Are we ready for me to start? We can begin. Okay, great. Hey, good afternoon everyone, and thanks for joining me on our second webinar, “Using Motivational Interviewing Techniques in Initial Assessment.” As Stephen told you, my name’s Jodie Sue Kelly. And I’ve been in the workforce field for 40 years. I’ve worked with, all the back actually — I’m embarrassed to tell you how old I am — but all the way back to CETA programs, on the workforce side. And I’ve worked with ADC, AFDC, as well as TANF programs all over the country. And I’ve had an opportunity to actually be on site at many of your locations. So that’s been a real opportunity for me. So, today, we’re going to be learning the basics of motivational interviewing. A few points about motivational interviewing before we get started. First, motivational interviewing, it’s an evidence-based practice that’s been researched and has been shown to be very effective. Much of the research has been done in the addiction field, drug, alcohol, tobacco, but it’s also been studied as a method for reducing risky behaviors and for increasing client engagement in any kind of treatment program. It’s more recently begun to emerge in TANF programs as well as other workforce programs.
Both Mathematica and MDRC, they’re both nationwide social policy research firms, they’re currently conducting studies of this technique in our field. So, second point is motivational interviewing is very effective, has been shown in the research to be very effective in brief encounters, such as what we have with TANF recipients, and so it doesn’t require years of treatment. Brief encounters actually will have impact. And the third thing is that motivational interviewing really involves people in their own care. An important characteristics of motivational interviewing is that the practitioner does not make decisions for the client. The client is in the driver seat. Now, I do warn you that it’s not easy to learn, and by no means will anyone be an expert in motivational interviewing after this session. It takes time and it takes a lot of practice.
Today, we’re going to be looking at using motivational interviewing techniques in the assessment process as well as during ongoing case management appointments. You will be able to apply some of the techniques after the session, and you should have a greater understanding of the philosophy behind it. So our agenda is as follows. We’re going to spend the first few minutes looking at what motivational interviewing is and what it’s all about. Then we’re going to talk a little bit about change, how people change, why people don’t like change, how to set up the right environment for change. Then we’re going to look, spend a little bit of time looking at comfort zones, because this is actually part of our issue.
Clients get comfortable on TANFs, and although they are not happy and they are falling behind, they know how to live there, so it’s comfortable for them. And so we’re going to look at what to do about it. Then we’re going to cover three elements of change and five basic motivational interviewing skills. At the conclusion, we also have, as I did at the last webinar, I have a homework exercise which will give you some practice thinking about motivational interviewing and using some of the skills. So what is motivational interviewing? As the definition on the screen says, it’s a client-centered directive method of enhancing intrinsic motivation to change by exploring and resolving ambivalence. So motivational interviewing really tackles the skill of how to talk to clients to help them to discover their own motivation. It’s collaborative in nature, meaning we are in this conversation together. It does not involve telling people what to do or why to do it. Instead, motivational interviewing guides clients to identify their own reasons to make a change.
The change could be getting a job, it could be meeting their hours, it could be earning a certificate, getting their GED, or resolving some issue that is keeping them from working. So the fathers of motivational interviewing are William Miller and Stephen Rollnick. I recommend that, if this webinar sparks interest, that either you or your agency to go out and buy the book. It’s available on Amazon, although I’m not doing a commercial for Amazon. I just looked last night, it is there, and as well as on many other sites. But I also have a book that I like, and I liked them in pair, but it’s called — get your pencil — “Building Motivational Interviewing Skills,” it’s by David Rosengren, that’s R-O-S-E-N-G-R-E-N.
Miller and Rollnick’s book is a little bit more of a textbook in nature. I mean, it gives lots of examples, it’s a great book, but Rosengren’s book is more of a workbook with activities to do, and you’re supposed to write in it, although I have to admit I won’t write in mine. But both of those are available. I’m sorry, I skipped ahead of one. So the last slide — I’m sorry, I think I have — excuse me, I have a problem. I skipped a slide. I wanted to tell you that the last page is an academic definition, but I just want to simplify what is motivational interviewing. It’s helping people talk themselves into changing. So motivational interviewing uses the psychological law that I learn what I believe as I hear myself speak.
We’ve all experienced this. You’re ambivalent about a decision that you have to make, and you’re holding two opposite thoughts in your mind at the same time, like I want to take some classes and I don’t want to take some classes; I want to go away this weekend but I don’t want to go away this weekend; I want to quit smoking but I don’t want to quit smoking; I want to buy a new car but, eh, maybe I don’t want to buy a new car. So we have these two opposing thoughts in our head at the same time, this is called ambivalence. I can argue — or you could argue — either side of the issue, and oftentimes we feel equally strong about both. This is where many of our clients are when they think about leaving TANF, they don’t want it, they want it and they don’t want it, both at the same time. So think about yourself for a moment, when you feel two ways about a thing, it’s really helpful to talk to someone else, not to have them make up your mind for you but just to listen to you.
You can make arguments to your friend or to this person for and against both sides. Like, for me, and this is true this weekend, should I have gone away — last weekend, do I want to go away this weekend or do I want to stay home this weekend. And somehow in the process of talking about it, you discover how you really feel. So that’s a truism that is I learn what I believe as I hear myself speak. So uncertainty and ambivalence isn’t a problem; it’s actually all part of the process of deciding which action to take. So part of coaching and case managing is to give people an opportunity to talk and to explore how they feel. It’s the client who should be voicing the arguments for change, not the counselor, because people have to talk themselves into changing. We cannot dictate change. So motivational interviewing sets the climate for a person to be able to explore how they feel. So the slide you see, Blaise Pascal, Pascal was alive in the 1600’s, he was a mathematician and a philosopher, but evidently also a psychologist, because way back in the 1600’s he observed that people are generally better persuaded by the reasons which they, themselves, have discovered than by those who have — than by those which have come into the minds of others.
So if you notice what I was just talking about, I want to go away for the weekend and I don’t want to go away for the weekend, if someone who I’m talking to pushes one side of the argument too hard, you will argue just as hard on the opposite side. It makes people dig their heels in and sometimes make the opposite decision to the one that you would recommend. People are better persuaded by the reasons they have discovered for themselves. It’s really psychology 101, if I have an idea myself, I feel I claim ownership over that idea, as opposed to taking somebody else’s idea, which basically, if I take somebody else’s idea, it says, “Oh, I’m going to defer to you as the authority on this.” Not everybody wants to do that.
