist's role is to remain consistent. Whole time. And so if I'm the person's inner therapist All I'm trying to do is offer.
565
01:25:00,000 --> 01:25:09,000
Offer back to the person what I'm experiencing. From them in their words. Right, so there's no negotiation about where do we go.
566
01:25:09,000 --> 01:25:14,000
Well, But through the eyes of love and And right, right.
567
01:25:14,000 --> 01:25:29,000
Oh yeah, 100%. 100%. I mean he even wrote that there's no investment in the outcome even if it's the outcome could create harm for the client.
568
01:25:29,000 --> 01:25:30,000
Wow.
569
01:25:30,000 --> 01:25:34,000
Right, you just have to trust the process. That they will. You know, a line they'll integrate was a word that he would use.
570
01:25:34,000 --> 01:25:42,000
They, they would become integrated. Within themselves and then they'll make better choices. They'll make choices that they can live with.
571
01:25:42,000 --> 01:25:47,000
I'll be a better way to put that.
572
01:25:47,000 --> 01:25:53,000
There's a comment about pluralism. In the back channel, but I don't know that that's something we can tackle in a minute or 2.
573
01:25:53,000 --> 01:25:58,000
Pluralistic.
574
01:25:58,000 --> 01:25:59,000
That's what
575
01:25:59,000 --> 01:26:02,000
Okay. Maybe it's, still, waiting aboard, but can I just, can I just share one little?
576
01:26:02,000 --> 01:26:10,000
It's not nitpicky makes it sound bad but a little thing that I just want to mention so in honest
577
01:26:10,000 --> 01:26:23,000
Tat she quotes at the end part of a Rogers quote that is pretty famous that I always get a little unsettled because it consistently gets misquoted and this is the misquote here.
578
01:26:23,000 --> 01:26:31,000
There's a quote is that you know the curious paradox is that when I accept myself just as I am that I can change.
579
01:26:31,000 --> 01:26:35,000
And that's why it's quoted everywhere, but in Rogers books, it's actually book.
580
01:26:35,000 --> 01:26:43,000
It's actually when I accept myself just as I am, then I change. And it might just, other people might not think that's a.
581
01:26:43,000 --> 01:26:51,000
Fundamental difference. But to me it makes it difference in that acceptance just doesn't just open up the possibility.
582
01:26:51,000 --> 01:26:52,000
In after which people can change because they're not locked up. That's a part of it.
583
01:26:52,000 --> 01:27:08,000
But from Rogers position designers that acceptance is change. And he talks about, and I think to go back to some of the ways he'd think about am I in a complicated nature of it.
584
01:27:08,000 --> 01:27:14,000
He talks about once there is acceptance change just kind of happens naturally. I don't even think about it.
585
01:27:14,000 --> 01:27:21,000
People don't even think about it just flows out of them kind of being more congruent and genuine in themselves.
586
01:27:21,000 --> 01:27:22,000
Wow.
587
01:27:22,000 --> 01:27:26,000
So that one always, I don't know why it's all. Thank you, Anna.
588
01:27:26,000 --> 01:27:27,000
Thank you.
589
01:27:27,000 --> 01:27:35,000
It's not your missed call. It's the way I see everywhere online is I can change but I've checked multiple editions of the book and it doesn't say can there.
590
01:27:35,000 --> 01:27:36,000
Incredibly, that's
591
01:27:36,000 --> 01:27:54,000
But I think that is profound, Chris. Actually, it's not, it's small, but it is profound because it speaks to Rogers fundamental understanding of of personality formation, personality change and what it means to be a human being that that self acceptance.
592
01:27:54,000 --> 01:28:04,000
The most radical thing that can happen. The the most profound thing that can happen. For the person and and it's the absence of self acceptance.
593
01:28:04,000 --> 01:28:11,000
The limitations on self acceptance that other source of suffering. And they
594
01:28:11,000 --> 01:28:12,000
And then.
595
01:28:12,000 --> 01:28:14,000
And what we can do is we can help you have self acceptance and quit smoking.
596
01:28:14,000 --> 01:28:15,000
That's right.
