Digging Deeper: Affirmations
As Motivational Interviewing (MI) practitioners and working in the helping professions, we consistently operate in a world where serving the better interests of people, families, and communities is not only good practice, but a fundamental truth of our work. I have come to understand that MI is a powerful way of being that provides helpers the structure and independence to serve the best interests of those coming to us for help; either voluntarily or mandated, we desire to be an affective resource for individuals. This assistance certainly looks different for each individual and circumstance. This is what I love about MI: it gives the helper options and a variety of tools to assist those working toward behavioral change.
Behavior change is a tough process. I often think about the families in the child welfare system working towards the change they need to keep their children and families safe. As we’ve traveled throughout Oregon Indian Country working with tribal personnel, our team has consistently heard how difficult the behavior change process can be for the families being served. A process filled with fear, conflict, insecurity, and confusion. For those using MI approaches, l helping people work through their concerns about a specific behavior change becomes less conflictual and more engaging Although this process can be complex, MI provides a way to help people while negotiating the waters of change.
The spirit of MI provides helpers the heart- and mindset to develop an empathetic perspective towards our work for the people being served. When coupled with the core skills or the OARS (Open-ended questions, Affirmations, Reflections and Summary statements), we as helpers are equipped to enter into sensitive conversations about change.
In our September newsletter, we discussed Open-ended questions and how they help us create a space for people to share their stories. This month, we wish to discuss Affirmations and how using Affirmations can help build hope and confidence.
What is an affirmation?
MI defines an affirmation as a statement or gesture that recognizes strengths, efforts, and perspectives towards positive change that a relative maintains[1]. Affirmations help us openly and explicitly recognize and acknowledge someone’s inner strength[2]. Affirmations help to build hope and confidence[3].
Here are some basic guidelines for affirmations:
We want our affirmations to be from our hearts and something we notice about the person(s) we are conversing with to build a helping relationship1. Our affirmations should be strength-based and acknowledge a relative’s strengths2. An affirmation should be used to support a relative within the behavior change process, no matter where they are in that process2. We want our affirmations to be specific and acknowledge a relative’s success2. And lastly, affirmations should be authentic1. Affirmations are about the relative, and too many affirmations can feel disingenuous1. Our affirmations are best given when the person is ready to hear them in a good way.
Examples of affirmations
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“Thank you for being willing to meet with me today"
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"You handled yourself really well in that situation"
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"Wow, you didn't smoke for 3 days this week – congratulations on meeting your goals! Would you like to review how you were able to have this success?
There are many ways to go about affirming the strength and positive characteristics and/or actions of our relatives in the change process. Affirmations are a fundamental way of building rapport and connection2. Perhaps the greatest benefit of an affirmations is how well these types of reflections build a sense of confidence and hope. The more confident and hopeful someone feels about engaging in and achieving their change goals, the more likely they are to continue to move in the direction of change.
While affirmations are a great skill to use in our MI practice, it is important to note that affirmations provide us an opportunity as helpers to develop the vision and perspective that looks for and acknowledges people’s strengths and actions towards change – training our minds to have a perspective that sees the positive and strength a person maintains.
It is also important to note that many of our friends and relatives have generational and current histories of experiencing trauma. Be aware that not all people will react to affirming statements in a good way. Some may have had negative experiences and not trust that we are genuine in our observations. They may suspect there is a hidden agenda. You may decide, due to that negative history, to offer affirmations by first asking if it is okay to offer an important positive observation you have made, showing your spirit of care and concern while doing no harm.
Our team invites people to build that perspective that notices the positive strengths in others, and when you notice that strength and or positive characteristic, simply acknowledge it.
[1] Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change (4th edition). Guilford Press.
[2] Shawn. (2022, March 9). Examples of motivational interviewing affirmations. Share Collaborative. https://sharecollaborative.org/examples-of-motivational-interviewing-affirmations/#:~:text=In%20Motivational%20Interviewing%2C%20affirmations%20are,pathway%20to%20rapport%20and%20connection.
[3] Understanding motivational interviewing. Understanding Motivational Interviewing | Motivational Interviewing Network of Trainers (MINT). (n.d.). https://motivationalinterviewing.org/understanding-motivational-interviewing
Tanning Hides and
Open-Ended Questions
Early in the project we trained in Chiloquin, Oregon with the Klamath Tribe’s Social Services team including Child Welfare staff. Tribal Elder Dalene McNair shared her story about learning to tan hides as a young child and how she continues that tradition today. With permission, our team continues to use part of the story in our trainings to teach MI. We humbly refer to Dalene’s story as “The Parable of the Stinky Hide.”
What is hide tanning and how does it apply to Motivational Interviewing? Tanning a hide consists of multiple steps and generally requires a number of tools to turn a raw hide into a finished, usable product. Similarly, working with individuals and families within the change process requires time and the use of tools.
Within the Motivational Interviewing (MI) practice are core skills. These core skills are utilized in an environment where the helping relationship is based on a particular Spirit and Style (compassion, acceptance, empowerment, and partnership) of any interaction between the helper and the people they are trying to support. The core skills are OARS (open-ended questions, affirmations, reflections, and summaries). These skills, when applied strategically and with the appropriate intent by a helper, can assist relatives and families discover their own reasons for change.
In this issue, we want to highlight open-ended questions, or the “O” in OARS. Open-ended questions are the opposite of closed questions, which generally elicit a simple and or single response like “yes” or “no,” “sure,” or maybe.” Open-ended questions provide a space for people to tell their story from their perspective and create a relationship where sharing is fundamentally welcomed and encouraged. Notably, open-ended questions typically are few when using the other OARS skill of reflection, or reflective listening. A good ratio is 1:2+ – that is, one open-ended question followed by two or more reflective statements. The quality of an open-question – how it is phrased, what assumptions are made in using certain questions (e.g., where is the person at in the process of change) – can provide momentum for people to explore requests of desires for change.
Open-ended questions are formulated with a lead-in that can include words such as how, describe, what are, when you, that seek to understand and elicit an individual’s perspective on situations, behaviors, and change. Here is one example highlighting the differences between a closed-ended question and an open-ended question:
Closed-ended question: Did you have a good relationship with your parents?
Open-ended question: How would you describe your relationship with your parents?
As you can see, the use of an open-ended question can elicit a vastly different answer. Here are a few more examples of open-ended questions:
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How would you like things to be different?
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What are the good things about ___ and what are the less good things about it?
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When would you be most likely to___?
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Describe a vision for the change(s) you would like to make?
Learning to use open-ended questions in a skillful manner is doable. Part of this process includes thinking about what underlying assumptions the question reflects:
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If you were to make this change, how would you… (assumes person is not ready to change)
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What plans have you made to implement your commitment to... (assumes person is ready to move toward a desired change)
Our team invites you to practice your open-ended questions with a colleague as a simple exercise to improve this skill. You may also note that a well-utilized open-ended question brings a spirit of sharing, acceptance, and nonjudgment, and the helper will better understand an individual’s perspective, experience, and personal story that serves as motivation for change.
Pathway to Learning MI
Competency in Motivational Interviewing requires a commitment to continual learning from initial training to competency and proficiency. Learn more about the learning path in the infographic below.