I mean, maybe I do if I’m talking to a surgeon, I’m going to defer to their idea, but not in daily life. That was the slide; these somehow have gotten out of order. So people talk themselves into changing. I learn what I believe as I hear myself speak. But let’s look at why do people change. Why do people change? They change because they want to. I mean, why do people quit smoking? Why do they stop drinking? Why do they stop gambling, start exercising? Why do people go to college, as examples? It’s because they want to. Notice that a person’s motivation is key to making a change. So if you see my illustration, the best one I could find, it’s you can lead a horse to water but you can’t make him drink, and we’re all familiar with that saying. But let me change the saying a bit to cover motivational interviewing, you can lead a horse to water but you can’t make him drink, but we can help him to become aware of his thirst so that he might choose to drink. Because no one can force you to quit smoking, no one can get you to stop drinking or gambling, no one can force you to stop exercising.
All of those things have to come from you. You can go through the motions without any commitment, and you’re likely to fail until you fully embrace the motivation to make that change. So if you’re not committed to the change, you’ll take the first or second exit ramp. The same is true for our clients. So the challenge becomes how do we get the client to become aware of his or her thirst so that he or she might choose to drink? So client motivation is greatly influenced by the process that we create and by the specific case manager to whom the client is assigned.
In the first webinar, like Stephen said, if you haven’t viewed that, I really recommend that you go back and view that webinar, because these two sessions are like hand in glove. So I went over some best practices at the webinar, and I also gave a “Best Practices” homework exercise. And within that, many of you came up with some very specific plans in the homework for changes that you wanted to make that would create the type of environment that allows motivational interviewing to work, creating the right environment is of paramount importance. So here’s a simple analogy. If I’m going to grow a crop and I throw seeds on unfertile ground, and it doesn’t have adequate water, it doesn’t have nutrients, there’s not enough sunlight, it won’t matter how many seeds that I throw, few, if any, are going to sprout.
The conditions weren’t right. So, to get the full power from motivational interviewing techniques, I need to make sure that the process feels personalized and it’s comfortable because the client has to be safe to speak and to explore that ambivalence. Ambivalence, again, do I want to go away this weekend, maybe I don’t want to go away this weekend. It could be, for them, making the choice between school and work. It could be the choice of should I participate or just go through the motions. Their ambivalence can be all over the map. So if you plan to implement some of the techniques that we’re going to learn today, for me, there are some prerequisites for setting this right environment, and this list that I have up on the screen is not exhaustive, of course.
If you remember back to the first webinar, the techniques and strategies that I recommended, such as having an engaging orientation, selecting a theme such as income improvement, avoiding labeling people with terms such as “high school dropout,” “offender,” and then setting life goals, those are all based on applied motivational psychology, because each of those ideas is in line with motivational interviewing techniques. So, conducting a motivational orientation is important because if people don’t understand the program and they don’t understand the benefits, they don’t understand how this is going to positively impact their life, all they understand is they got to do 30 hours, or however many hours, then the client cannot collaborate or help to make decisions.
If I don’t understand the program, then I have to defer decisions to my case manager, and that’s the opposite of motivational interviewing. Collaboration is key. We are all in this together. Giving people written materials that provide an overview of the options, because some people’s learning styles need to see it and/or, at orientation, to hear it. But, again, I think that this information is important because if we’re giving people new information, then they’re going to forget what we said during orientation, and it will be harder for them, again, to collaborate.
And I’m guessing that many of you, when you’re dealing with a customer and you’re trying to explain the program, you’ve had this feeling that when giving clients information, we’re giving them information overload. And I’ve always said that, in my experience, having sat through lots of orientations, we give people both too much information and too little information at the same time; too much bureaucratic information and too little information that spells out what this can mean to them. And in my last box, you have to make sure that you’ve set aside enough time to meet with the client. Motivational interviewing requires time to do. I mean, as you’re going to see, one of the foundation stones of motivational interviewing is using open-ended questions. It sort of defeats the purpose if I ask an open-ended question and then I rush the client as he or she begins to answer the question.
So we do need to set aside enough time to meet with the client, to have a meaningful conversation. How much time? Well, that depends on how far you want to get with the client and where the client is in terms of their motivation to change. So what I’m saying is that the power of motivational interviewing techniques is far greater when the right climate has been set. So it’s really best to build the strongest foundation that you can before applying these techniques.
So, as I just said a couple slides ago, client motivation is influenced by the process, but it’s also influenced by the case manager him or herself. Counselors can vary dramatically in their effectiveness. Staff working in the same setting with the same type of clients offering exactly the same services will show dramatic differences in the success with their clients. So counselors who have the characteristics of what you see on the screen, the upper arrow, those counselors tend to bring out high levels of change talk from the client and relatively low levels of resistance. Those practitioners, they’re inquisitive, they’re curious, they’re affirming, they emphasize choice. So they draw out the client and their views. They emphasize choice. They’re accepting. They compassionate.
Counselors who have the characteristics of the lower arrow tend to evoke high levels of resistance and relatively low levels of change talk. Confrontational counseling is associated, according to if you read research, with a high dropout rate and poorer outcomes. So this type of practitioner will jump to conclusions, cut off conversation, pressure clients, prescribe schedules, and over-advise people, basically it’s not being very interested in the client’s perspective, it’s look at everything from the agency’s.
So the relationship with the client is built very early in the process, like, at the first meeting. So I know there’s a lot of paperwork to be completed and lots of documents to be signed, and a lot of boxes that have to be checked, but because the relationship that the client forms with the case manager is so important to motivation, we need to pay special attention to that first interaction because, as you guys know, you never get a second chance to make a first impression. So these are examples of some kind of things that don’t work. “I tell my clients what to do all the time, and they don’t listen.” Or “I educate, I give them options, what else can I do?” Or “She resists every single thing that I suggest.” Or “Some people just don’t want to be helped.” “He is in total denial about his problems.” “Sometimes I just have to tell them the way it is.” Why don’t these things work? They don’t work because of thought. People are not resistant to change; they really aren’t.
They are resistant to being changed. They’re resistant to someone insisting that they change. People change all the time, attitudes change, beliefs change, priorities change, but change is self-directed. So, quickly, let’s take care of what doesn’t work first, and then we’re going to go into what does work. We really want to avoid building resistance because that means we have to work harder when we have a resistant client. And I don’t know about you but I like to work smart, not hard. So the job is hard enough already. So, here’s what motivational interviewing is not. These strategies, criticizing, name-calling, diagnosing, ordering, threatening, moralizing, these strategies interfere with the client’s forward movement toward change because they create resistance, and they create distance between the case manager and the client. The problem is that they tear down relationships that we’re working so hard to try to build. So these are roadblocks, and roadblocks have the effect of blocking, stopping, diverting, it changes the direction of the interview, but it also tends to imply an uneven relationship or a “one up” relationship.