597
01:28:15,000 --> 01:28:17,000
Okay.
598
01:28:17,000 --> 01:28:24,000
If you're, if you're gonna feel good about yourself, let's set it up so you can feel about yourself longer, like longer.
599
01:28:24,000 --> 01:28:25,000
Yeah.
600
01:28:25,000 --> 01:28:26,000
Stay around long enough. Yeah, to be able to enjoy it exactly.
601
01:28:26,000 --> 01:28:28,000
Yeah, it's really superb.
602
01:28:28,000 --> 01:28:32,000
In the context, they would have been smoking in the sessions back then too.
603
01:28:32,000 --> 01:28:33,000
Well.
604
01:28:33,000 --> 01:28:36,000
Yeah, we've seen that great.
605
01:28:36,000 --> 01:28:37,000
Right.
606
01:28:37,000 --> 01:28:54,000
Yeah, I study. I'm a couple of my professors in fact were guys who had been with Rogers in Chicago and all of them smoked like chimneys in the Even this is either of course I was in grad school in the early eighties and and but It was a constant in all the sessions.
607
01:28:54,000 --> 01:28:55,000
Yep.
608
01:28:55,000 --> 01:29:05,000
It is now on the half hour. So the session is now closed. Please feel free to leave. Thanks everybody.
609
01:29:05,000 --> 01:29:12,000
You've been thankful nit picking. Christmas. Is quite a compliment.
610
01:29:12,000 --> 01:29:14,000
8 days.
611
01:29:14,000 --> 01:29:27,000
I wanted to, I felt I didn't get to bring, to address Dave's comment earlier in the chat and looking for an opportunity to and didn't get to but amplifying the idea that exploring sustained talk.
612
01:29:27,000 --> 01:29:41,000
That is also is sort of drawing a parallel with. Messages of positivity that that lead people to be afraid to explore.
613
01:29:41,000 --> 01:29:51,000
Difficult emotions like regret. Sadness longing and how powerful it can be to give people that space.
614
01:29:51,000 --> 01:30:09,000
To to not shy away from or not think if we if If we allow people, you know, or invite people to express those feelings that we're that we're keeping them stuck or that we are in some way interfering with their their growth, but very often it's an important part of.
615
01:30:09,000 --> 01:30:12,000
Their ability to grow from their experience.
616
01:30:12,000 --> 01:30:17,000
Yeah, and if I have a regret, it's ever put, this is just personal, Len.
617
01:30:17,000 --> 01:30:24,000
I'm not, it's not a party line. I, I very much regret ever creating the impression.
618
01:30:24,000 --> 01:30:31,000
That MI is about cultivating change talk at the expense of sustained talk. I think it's a naive.
619
01:30:31,000 --> 01:30:40,000
An unhelpful. Proposition We've been too many occasions. I had 2 or 3 this morning.
620
01:30:40,000 --> 01:30:51,000
Too many occasions where you give someone Space to get it off their chest and to really Describe how to moralize they feel and why.
621
01:30:51,000 --> 01:30:56,000
It opens up the avenue for change and
622
01:30:56,000 --> 01:31:03,000
To me, it's one it's one useful tool in MI and we're much better off to be able to think.
623
01:31:03,000 --> 01:31:13,000
In this moment, it seems like cultivating the change talk and softening the stain talk or however you might could be helpful and then there are other times ago no this person just needs to vomit it all out.
624
01:31:13,000 --> 01:31:19,000
They need to say everything that's bad about this, everything they hate and then kind of go, okay, now what do I need to do?
625
01:31:19,000 --> 01:31:21,000
You know, they're times building confidence.
626
01:31:21,000 --> 01:31:22,000
And that would that would be in a more person center framework.
627
01:31:22,000 --> 01:31:35,000
Bye. But I think it's almost inevitable, right? When, I mean, I, you know, my perspective is that the idea of self motivational, you know, statements or change talk and this whole.
