Bringing it Together: Motivational Interviewing and Trauma-Informed Care

Bringing it Together: Motivational Interviewing and Trauma-Informed Care

Motivational interviewing (MI) has been a part of my life (professional and personal) since the late ‘90’s, and as I look back, I can see that the aspects of MI that beckoned me to learn more about it, are also important principles of trauma responsive care. I invite you to join me in reflecting on their similarities and how each approach supports the other.

Safety and trust are important in any relationship. That importance is magnified when working with those who have been unable to trust others in their lives. If we “go too fast” (faster than the person is able to go) or try to “fix” the person, the presence of safety and trust is threatened. MI offers guidelines in building trust. The words we choose and how we deliver them will either erode or build safety/trust. One aspect of MI that contributes to the growth of trust is our “way of being” which includes a recognition that the relationship is a necessary part of healing. Engagement is possible when we bring compassion, acceptance, unconditional positive regard, affirmation and deep reflective listening; these are some of the spirit and skills of motivational interviewing!

Collaboration suggests a relationship where both people bring expertise and where power is shared. Ultimately, when we are using MI, the person we are supporting will be the one who decides what they will do with any “expertise” that we may offer. MI’s “way of being” includes evocation which is practiced by having the person share what they already know, what they would like to know and what they think about any additional information that we may offer (offered using neutral language). The people we support are the experts about themselves, something that we can only understand when we empty our “cluttered mind” so we can deeply listen to their perception and understanding of their life. An important skill in MI is learning to “tolerate the uncertainty” that results when we share power and honor the autonomy of the other person.

Empowerment (Activation) is nurtured when we gently guide the person towards recognizing and using their personal power. Motivational interviewing accomplishes this by emphasizing and supporting the person’s autonomy (sometimes we just need to “get out of their way”). Skills and approaches that can motivate others include:

  1. Deep reflective listening, focusing on what the person would like to see change and how they would like to achieve that change
  2. Asking questions that are open ended and seek to move the person towards wellness
  3. Evoking hope and confidence. We lend our hope until they can find their own.
  4. Genuine affirmations for their strengths.

There is synergy between trauma responsive principles and motivational interviewing. Safety, trust, partnership, choice and empowerment are important for both.

Deep reflective listening, affirmations, and recognizing/strengthening the person’s change talk will contribute to creating a relationship that embraces the principles of trauma responsiveness.