The underlying message is “Listen to me, I know best.” The roadblocks, as you can see, fall into three main categories, judging, like criticizing, name-calling — I tried to color code them — and name-calling, which is why I hate — you guys remember from the first webinar — words like “dropout,” “offender,” “homeless,” because they build resistance, because they’re a form of judging people. Sending solutions, ordering, threatening, moralizing, taking charge, those create resistance, as do diverting, logical arguments, and reassuring. Some are worse than others, but all should be avoided. So let me give you a couple examples. And I’m not going to read all these to you, I promise, but you can view them. So I’ll say a couple. When did it happen? Are you sorry you acted that way? What did he say? What did you say? That’s excessive questioning, and that stops forward momentum. Or if I said to a client, “Let’s look at the facts, if you go on vacation, you’re going to miss a week of class, you’re going to get behind, you’re not going to be able to catch up, and you’re going to have a week’s worth of hours you go to make up.” That’s a logical argument, and that creates resistance.
Or “You should just do what your caseworker said and comply with the rules,” that’s moralizing. Or “You think you have it bad; when I was going to school, I only got about four hours of sleep a night, I worked a job, I had kids, and I went to school at the same time,” that’s called diverting. Your parents probably did that last one to you. Say that you’re complaining to your parents about how cold it was standing while you’re waiting for the school bus, and they’ll say something like, “Well, when I was your age, I walked to school both ways uphill with no coat and cardboard in my shoes.” Notice that that’s diverting because we’re no longer talking about me being cold at the bus stop, we’re now talking about their experience.
So we’re not talking about the client. So these all create distance between the case manager and the client. Again, it’s one-upmanship, “I know better than you.” And so these kind of statements make people feel bad. Basically, they have this whole mix, as I’m displaying, of negative feelings. So, as an aside, there is a widespread misconception that punishment and sanction will increase participation. So, within that context, an adversarial relationship between the staff and the client develops.
The belief seems to be that because the client is, in a sense, captive or mandatory, then collaboration with them is unnecessary. There’s a temptation in TANF to tell clients what they have to do, to mandate the set of activities that they have to do, which, by definition, eliminates freedom of choice and responsibility. Even though I think it’s ironic, we call the plan a personal responsibility plan, we make it not personal. So, in this type of system, it’s not uncommon for the client to simply, as I’ve already said, jump through the hoops by participating, but showing little personal investment in change, or they will engage in refusing to do anything, which obviously is a problem, and then we sanction.
And what they’re trying to do by not participating is an attempt to assert his or her own freedom. And in the future, my guess is they’ll be right back in the door, it’s what I call the “revolving door syndrome.” So motivation in that case is oftentimes thought of as a client trait rather than a reaction to the counselor’s style or to the process. And what I’m saying is sometimes the lack of motivation is caused by the process that we’ve created or, in some cases, by the practitioner, hopefully none of you. By telling clients what to do, we build resistant behavior, and it isn’t that they don’t have to do a certain thing, I get that, I totally understand they’ve got to meet hours. I’m not saying that they don’t have to; I’m saying it’s how we approach it, how we say it that is important.
So if those things don’t work, what does? Well, no matter how they enter a program, whether it’s mandatory, voluntary, change is the expected outcome. We want change. We want certificates, diplomas, licenses, full-time jobs, increases in income. We want self-sufficiency. Doing these things require life changes for our clients, and it seems apparent to me, and probably to all of you that change would be good for you, yet sometimes it’s like pulling teeth to get them to participate. They resist. They negate. They argue. They withdraw. It seems to me then that helping people to get ready for change and helping customers to maintain their momentum is a key job for the case manager. By the way, getting somebody ready for change and helping a client maintain momentum, that’s two different things. A client cannot maintain momentum for a change if he or she hasn’t yet made the change, so they’re different. So what we’re going to look at is what are those stages of change. So change is a process that occurs in increments; it’s a progression, although oftentimes, I have to admit, it’s not a smooth progression. But if we just walk through the stages, it starts with pre-contemplation.
That’s where the client doesn’t even recognize that they have a problem. For example, a client doesn’t even understand that in some of the TANF programs — I mean most of them, but I know that in the tribal TANFs sometimes this can be different — that clients don’t even understand that there are time limits. They haven’t ever even thought about it. So they can’t contemplate something that they’re unaware of. I’ll give you an example for me. I have never thought about starting on a diet for a diabetic. Why would I? I don’t even have a problem with it. So that’s pre-contemplation, “Problem? Problem? There’s no problem. I am fine.” Contemplation is the next step, and that is where the client starts to debate in their mind if this is really a problem.
Maybe they hear from another client that the time limit thing is real, or maybe they hear from another client that if you don’t do these hours, you actually could lose your benefits, and this time a lightbulb goes off, but then they think, “Well, maybe this doesn’t apply to me,” but then they think, “Well, maybe it does.” That’s ambivalence. For me, back to the diabetes, I accidentally had a blood test, I mean it was accidental because the doctor did not intend to order it but just happened to click on A1C just as he was shooting out other blood tests he wanted to give me, just for a normal physical. And when the results came back, it showed I was pre-diabetic. But it was so close to the line, like only .1 above the normal, it was so close to the line, I debated if that was just my normal and maybe it’s not indicative of disease, or, I don’t know, maybe it’s a real warning sign.
Do you see? That’s contemplation. You start thinking on both sides of the equation. Preparation is where the client decides, “Yeah, I want to do this,” and they start planning to make the change. A client who willingly meets with a job developer, if they’re willingly meeting with a job developer, that’s an indication they’re planning to get a job, or at least they’re taking action, they’re taking steps, or maybe they’ve called a GED program. So they are preparing for change. They called a daycare provider to find out what facility they can find for their children, or they apply for a vocational training program. Now, for me, back to my diabetes, I didn’t actually do anything, I was sort of contemplating it, and I can’t figure it out, and then I’m going to wait a year and see what the test shows, but I did start reading online just a little bit about diabetic diets, just to see how different it is from how I eat, doesn’t mean I went on one, but it was just some reading and preparing in case I decide.
Then the action steps is where the client begins implementing the change. So now they’re applying for jobs, they’re going to school. For me, I bought a diabetic cookbook so I could read recipes. Then, once they’ve made the change, now we move to maintenance, and retaining a job would be an example of maintenance. And then, from time to time, we relapse. I do it all the time with diet and exercise. I mean, change is not a straight line. There are roadblocks, we have setbacks, then we get back on the horse and try again, and some people don’t ever get back on the horse, but these are the stages that all people go through as they make change.
