This episode explores the nuances of the "engaging" process within Motivational Interviewing (MI), a therapeutic approach. Against the backdrop of a common assumption that engaging is a non-directional process, the hosts and guest, Dr. Allan Zuckoff, delve into differing perspectives on its directionality. More significantly, the discussion reveals that while empathy and autonomy support are universally agreed upon as crucial, the degree of directionality in engaging varies among practitioners. For instance, Dr. Zuckoff recounts a conversation with a training team member that sparked his curiosity about the lack of a standardized measure for engaging, unlike the existing measures for evoking change talk. As the discussion pivoted to the nature of directionality, Dr. Zuckoff initially aligned with the non-directional view presented in foundational MI texts, but later shifted his perspective, acknowledging a subtle directionality focused on establishing a trusting relationship rather than directly targeting specific behaviors. This involves creating a safe environment where clients feel comfortable opening up, which might intertwine with focusing on the issue at hand, especially in time-constrained settings like healthcare. What this means for MI practitioners is a need for greater awareness of the subtle interplay between engaging and focusing, and the importance of building trust and rapport before directly addressing the issue.