628
01:31:35,000 --> 01:32:02,000
This was this is you know one of the primary innovations that MI brought. To to the field and and it's an and sort of really important innovation and certainly I think for any of us who practiced and trained MI, or you know, you know, feel we'd probably feel very strongly about that that I can I can't imagine my practice now without that construct before I back to before I had it I feel
629
01:32:02,000 --> 01:32:14,000
like I was so much less effective as a therapist and as a practitioner. And I think when you have something like that that you know, it's in there almost inevitable that it becomes.
630
01:32:14,000 --> 01:32:19,000
You know, that there's a pendulum swing towards it, right? That it, that it becomes the thing.
631
01:32:19,000 --> 01:32:38,000
And we then lose sight of its place in in a broader. Context and and maybe that's where really what we would like to be seeing is that kind of re contextualization, not losing it, but having it have its proper place.
632
01:32:38,000 --> 01:32:41,000
In the broader milieu of MI practice.
633
01:32:41,000 --> 01:32:58,000
Helen, you're flying. It's absolutely beautiful. Because I found today that when I used reflection in response to change talk, it speeded up the process of receiving this shower and this person feeling acknowledged and heard.
634
01:32:58,000 --> 01:33:13,000
So it it was much better to use reflection in response to. Sustained talk. I guess the key thing is my awareness of what it is someone was saying that it was sustained talk.
635
01:33:13,000 --> 01:33:14,000
Yeah, it's very helpful. Yeah.
636
01:33:14,000 --> 01:33:22,000
And, you know, and my awareness that it a certain point I might well dive in and say, where does this leave you now?
637
01:33:22,000 --> 01:33:26,000
And where would you like to go? Yeah. Exactly.
638
01:33:26,000 --> 01:33:27,000
In the
639
01:33:27,000 --> 01:33:38,000
Yeah. And then. So it comes a fit and it was an efficient conversation with somebody who was very distressed where there was a lot at stake it was an athlete a lot at stake in this conversation.
640
01:33:38,000 --> 01:33:51,000
And I think he felt very validated by me hearing exactly how to moralize and angry and upset and misunderstood he felt.
641
01:33:51,000 --> 01:33:52,000
No question.
642
01:33:52,000 --> 01:33:57,000
Absolutely.
643
01:33:57,000 --> 01:33:58,000
Yeah, exactly.
644
01:33:58,000 --> 01:33:59,000
Yeah, the goal of MI is not a listening change talk. It's helping people change. It's important to know about eliciting.
645
01:33:59,000 --> 01:34:03,000
Well.
646
01:34:03,000 --> 01:34:04,000
That's very beautiful.
647
01:34:04,000 --> 01:34:06,000
Change talk as part of that, but that's not. Our goal. That's a method for the end.
648
01:34:06,000 --> 01:34:07,000
Yeah.
649
01:34:07,000 --> 01:34:12,000
And change talk and sustained talk, or just the 2 sides of ambivalence.
650
01:34:12,000 --> 01:34:19,000
So either you can you can say, oh, I'm doing with change talking. So state like, no, you're helping somebody explore and resolve their ambivalence.
651
01:34:19,000 --> 01:34:21,000
Is what you're trying to do.
652
01:34:21,000 --> 01:34:24,000
I love the look.
653
01:34:24,000 --> 01:34:25,000
Yeah. I will.
654
01:34:25,000 --> 01:34:30,000
That's still how I conceptualize it, Joe. I will never let go of, of, ambivalence being at the heart of how I conceptualize our
655
01:34:30,000 --> 01:34:37,000
And this guy that I spoke to today where there were quantities of both, I didn't experience it as ambivalence.
656
01:34:37,000 --> 01:34:44,000
You see, but maybe I'm wrong, but he was Just demoralized, misunderstood, distressed.
657
01:34:44,000 --> 01:34:52,000
And pessimistic. That's how we felt. He felt bad. Okay.
658
01:34:52,000 --> 01:34:57,000
So yeah, there you go. And then it's swung round.
659
01:34:57,000 --> 01:35:06,000
But we're well past the needing to be. Mindful of what we say.
660
01:35:06,000 --> 01:35:09,000
Yes, we're well past the button needing to be mindful. Yeah.