The timeframe for moving through the stages is going to vary by individual. But a TANF recipient, as an example, can walk in and they can be anywhere along this continuum. So a challenge that we have when a client comes in is that the program requires that we immediately jump into the action stage when the client may still be at pre-contemplation and doesn’t even see a problem at all, but they’re mandated to do something. So our challenge is to get them to the point that they are willing to do what is required. Motivational interviewing, as it turns out, is a very effective technique to begin moving clients through that change process. And how will we know where they’re at? By asking questions, and we’re going to get to that in a minute.
So why is change so hard? Why is it just so difficult to change? And I’m talking about long-term, sustained change, not short-run bursts that sputter out before any real change happens. So, whether change, even think of you, involves diet, exercise, some habit, dependencies, TANF, or anything else, changing behavior is one of the hardest things that any of us will ever try to do. There are five reasons — there’s actually a lot more, but I’m going to pull out five reasons that change is hard. Number one, people are oftentimes initially motivated by a negative emotion.
With TANF participants, as an example, sometimes that is fear, their motivation is fear, fear of losing their benefits. For others, it’s shame, they don’t want to be on TANF, they don’t want other people to know that they’re getting welfare. The problem is that negative emotions don’t create lasting behavior change. There was a review I was reading of the literature that they reviewed 129 behavior change studies, and they found the consistently least effective change strategy hinged on fear and regret. So negative emotions get people started, but they’re not going to sustain it. Number two, people get trapped into what I’m going to call a thinking fallacy, like “I’m going to charge in and I’m going to change, and if I fail, that means I just can’t do it.” That’s called “all-or-nothing thinking,” it’s all in or all out. You might be familiar with this even yourself, you decide on a change, whatever that is, diet, exercise, whatever, and you slip up, and then you quit and you tell yourself, “What’s the use? I can never do this.” It’s like it’s all or nothing.
Third reason that change is hard is because people try to change too much at one time. I’m going to try to explain this. It’s a difficult concept, but to change mentally, you have to use attention, you have to pay attention to whatever it is that you’re trying to change. You have to become aware that you’re doing whatever it is or that there’s something else that you’re not going to do. So you have to attend to the change. You also have to use self-control, because I’ve got to make myself not do whatever it is I’m trying to change or to start doing something that I’m trying to change, and it is motivation.
So, to change, you have to have attention, self-control, and motivation. Well, those, in any one person, are limited resources. I mean, I could be trying to change something, but I have other things I’m doing in my life that also require my attention, my self-control and motivation. So trying to change too much places unrealistic demands on your attention, your self-control, and your motivation, and then that dooms your effort. So, I mean, it’s really, if you think about it, alcoholics anonymous, perfect slogan for this, “One day at a time,” and you can break it down, you’re making the change one minute at a time. Fourth, change is never just one thing, it’s a lot of connected things. TANF clients have families, they’ve got children, they’ve got friends, they’ve got other things going on in their lives, and all of those things are connected to each other.
So if you change one thing, it’s like a domino, many other things have to change in terms of their relationship, their children, their daycare, all kinds of things, but finally and perhaps the most important, what the best of behavior change research tells us is that if we haven’t made a commitment to accomplish whatever we want to accomplish, then it’s not going to happen. Clients have to be committed to getting a job, finishing their education or doing whatever; no commitment, no change.
So everything else has got to start there. As an aside, I just read something as I was preparing for this webinar that I just found shocking, and that’s, in 2016, there was some new research that suggests that smokers make an average of 30 attempts before they successfully quit smoking. That just shocked me. But what it does show is change is really hard. It’s a grind. If change was easily accomplished, it would have already happened, and clients wouldn’t need our assistance, but it’s tough, as I just showed.
And it requires that we leave our comfort zone. So what’s a comfort zone? Well, you live in one of three comfort zones. One is your comfort zone, or I’ll call that status quo; one is courage or learning zone; and the other you can call it terror or panic zone. So if you just think about yourself, 95 percent of your day is spent in your comfort zone. You wake up in the morning, you have a routine. You drive yourself to work the same way every day. You may be in a relationship that maybe isn’t what you dreamed about as a child, but, you know, there it is. We work in jobs that sometimes we don’t love, but it’s a paycheck.
You’re living in your comfort zone because it’s easy, it’s routine. We know how to live there, so it just minimizes the stress, it minimizes risk. So it gives us some security, but it does not mean we’re happy. It just means that I’ve learned how to live here. So TANF recipients don’t necessarily like being on TANF, but they’ve learned to live there. That’s comfort. The second zone is the courage zone or the learning zone. This is where we want our TANF recipients to be. This is where you step out and you do thing that maybe you’ve never tried before; or you try something that you have done before but it didn’t work out so well the first time, like maybe getting a GED or getting a job and staying on it.
When you are in this courage and learning zone, you’re now taking a risk, and it’s possible to not be successful at whatever you’re attempting. So it causes some level of fear, but this is the zone that you see growth. And the last zone is the terror or panic zone, this is where you’re so overwhelmed by fear or frustration that you almost become paralyzed. When people hit the terror zone, they retreat back to their comfort zone to find safety.
I tell the story in workshops that I took my nephew, he was only ten at the time but I took him ziplining, and he was all so keyed up to go, he was so excited. Then we got up on the first zipline run and I could see the fear in his face but I thought, “Eh, it’s only because it’s the first one.” And on the second one, he could not brake. You have to brake when you’re on zip lines. He could not save himself. The little guide had to put herself in between him and the tree trunk that the zip line was tied to to keep him from slamming into it 30 miles an hour. And she was yelling at him and said, “Why didn’t you brake? Why didn’t you brake?” And he said, “I couldn’t, my hands were stuck.” And I thought he meant that the glove was stuck in the apparatus, but what he was saying was I was so paralyzed with fear and in so much terror I couldn’t even move my hands.
Obviously, we let him climb down at that point, and he didn’t have to go forward. So when people hit that terror zone, just like my nephew, they want to retreat back to their comfort zone, which, for him, was going and sitting in the welcome center at the ziplining place. He was happy to play with his cell phone for an hour-and-a-half while we continued. But I was at one of the tribes in North Dakota, Turtle Mountain, and I remember that it was a HPOG program, but they were sending people through the medical training and the clients were going into the classes and they were passing the classes, but taking the state test was so overwhelming that the staff was struggling because the clients, that was the terror zone, to take that test, and so they were avoiding taking the final exam. And when I was in Pittsburgh yesterday, I was hearing the same thing from the Pittsburgh staff. People have one year to take the exam, and nine months have passed, and they still have excuses for not taking it. It’s just too scary. So, let me give you an example.
