Listening to Families Gayle MCKerracher Consultant Clinical Psychologist

One of the most sincere forms of respect is actually listening to what another has to say There is a big difference between listening and waiting for your turn to speak (Simon Sinek)

What has been the best thing about today so far? 2 minutes talking Listeners: No talking at all At the end listener give ‘an appreciation’ …. “I really appreciated….” Talkers – how did you know your partner was listening? SWAP

Dealing with change, ambivalence and setbacks Understanding ambivalence Understanding where everyone is on the change cycle What comes next Understanding motivation – why do they do what they do? Ideas for exploring, opening up and encouraging conversation Rolling with resistance

To want and not want simultaneously Ambivalence To want and not want simultaneously Want Not want Towards change (pros) Away from change (cons)

Cycle of Change (Procheska & DiClemente, 1982) Pre-contempla-tion Contempla-tion Decision Active changes Main-tenance Relapse

Don’t want to change, not a problem Alternative version Don’t want to change, not a problem I’m thinking about it I will change I have started to … I am changing … oops

Where does change happen? Parents’s goal Team’s goal Young Person’s goal

How can we help? Understanding why people make the choices they make Capturing opportunities to change & encouraging change Building on & sustaining change

Why did you get drunk with your friend? Critical It’s your fault, you know you shouldn’t have Why did you get drunk with your friend? Why do ‘why’ questions often not work?

How can we ask for information in a way that: opens and encourages conversation gives insight into the person’s motivations for the choices they have made?

T E D what it was about your friends that made you choose to drink? Tell me… T Explain what it was like … E Describe what was happening … D What were you thinking about when the others started drinking? Tell me exactly what was happening just before you opened that can of beer?

Thinking about change Advantages of changing Disadvantages of changing Disadvantages of staying the same Advantages of staying the same

Thinking about change Advantages of changing Disadvantages of changing Disadvantages of staying the same Advantages of staying the same

Disadvantages of staying the same Kelly’s see saw Advantages of changing I might feel better People will stop harassing me I will get to do more stuff Disadvantages of changing Not sure I’ll be left to manage it on my own Advantages of staying the same People help me People look after me I’m never on my own Disadvantages of staying the same I will keep getting ill People keep nagging me Long term problems

Roll with resistance

Top Tips Don’t tell people what to do LISTEN Let them tell you they need to change Cognitive dissonance (I smoke & I want to be healthy) Helping people feel confident Discrepancy between goals and beliefs

The Bus Metaphor

“MI is not a series of techniques, it’s a way of being with patients” Bill Miller, 1991

“There is a reason mouths shut and ears don’t”