661
01:35:09,000 --> 01:35:16,000
Go, go, one thing for the few is to ask Ellen and Chris and whoever else we can find.
662
01:35:16,000 --> 01:35:23,000
What? So link between am I and acceptance and commitment therapy.
663
01:35:23,000 --> 01:35:24,000
Oh, don't ask me that. I'm not the right person.
664
01:35:24,000 --> 01:35:31,000
Oh, that would be fun. I will ask Chris that Chris is the guru on act.
665
01:35:31,000 --> 01:35:32,000
Yeah.
666
01:35:32,000 --> 01:35:33,000
Chris had someone.
667
01:35:33,000 --> 01:35:41,000
God, you're messing with me now. Joe's on up. Joe's on a conversation thread where I just said I just spent a month teaching act and then I went to try to read a Steve Hayes article couldn't even make it through.
668
01:35:41,000 --> 01:35:42,000
Yeah.
669
01:35:42,000 --> 01:35:46,000
I did. Totally lies that like what an imposter. I just thought something I can't even read it, but.
670
01:35:46,000 --> 01:36:06,000
But I think we should want to give credit to, you know, the use of the word acceptance and what do they mean there and I had a sports psychologist come to me today and said, Oh, Steve, it's very interesting to meet you.
671
01:36:06,000 --> 01:36:07,000
Yes.
672
01:36:07,000 --> 01:36:10,000
And my preferred way of working is acceptance and commitment therapy. It's quite widespread and be quite nice to understand what it is that that is a value in it.
673
01:36:10,000 --> 01:36:11,000
And how would
674
01:36:11,000 --> 01:36:15,000
That would be a great webinar. Topic actually.
675
01:36:15,000 --> 01:36:23,000
Yeah. Well, maybe we could look at something like, you know, people will also say. That evolution focus therapy and MI.
676
01:36:23,000 --> 01:36:26,000
Are a lot alike. And I know there's, you know, the one of the differences about.
677
01:36:26,000 --> 01:36:30,000
Yeah, solution focus therapy, I think is, is a thing of the past really, Joel.
678
01:36:30,000 --> 01:36:36,000
I mean, it's it's just kind of but I think it acceptance a commitment therapy is very much of the moment.
679
01:36:36,000 --> 01:36:37,000
It is, it is.
680
01:36:37,000 --> 01:36:38,000
Okay.
681
01:36:38,000 --> 01:36:43,000
And we have, of my practitioners and trainers who do both and who who really value see the the overlap.
682
01:36:43,000 --> 01:36:51,000
I'm not one of them but I know we have many and Great.
683
01:36:51,000 --> 01:36:52,000
Well, I'm sure.
684
01:36:52,000 --> 01:36:57,000
I would love to be a part of or at least listen to that conversation. Yeah, so for the last teaching a circle of approaches, am I?
685
01:36:57,000 --> 01:37:14,000
Act positive psychology DBT. Sematic therapies and compassion therapies. Because I got into this habit for years of only doing MI and I just started seeing everything as MI the whole hammer nailed like, oh, I can figure out a way to call that MI if I like it.
686
01:37:14,000 --> 01:37:20,000
And so I wanted to start separating these out in my mind if figure out what really are the areas of overlap and and difference.
687
01:37:20,000 --> 01:37:21,000
And I think different differences with act.
688
01:37:21,000 --> 01:37:29,000
Yeah, and then. And Diane Slate is quite rightly pointing out there's a lot of process based research which is worth looking at.
689
01:37:29,000 --> 01:37:36,000
Then there's compassion focused therapy and there's a fella. Who fronts that who will come onto this.
690
01:37:36,000 --> 01:37:40,000
I know him. We've communicated. I'm sorry. I've forgotten his name.
691
01:37:40,000 --> 01:37:45,000
We didn't meant to stand, but if you're talking about the
692
01:37:45,000 --> 01:37:46,000
So.
693
01:37:46,000 --> 01:37:51,000
You might be thinking of more of a British, there's a couple of British guys who are very, yeah, yeah.