Let me show you how this works with you. So, using chat, I want you to write down one reason that you were not doing one of the things on the list that I have provided here that you know you should be doing, starting an exercise program, quitting smoking, starting on a diet, going back to finish a degree, cutting sugar out of your diet entirely. Pick any one of those things and write on chat why you’re not doing it right now. Stephen, do we have any participants who have written in chat? Can you tell me a couple things that they’ve said? Absolutely. A few have come in. We’ve definitely heard a lot in terms of time, feeling overwhelmed, having a lot of things to do, being very busy. There’s a chance that you could fail, but also somebody said “I love to eat.” Yeah, I love to eat, too.
Anybody say anything about cost? Yes. As a matter of fact, we just got financial reasons, and also stress. Interesting. We’ve also heard people saying that it’s hard to be motivated to do these things, and there’s a fear of actually failing if they begin. Well, I’m going to let people keep typing, if you like. I’m going to continue. Thank you, Stephen. I’m going to set that aside for a moment. I am going to come back to that. But set that aside. We’ll come back to your list and, Stephen, you will be able to tell me if anything else appears here in a second. But motivation for change occurs when there is a discrepancy between where a client wants to be and where they are right now. For example, maybe a client, I want to be living on my own, but I’m stuck living with my parents because I can’t afford my own place; that’s a discrepancy between where they want to be and where they find themselves right now.
People make change when they have a clear vision of where they want to be. Again, this is why setting life goals and doing visioning boards are so important, because when I can see where I want to be and it seems achievable, then I’m not happy where I’m at. It’s no longer comfortable. So, I had a youth in a program that had left school prior to graduation, and several years later, when he joined our program, he wanted his GED.
I asked him why. The young man said he wanted to graduate to give his grandmother the gift of being able to watch him walk across the stage and collect his diploma. And he also told me that if he got his GED, he could get a better job. He had worked before. When he came in he was unemployed. But they were all entry-level jobs that weren’t getting him anywhere, and he wanted more.
I knew I would need to know his motivation; that I needed to know these motivators, his grandmother and getting better jobs, so I could incorporate his goals into our case management session. Bottom line, if there is nothing that the client wants or no better place that they want to be, then there’s no motivation to get there. So, for clients, that’s where I have to start. But setting a goal was the first step. But that doesn’t mean that a person is ready to take the next step. Motivational interviewing says that people have to be ready to change in order to be committed to the change, just like the pre- contemplation, contemplation, all the way up the ladder of change. So, just like you think about a hospital, vital signs or blood pressure, temperature, pulse, when you look at readiness to make a change, they’re confident, important, and the right time in the right way, and so those are going to be our vital signs.
So, to get a person to make a change, first of all, they have to believe that that change is important, and what I would suggest being in the first webinar, we’ve got to, again, to get at that process right that orientation. They also have to have confidence that they can achieve that goal, and so if they don’t have confidence, they will not. If I don’t think I can do it, I won’t even try, and then the time has to be right. If the client’s dealing with other things that preclude them from changing right now, like a sick child, a dying parent, then the timing is not right. And so, if I want to simplify this, it’s that you have to be ready, willing, and able. So, let me define what those mean.
Willing, basically is this a priority for the person. And let me give you two in of the continuum, all the way from this isn’t even important at all, to this is crucial for me. Ready is the timing right, two ends of the continuum. I want to but not now, Scarlet O’Hara, tomorrow is another day, or I want to go to school someday, but not today. And then all the way to the other end is, I want to and I’m ready right now, and what is able, do they see a realistic way to change that they actually believe can work.
If they don’t have the confidence that something will have a good outcome, then they won’t try. So, I am confident that I can do this is at one end of the continuum, and this will fail at the other. So, if a client doesn’t think he or she can get a GED, then he or she is going to avoid it. And here’s the kick in the pants. All three of those components of motivation, motivation to change, they all have to be present at the same time. If someone is high in confidence, like I know I could get my GED if I tried, or a job, but it’s not important to them, then, as a case manager, I want to focus on importance with them, because they already know they can do it.
Confidence isn’t the problem. Readiness isn’t the problem. The problem is important, is willingness. So, the way I might focus on that is to ask them what would be some pros of you getting your GED. What would be some advantages? Or what would it be mean to your children if you got your GED? What would they think about that? So, you focus on the component of motivation to change that is not present, what’s getting in the way. So, if I go back to your examples, why don’t we do these things when we know we should? So, somebody said, “I have no time.” I’m going to put that in a priority issue.
I mean, everybody has the same amount of time in their life. Some people find time to exercise. Some people don’t, or diet or do whatever. That is that. I’m too busy, same thing. I could fail. That’s a confidence issue, fear of failure. I’m too stressed out. I would put that in — that’s an ability. I just don’t feel like I’m able right now. Financial reasons. Ability, I like food. That’s a priority issue. So, when you go back over your list, what I just want you to see, that when you connect your reasons for why you’re not doing something, I just think it’s really important to see that we are really no different than our clients. If we’re not ready to change things that we know that we should, then that gives us some insight into what our clients are going through, because many of the things that you just named, other than I like food, are exactly the same things that clients feel about what we’re asking. You know, I’m busy. I could fail. You know, I think that the reasons, or let’s call them excuses, that we don’t do things fall in the same category, but people have to be ready, willing, and able.
So, what that means is we need to know initially, at that initial assessment, where they are in the process of readiness to make a change, and then we need to check in with this during case management, because readiness isn’t static. Somebody doesn’t make a decision to change toward a specific goal and then it all runs smoothly. Readiness changes, so we have to stay tapped in. Let me show you one option. So, here is a script for how I might begin the initial assessment appointment. I want to start by asking you some questions to help me understand what sort of things you’re interested in and how this program might be able to support you in achieving your goals. Does that sound like a good place to start? Yeah, it’s rhetorical. They’ll say “Yes.” And then we’re going to do an assessment, and so here are some of the questions they get asked, their readiness. I put them in categories, but they aren’t necessarily sequential. What kind of life, eventually, do you want for yourself and your family? What kind of things do you need? What kind of things do you need to do to make that happen? What would be some advantages of working or going to school? How important is getting a place on your own, making a better life for your children, getting a job? How important is that to you on a scale of zero to ten.