694
01:37:51,000 --> 01:37:54,000
They'll come on and help us with that.
695
01:37:54,000 --> 01:37:59,000
So if we do that, I would want to invite you to also consider self-compassion work.
696
01:37:59,000 --> 01:38:06,000
Which is adjacent to compassion, focused their boot is really a different model. In many ways.
697
01:38:06,000 --> 01:38:17,000
That's really super of course being in sport. You know, guys, people, women and men beat themselves like, up like you wouldn't believe, right?
698
01:38:17,000 --> 01:38:22,000
So if you ask them, what's it going to be like if you're only 75% today?
699
01:38:22,000 --> 01:38:27,000
You know, you what you're inducing is the sense of. You know, compassion for themselves.
700
01:38:27,000 --> 01:38:34,000
And they go out and perform better. That's my experience anyway. I'm a very concrete guy, Chris.
701
01:38:34,000 --> 01:38:36,000
I live in a very concrete world.
702
01:38:36,000 --> 01:38:39,000
Right.
703
01:38:39,000 --> 01:38:42,000
That
704
01:38:42,000 --> 01:38:44,000
Alright, we gotta go. Looks like Angela already is like, all right, I'm done.
705
01:38:44,000 --> 01:38:46,000
Yeah.
706
01:38:46,000 --> 01:38:47,000
She left.
707
01:38:47,000 --> 01:38:48,000
Yeah, no, she made me host.
708
01:38:48,000 --> 01:38:53,000
Yeah. Thank you for the, for this opportunity to have this conversation. It's,
709
01:38:53,000 --> 01:38:54,000
Yeah.
710
01:38:54,000 --> 01:39:03,000
No, I remember the 3 of us did something similar. With Bill and England at Sheffield.
711
01:39:03,000 --> 01:39:06,000
But it didn't, don't recall it as being we didn't have this long. So.
712
01:39:06,000 --> 01:39:11,000
No, and we had we had, that's where actually I forget the gentleman's name now.
713
01:39:11,000 --> 01:39:13,000
The person said, I forgot his name.
714
01:39:13,000 --> 01:39:25,000
Yeah, we talked about the tribes of that was the first time I heard that term the tribes of of the person centered field and this idea of you know, these the subgroups within it.
715
01:39:25,000 --> 01:39:40,000
Yeah, that was fun. I mean, it's It's certainly been our, you know, for several of us, it's been one of our, I think, recurring, you know, goals to continue to bring.
716
01:39:40,000 --> 01:39:54,000
Bring Rogers and the person centered world together. And Of course, Bill has adopted that to some extent as well by going to PCE and giving those talks and We haven't, I don't know that we've had a lot of receptiveness on the PCE side on the on the person sentence.
717
01:39:54,000 --> 01:40:01,000
It's mixed. Yeah, the call that I've been to and presented. It's mixed, certainly.
718
01:40:01,000 --> 01:40:06,000
You know, cause it feels like I think there's a competition for turf and like who's this?
719
01:40:06,000 --> 01:40:15,000
They're new, they're not really. Person centered and they're a lot bigger than most of these approaches in terms of studies and reach.
720
01:40:15,000 --> 01:40:16,000
So.
721
01:40:16,000 --> 01:40:21,000
Good.
722
01:40:21,000 --> 01:40:22,000
You might.
723
01:40:22,000 --> 01:40:25,000
I think Robert Elliott talked about at last year's PCE. He does always analytic work on psychotherapy effectiveness.
724
01:40:25,000 --> 01:40:34,000
And the client center therapy was looking pretty good, but he acknowledged that the reason why clients send the therapy was looking pretty good was that there were a lot of MI studies in there.
725
01:40:34,000 --> 01:40:42,000
And they were, from his perspective, It would be, included, but.
726
01:40:42,000 --> 01:40:43,000
Yeah.
727
01:40:43,000 --> 01:40:52,000
Did it didn't weren't you one of the conferences Chris where You're talking about a study, maybe the, the Selman study where They compared MET to.
728
01:40:52,000 --> 01:40:57,000
Person centered or probably more of like an.
729
01:40:57,000 --> 01:41:01,000
Catholic counseling. And somebody said, who role played the person sitter counseling therapist?
730
01:41:01,000 --> 01:41:09,000
It was it was Bill presenting on one of Terry's study where they contrasted. MI versus the non directive.
731
01:41:09,000 --> 01:41:17,000
Selective practice and the advantages of MI. And yeah, that was the Very challenging question from somebody in the audience.
732
01:41:17,000 --> 01:41:21,000
So who role played the person-centered therapist? With the clear implication that like you don't really know what you're doing.
733
01:41:21,000 --> 01:41:29,000
You can just pretend to do it. And so it's not, and actually.
734
01:41:29,000 --> 01:41:34,000
I think there might be some legitimacy to that, not to question what Terry and others do, but.
735
01:41:34,000 --> 01:41:41,000
You know, again, I think in the MI world we tend to think of person centered therapy as am I without direction.
736
01:41:41,000 --> 01:41:46,000
And there's so much more and different to it. It's not even, you know. Okay.
737
01:41:46,000 --> 01:41:53,000
Did he ever use the word joy?
738
01:41:53,000 --> 01:41:54,000
Joy?
739
01:41:54,000 --> 01:41:56,000
Yeah.
740
01:41:56,000 --> 01:41:57,000
Rogers.
741
01:41:57,000 --> 01:41:58,000
Yeah, or Miller, we have.
742
01:41:58,000 --> 01:42:03,000
Ha ha.
743
01:42:03,000 --> 01:42:15,000
Well, I have to say the biggest emotional response I've ever, one of the biggest emotional response I've ever seen from Bill was his reaction to The paper I did with Karen on positive emotions and positive.
744
01:42:15,000 --> 01:42:20,000
Psychology into MI.
745
01:42:20,000 --> 01:42:21,000
I don't, about it.
746
01:42:21,000 --> 01:42:38,000
Hmm. I think this, you know, You know, I do think there is another, I mean, this contrast is partly characterological as much as anything else between MI and, and clients in the therapy right because Rogers the form of of the classic, you know, Rogers response was always you really feel, right?
747
01:42:38,000 --> 01:42:47,000
I mean, they when they did teach it as a technique, it was Start with you really feel. And what really matters are the feelings.
748
01:42:47,000 --> 01:42:53,000
And you know, when you watch, you know, Bill doing MI, you know, from the earliest demonstration.
749
01:42:53,000 --> 01:43:05,000
It's very much more of a cognitive. The thought focused process and and I think that And I think that's what allows MI to be.
750
01:43:05,000 --> 01:43:15,000
Brief and to be focused and to be all many of the things that that we all appreciate. Good.
751
01:43:15,000 --> 01:43:23,000
It's not about. The depth of feeling per se.
752
01:43:23,000 --> 01:43:32,000
There's joy.
753
01:43:32,000 --> 01:43:33,000
Alright.
754
01:43:33,000 --> 01:43:39,000
I love it. That's a great quote, Joe.
755
01:43:39,000 --> 01:43:40,000
I'm happy to stick on or go whatever Joel you direct us in.
756
01:43:40,000 --> 01:43:43,000
Yeah, I, I probably should go. I have a meeting that I've. I'm late too, so and happily late too, but that's fine.
757
01:43:43,000 --> 01:43:53,000
I should probably still go to it. Even though this is more fun.
758
01:43:53,000 --> 01:43:58,000
Yeah. Okay.
759
01:43:58,000 --> 01:43:59,000
Okay.
760
01:43:59,000 --> 01:44:00,000
Okay.
761
01:44:00,000 --> 01:44:01,000
Lovely. To be with you guys. I'm gonna go now as well. Thank you so, so, so, so much.
762
01:44:01,000 --> 01:44:05,000
Thanks guys. Much for Chris. I'll talk to you later.
763
01:44:05,000 --> 01:44:11,000
Thank you for the conversation. Steve, it's really my experience kind of rare to be able to.
764
01:44:11,000 --> 01:44:21,000
Have conversations with people who are founders, co-founders, co-developers who are so rigidly attached to the way they see things that it kind of takes over the conversation.