You know, whatever their answer, it’s like, well, what would it take to — like let’s say they said a seven, what would it take to make that a ten? And then ability, confidence, how confident are you that you can get your GED, that you can complete school, get a job. What in your life could help you be successful? What do you think could get in the way? Of the things that we’ve discussed, what concerns you the most? And then ready, is the time right? Hey, so if you decided you want to go to school or get a job, what steps would you need to take? What steps, if any, do you feel ready to take, and what changes, if any, are you thinking about making? Although I’m going to talk about change talk a few slides from now, if you look at these, take a minute and look at these questions, you’ll notice that all of these questions lead the client to talk about change.
That’s the essence of motivational interviewing, and, quickly, if we analyze the questions, how are these questions different than the type of questions we generally ask? I’m guessing because they’re open-ended. They’re directive but they’re open-ended. There’s a purpose behind every question. Who elicits change talk? The case manager does, through the questions that they ask. Who owns the problem? Who solves the problem? Who makes the decision? Who decides what step is next? And who is more empowered by the conversation? The answer to all of that is it’s the client.
So, our role is eliciting. Their role is talking themselves into the change. So, there are five critical motivational skills that you have to answer. These are foundation skills. Understanding change, what we’ve already talked about, and how people change is important. It’s really important. But that really isn’t a skill. So, these are the skills you want to use and you want to learn. We’re going to walk through each. But each of these skills takes practice to master, and it takes practice to know when to use them. So, open-ended questions, affirmations, reflexive listening, summary, and then I’m going to call it “plus information.” First skill is open-ended questions. Open-ended questions are used to start a person thinking and talking about change. Open-ended questions, they can’t be answer with just yes or no or a simple phrase.
That actively involve the participant. Now, you will notice that I added a second bullet, use open-ended questions rather than closed, but I added this second bullet, “Ask for their resources before you offer yours.” I added that just to give me license to make another point. Don’t offer your resources before you ask for theirs. That creates an entitlement mentality, and then they begin to think about us like a bank. You need child care, hey, here’s some money. You need transportation, here’s some money. You need an interview outfit, hey, here’s a gift card.
Avoid that approach. So, let’s look at our two pairs of questions. Do you have reliable childcare? Do you have reliable transportation? Those are closed questions. The second question, what kind of child care do you have, or what options do you have available for transportation if you did go to school or got a job, that makes the client think about the problem. It lets them explore their options. I mean, if they need money, I’m going to provide it. Don’t think I’m not. But let them own the problems first. Open-ended questions allow the person the freedom to talk, to tell their story. It creates forward momentum, and, what adults are really good at, it builds relationships. When we understand the client’s point of view and have elicited their feelings about a topic, then relationships are formed. The idea behind open-ended questions is that the client should be doing most of the talking.
So, here’s some other examples. If you look at the first column, I think it’s easy to see that these are closed questions, and they sound like data gathering. Have you ever been in a program like this before? Have you been applying for jobs? Where? If offered employment, can you begin working immediately? They all say, yes, that they can. And do you know what career field you want to go into? These are transactional-type questions.
We ask the client, the client answers, and we move on to the next question. Most initial assessments that I’ve observed follow this kind of format. Notice the open-ended questions give people an opportunity to tell their story. So, tell me about your experience being in TANF or WIOA before, what worked with you in the program and what didn’t, or, hey, when you’ve looked for jobs before, what’s been successful for you? How did you go about it? And notice there, I’m using that question to help them build their confidence. If an employer offered you a job and the start date was tomorrow, what would you have to get organized in your life so that you could begin work? Notice I am asking questions that make them think about change. Or talk to me about jobs or careers that interest you. Hey, what attracts you to that type of work? The open-ended questions give you much richer information about the client so you can understand what they’re facing, what his or her thoughts are, and experiences have been, and what their readiness is, and, again, they elicit change talk.
So, I’m giving you I think at the end you also can get this PowerPoint. You can get a PDF. I think you can download it. So, you definitely can of the homework, or when we do office hours. I’m just giving you a cheat sheet. When I write open-ended questions, say, when I’m on a consulting venture rewriting an assessment instrument, I always have a cheat sheet like this in front of me, so I’m just providing it to you as well. Anyway, so look at your own initial assessment and instrument. If the question that you’re starting with are do you have you, have you, are you, when did you, how many children do you have, those are closed questions, and, again, are the opposite of motivational interviewing, so you might want to look at changing the form. Now, we do need to come up with a plan that includes 30 hours of activity per week, or 20 hours, or, if they’re in community service, some odd number of hours. Let’s look at some of the options. So, anyway, this is a script I’d actually use with a client, so we do need to come up with a plan that includes 30 hours of activity per week.
Let’s look at some of the options together. You will be the best judge of what works for you. Unlike true motivational interviewing, clients don’t have an unending amount of time to make choices. They must do a certain number of hours. I can use motivational interviewing techniques to always present things as options and allow them to make the choice. But if you’re going to drug and alcohol addiction, really, everything is up to you and you can go as long as you want. TANF is a little different, because there are more general requirements. So, anyway, I’m starting with this, and then I’m moving to still part of my script, so you have more options, and maybe you guys have more. I just picked four. You can actively look for a job or work. That would involve X, Y, Z.
You can learn new skills by doing community service. Some examples of that are — tell what the examples are. You can learn new skills. You can also work on your GED. We have two schools that are options, or two approaches, or you could go to vocational school to learn a skill or a trade in some programs in our area that are available, and. you know, outline that. So, which of these sounds most interesting to you? Which would help you move toward building a better life for you and your daughter? So, I mean, allow them to ask any questions or whatever, but let them make the choice.
Don’t assign them an activity or push for a specific activity. The choice should be theirs. I mentioned a few slides ago, probably a dozen, about change talk. Change talk is any self-expressed talk, anything that they say is an argument to make a change. So, as you ask questions, listen for change talk, and only open-ended questions will evoke change talk. Change talk has three elements. First, they can contain a statement about change, like, hey, I called the school or I want a better life for my kids. Well, if I get a job, I wouldn’t have to come here. Even if it’s said in the negative, it’s still change talk. Or I can’t live on this small amount of money. That may sound negative to you, but it’s change talk.
Another element is it has a specific target. I need to get a job. I want to get a GED. I don’t want to be on TANF. And, typically, change talk is phrased in presence tense. I wish thing were different. I’m hoping I can get my GED. God, this is not where I want to be. I know what I have to do, I just need to do it, or it would be nice if I had more money. Why is change talk important? It’s important because a client’s language matters. Research shows that what the client says, not only reflects what they’re thinking, but it also influences what they are thinking. So, this circles back to that statement I showed earlier. I know what I believe when I hear myself talk. When a client gives voice to making a change, it makes it sound more real, and they’re more likely to contemplate making that change, so we want to encourage and reinforce change talk. We want to ask the kind of questions that get people to see themselves changing.