765
01:44:21,000 --> 01:44:29,000
You can't really, it's not really a You know, a mutual conversation. It's just people talking and it's nice to actually feel.
766
01:44:29,000 --> 01:44:34,000
The back and forth and you know, you listening and reacting. Even if it's, what was that face you made?
767
01:44:34,000 --> 01:44:38,000
Yeah.
768
01:44:38,000 --> 01:44:40,000
It was a great face. Something either I or Alan would say you guys forget and then
769
01:44:40,000 --> 01:44:46,000
Okay.
770
01:44:46,000 --> 01:44:47,000
And, and, and then the moment.
771
01:44:47,000 --> 01:44:48,000
Okay, it was me talking about that, you know, the deep empathy. Yeah, entering another person's, world.
772
01:44:48,000 --> 01:44:52,000
Yeah, yeah.
773
01:44:52,000 --> 01:44:53,000
Yeah, the moment.
774
01:44:53,000 --> 01:44:54,000
Okay.
775
01:44:54,000 --> 01:44:55,000
Yeah, Oh. Not that I don't need value, Ellen.
776
01:44:55,000 --> 01:44:57,000
No, no, no, but I, your point, I agree with completely, Steve.
777
01:44:57,000 --> 01:45:00,000
Yeah.
778
01:45:00,000 --> 01:45:06,000
Yeah, the points where you say we're not sure we did it right. I mean, just So good to hear, right?
779
01:45:06,000 --> 01:45:18,000
Because the danger of all of these things I think is they get locked into some. I mean that's the we could eventually have a splintering when you and Bill stopped contributing.
780
01:45:18,000 --> 01:45:26,000
Or we can hopefully have a way that there is some sort of umbrella that people can have different.
781
01:45:26,000 --> 01:45:30,000
Pieces under and will argue you know is one of your one of your feet on the outside of the line or not but
782
01:45:30,000 --> 01:45:31,000
Exactly.
783
01:45:31,000 --> 01:45:35,000
We're gonna have different tribes.
784
01:45:35,000 --> 01:45:40,000
The I think I think I heard you say Jeff Allison was on at some point, but I missed that.
785
01:45:40,000 --> 01:45:44,000
Thank you, for you sent me an email.
786
01:45:44,000 --> 01:45:53,000
Because there was something else we could have talked about like toward the end of Rogers work. And particularly Gene Genland who picked it up.
787
01:45:53,000 --> 01:46:06,000
And I don't know if Rogers totally agreed to gentlemen, but Genolin was saying. Focus your attention on things that are unclear where the story is vague and is not yet unpacked.
788
01:46:06,000 --> 01:46:14,000
Because it's behind that where you can really help somebody. And it reminds me of some of what Jeff used to say about ambiguous talk, I think he called it.
789
01:46:14,000 --> 01:46:23,000
And I believe you just presented on that and at the UK, Ireland. Thanks. So, happy to see him kind of back in the mix.
790
01:46:23,000 --> 01:46:24,000
Talking with us all.
791
01:46:24,000 --> 01:46:25,000
Yeah.
792
01:46:25,000 --> 01:46:26,000
I would love to hear that. Would have loved to have heard that talk. But Yeah.
793
01:46:26,000 --> 01:46:27,000
Okay, on this computer.
794
01:46:27,000 --> 01:46:37,000
Yeah, the idea, you know. Part of his idea was, you know, find those things are ambiguous and work with it and see if you can help somebody find change talk in that.
795
01:46:37,000 --> 01:46:39,000
Yeah.
796
01:46:39,000 --> 01:46:47,000
That is not always clear if it's change or sustained talk that sometimes it's kinda depends on how you hear it and you know what you went back.
797
01:46:47,000 --> 01:46:50,000
Alright, see you all and have a good meeting. See, Even have a good evening, Joel.
798
01:46:50,000 --> 01:46:51,000
Yeah.
799
01:46:51,000 --> 01:46:54,000
Yeah, Thank you. Thank you all so much. It's been a joy.