We want to ask them to or get them to articulate the benefits of change or maybe how to help them see difficulties of their current situation or you ask them questions that get them to express some desire to change. So, here are some. I’ll give you some major methods to evoke change talk, how do you evoke it. Some techniques we talked about in the first session that I can use, one is showing them how long it’s been since TANF had an increase in cash assistance. So, we looked at, last time, it’s been a lot of years, 30- some years in some states, but I did it as a game “Price is Right,” if you remember, so it’s self-discovery. I’m not telling them, they’re telling me how, like, braces have gone up and TANF has not. It could be having them do a worksheet so that they could see the financial benefits of working and social security and the tax credit and the EITC so, again, they see that they’re better off.
I could give them a chance to write down five ways their life would be better off working rather than being on TANF. Now it’s their idea, not my idea. So, all these activities let them learn for themselves what we already know, and that TANF shouldn’t be a lifestyle, but this approach is empowering. So, how do you evoke it? Here are some other samples of questions that evoke change talk. So, I know that you have a lot of good reasons for going onto TANF. What are some of the downsides of being on TANF, if any? And they might talk about the hours, having to come into your office, that they got to get a ride, all of that is change talk. Where, if I said, so, let me ask you, if you were successful getting your education or you were successful getting a job, what would be different for you? What would be the best thing that might happen if you went to school or got a job? How would you like for things to be different? What are your hopes for the near future? Obviously, the questions that you pick will influence what you get the client to think about and to work through.
But what you get them to think about and work through will plant seeds for contemplating change. So, a second skill is affirmation. It’s affirming, making affirmative responses. Affirmations are statements and gestures that recognize clients’ strengths and acknowledge behaviors that lead in the direction of positive change. No matter how big or small that change is or that step has been, that’s great you called the GED program. You’re already moving ahead. Affirmations build confidence in the client’s ability to change or meet goals. Remember that confidence is one of those vital signs to making change. They have to be ready. They have to be willing. They have to be able. So, this helps clients increase their readiness to take risks and leave that comfort zone. Obviously, your affirmations have to be genuine, so I’m not going to say something if it’s fake or I don’t believe it. So that’s, oh, my gosh, it sounds like you have a really good plan, or it sounds like you have thought a lot about this and have some really good ideas about how you could go about getting a job. That’s a really good suggestion. Or it sounds like you’ve had a setback but you’re really trying.
Let’s look at all the progress that you’re making. Notice that they build hope and they strengthen the connection, and also notice that the word “you” is generally used as you start the affirmation. Affirmations are particularly positive when you use them to reinforce change talk. So, an example, the client says I want a better life for my kids, and that is change talk, an affirmation would be, wow, you’re already taking some really important steps to get there.
The third skill is reflective listening or active listening, whichever way you want to call it. Reflective listening, it’s a skill that can be acquired and developed with practice. I’m going to guess that many have been through workshops on this at one point or another in your career, but I just am warning you, active listening can be difficult to master and will take time and practice to develop.
It’s one of the most important skills in motivational interviewing; yet, for whatever reason, it’s the skill that practitioners, they need the most work on, but they’re the least enthusiastic about spending training time learning it, probably because you’ve got to role play a lot. Yet, without this skill, it isn’t even possible to do motivational interviewing. You can ask open-ended questions all day long. If you’re not doing active listening or reflective listening, you are not doing motivational interviewing.
So, even if a person has been trained and practices all the time, they still, from time to time, need to fine tune their skills. So, what is reflective listening? It’s fully concentrating on what is being said rather than just passively hearing. So, the key to active listening is that after somebody speaks — I used to be able to repeat or paraphrase what the speaker has just said, because I have to be sure that what I heard is what they said or what they meant to say. You might think you heard what they said, but unless you double check by repeating it, you cannot be sure. So, you probably use this skill all the time. If somebody gives you directions, you repeat them back to make sure you understand, because communication is so inexact. So, basically, you’re seeking to understand. You’re trying to capture the essence of the message, and if you take time to listen, clients will tell you what’s worked and what hasn’t, where they are in terms of wanting to make a change, what they hate about their lives right now, which is change talk, what could be better, what moves them forward, what has set them back in the past.
I’m telling you, when you’re in doubt, actively listen. And it’s okay if you’re incorrect, like that paraphrase and I get it wrong. You don’t have to hit the ball out of the park. All you’ve got to do is get your bat on the ball. So, active listening involves six behaviors. Number one, look interested, not at the keyboard. Establish and maintain eye contact. Second, ask clarifying questions if you don’t understand, or even when you think you do understand. Third, stay on target. Make sure that if you’re asking a clarifying question you’re not changing the subject. You’re staying on the subject. Four, test your understanding by paraphrasing to make sure you understood. Five, evaluate what they’re saying. So, if they’re making change talk, I definitely want to paraphrase that, and then neutralize your feelings, whatever the client says. I don’t want to be here, I don’t like being on TANF. You guys are always just making me do stuff. Whatever they say, it is not personal. It really isn’t about you. Just stay neutral. I mean, I might say, so, it sounds like coming here is not a joy in your life.
It’s not about me. So, paraphrasing, by the way, is not the same as agreeing. All you’re doing is trying to understand. So, let’s look at an example. Here is an example. A client says, I don’t know what kind of job I want to do. I’ve thought about a lot of different jobs in the medical field, but I can’t decide on which one is right for me. Paraphrasing is, so I hear you saying that you’re still torn about the many opportunities and career pathways that are available in the medical field, and you haven’t been able to pick what’s going to be a good fit for you. Repeating, I just basically repeat what they said, so you don’t know what kind of job you want to do. You’ve thought about a lot of different jobs, mostly medical, but you still can’t decide. Summarizing is just taking out key points. So, let me try to summarize what you’ve said.
Although you’re spent time thinking, mostly in the medical field, you’re still undecided. So, those are three methods of testing that you understand. And, again, this is the most critical skill for active listening, so let’s do a quick example. Client says, “I haven’t worked before at a real job. I doubt anyone would hire me.” If we say, A, we place people all the time who haven’t worked before; B, you’re thinking that an employer wouldn’t hire someone who doesn’t have work experience, and that makes you nervous to try; C, we have a job developer who can give you job leads.
You should go talk to him; and, D, well, community service would give you experience, maybe you should consider that. Which one of these in chat, A, B, C, or D, is the active listening response? Stephen, we getting any response? Yes. We have a lot of people that are saying B. And B is correct. Let’s say that it’s like — I mean, one of the things that I did when I was learning active listening, you do a lot of it by paper on pencil just like this. You write answers, you identify them, because you have to have it in your mind before to really be able to focus and to be able to take what somebody said and reflect it back. I’m giving you a cheat sheet again. These are just starters. So, you feel, it sounds like, so you’re wondering, so what I hear you saying is, et cetera, so you’ll get this in the PDF. When I was first learning how to do this, when I ran the Youth Program, never learned it in my Psychology college course because I never anything practical there, but I learned this when I was working for this program.
I had had this little cheat sheet on my desk because I’m not so smart that I can think of these things like right on the spot. Well, anyway, common reactions to being listened to, nothing hurts more than a sense that someone isn’t really listening to what you have to say. People complain about this all the time. Like parents complain their children don’t listen. Children complain, actually, that their parents don’t listen. Supervisors complain their workers don’t listen. Workers complain their supervisors don’t listen. Even friends, who are mostly a reliable source of an ear, oftentimes are too busy to listen. So, like, imagine that you come home from a day at work or you were at a conference and you’re all excited to share what happened with your significant other, and as you’re telling your partner how it went, he falls asleep while you’re talking. If you think about how you feel, you feel hurt and betrayed. So that is by finding someone who really listens is so powerful.
People want to be understood. Being listened to means that we’re being taken seriously and that our ideas and our feelings matter, and, by the way, that builds self-confidence and it build self-esteem. A listener’s empathy, trying to understand what we’re saying, like it builds a bond of understanding, and, again, it strengthens relationships and it brings us all these positive reactions that I’m showing on the slide. So, another form of listening but still four is summarizing, and it’s a special application of reflective or active listening. So, when you’re having a discussion with a client, my guess is that you will have covered a lot of territory, and you’re going to need to summarize the discussion. That’s another point at which motivational interviewing offers a strategy. Because when you do a summary, it’s great, because you get to make decisions about what to include and what to exclude, and you decide how to present the information. What you generally will include is anything that helps the client to move forward. So, basically, you’re picking out change talk, because this allows the client to hear his or her own change talk for a third time.
Summary shows the client that you’re been listening. So, here is an example that I might say. We’re about finished here, and I just want to make sure that I’ve understood things correctly. You said that you want to meet the requirements to continue to receive your cash assistance. You’re really wanting a job, and at the same time, you worry about after-school care for your children. If you go to work, to help you prepare for work, you want to attend some resume writing and job interviewing workshops to build on your skill and you make yourself more competitive, and you want to call a childcare worker to find out what options are available for after school. Have I missed anything? So, it’s basically you just summarize, now, everything that we’ve talked about were agreed upon at this particular meeting, so we’re closing the assessment.
Now, our last step is step five, one plus, ask permission before giving advice or providing information or expressing a concern. See, from time to time, you’re going to need to offer advice to a client, because a client can’t know what she doesn’t know if she doesn’t even know that she doesn’t know it. But while advice seems like it would be really welcome, oftentimes it’s not, and it creates a trap. There is a tendency of practitioners to actively try to fix problems in the client’s life, and it really begins with our desire to help others, so it’s positive. I mean, it’s a positive motivation to try to fix the problems when we see them, and there’s nothing wrong with wanting to help our clients live happier easier lives. But the problem is that fixing things for people undermines the entire concept of empowerment. We want our clients to be active participants, not passive recipients of our service. So, instead of viewing our role as I’m the expert, we need to view our role as, I have some expertise, but clients are the experts on their own lives.
So, sometimes we have this information that we think would be really helpful to a client; however, information is only helpful to the client if they want to hear it. So, the best tactic is to ask permission if clients have not asked for the information. So, I can say, “I have some information that might be helpful. Would you be interested in hearing it?” If they say, “No,” you have to respect that. But the vast majority, trust me, will say, “Yes.” I mean if there’s imminent danger then we don’t have to ask permission, but those instances should be few and far between.
So, I’ve given you examples here of how to act, and I think that that fits in with the entire concept of motivational interviewing. We let our clients make the decision. So, change is a process, it’s not an event. Motivational interviewing is not really a collection of techniques, it is, as much of anything, a belief that as a counselor, as a practitioner, I help people to think things through, to live their own lives, to make their own decisions, and that spirit is embodied in a set of techniques and skills that the counselor must learn. But it’s a spirit, it’s a philosophy of working with people. So, if we did a quick review of the skills to summarize, I mean, you definitely, at the front end, need to know about change and about comfort zones and how people change, but the actual skills are open- ended questions, affirmations, reflective listening, summarizing to emphasize change talk, and providing information after you’ve asked for permission.
So, I do hope that you’ll spend some time to learn more about motivational interviewing. Obviously, we’ve skimmed the surface, but I do hope that you got a strong sense of what it is all about. You will get an e- mail that will give you the homework assignment that I’ve prepared. Basically, it is three parts. First, I give you a sample conversation, where I’m the motivational interviewer and you have a client, so it’s written like a conversation, and you have to identify the skills that the motivational interviewer is using, is that active listening, is that summarizing, is that open-ended questions, so you get to see it, and you’ll get a few closed questions, and then you’re going to turn those into open-ended questioned. And, last, I’ve given you a few questions to actually use with clients during an initial assessment to give you an opportunity to practice some small part of motivational interviewing. So, our office hours — and this will all be sent out in an e-mail — are going to be April 5th, either at 11:00 or 2:00 o’clock.
I hope that you will sign up. I would like to see all of the homework by March 29th, so I have some time to look at it before our office hours. So, we have two upcoming sessions, one in May, one in June, and I know that you’re continuing to get e-mails about that. I really do appreciate everyone’s participation, and I know I went four minutes over, but we started four minutes late. Stephen, is there anything else that we need to say to wrap up? Just a couple of things. One, again, if you have any final questions, please submit them.
Also, there will be an evaluation of this webinar, and we really ask that you take time to complete the evaluation, because, again, it provides some helpful insight in terms of things that we can do well or things that we continue to do. Right now, again, you have the office hours, and I encourage all of you to please register for those office hours. As well, if you want a copy of the last webinar, please go to the PeerTA website, and you will have a link to be able to get to that website as well. So, we’re doing one final check to see if there are any questions, and right now we don’t have any final question. Folks are just thanking for the information. Hey, see you guys. It’s been fun. .