Listening very well....

I haven't done clinical work in almost 4 years, and I have found that I am losing the skill of listening actively.  Listening actively means actually being present with the client, not planning my grocery list or how I have to pee.  It is (for me) listening with my "eagle ear" so that as the client continues, I begin to get an idea of where they are at in the world.  Not completely.  Whoever could?

Yet everyone has a story and wants very much to be heard.  And there is the explicit content of our conversation and then there is the implicit "story within the story", which is usually a powerful emotion.
It is usually sadness, and if they begin to pool up in their eyes or start to weep, it is all over.  I am weeping with them.  I weep with everyone because their suffering touches my suffering, and in that moment, we are kinfolk.

That is compassion, I believe.  More than empathy, it takes some sort of action on the part of the practitioner to express compassion to the client.  You can't just say "I am feeling compassionate for you right now."  That ain't gonna cut it.  Yet, if you meet their eyes and allow your suffering to touch theirs, if you touch their hand, if you offer them a kleenex (which many find disrupting yet please, boogers are rolling down their noses and they are so grateful for the kleenex!)

I am still so nosy to see how compassion plays out in MI as if it can be introduced as a core principle of the Spirit score, folks will actually have to act or speak in compassionate ways.

Going to go do my sitting meditation, which I forget today and I am working on compassion for myself and all of you.

Love to you all,
XXOO

Jacque

Intro to MI and Intermediate MI Online courses coming up!

Hi everyone!

My new website is up and our new course schedule is on there.

We have an Introduction to MI Online beginning on Tuesday, 4/15/14 through 5/20/14.  The cost is $500.00 USD and I will be the trainer.  The course runs for 6 weeks and we have a weekly 90 minute
Skype call that meets at 10 am CST and 6 pm CST.  Syllabus and registration are available on the website.

Intermediate MI also runs 6 weeks online and begins Tuesday, June 3 through July 8, 2014.  Once again, the cost is $500.00 USD.  The Skype calls for both courses are always on Tuesdays and we have the 2 times to accommodate non North American folks.

I find myself very busy teaching at Dominican University part time and most of my MI work is coding and teaching coding.  Lots of changes in coding have already occurred and it will be exciting when the MITI 4 comes out.  There is no due date for it at all at this time.

Many thanks and pass this info on if you know anyone looking for some good MI training with no airfare, hotel costs, time off from work and you can work in your jammies if you want!

Jacque

Behavior change for MITI coders...

Hi all:

As a MITI coder and trainer, I have had the lovely experience of behavior change for myself as I listen to practitioners' session.  I remember one project I coded where I listened to about 50 sessions with dentists as the practitioner.

When it come to Giving Information (facts about dental hygiene), I repeatedly heard facts and techniques of dental health.  I learned so much about dental health that my teeth were the healthiest that had been in my life.

I have had the same experience when doing role-plays (or real-plays) in f2f trainings.  I began using cloth napkins instead of paper napkins after doing a real-play in which I was the practitioner.  After hearing all the reasons why my "client" thought it was important for the environment to not use as many paper projects, I bought into her arguments for change.  I still use cloth napkins to this day and think of her every time I do.

I learn more from my trainees that they can possible imagine, and I have heard from many trainees that they made big behavior changes after being the client in a real-play.  It goes both ways.  I have found (as practitioner) that I make behavior changes just after coding sessions, listening to clients or working with trainees.

It is not only free therapy for the trainees.  It is free therapy for me.

Jacque

Morning folks!

I have been offering MI and MITI coding training for over 4 years now, and as a result, my f2f training business has trickled to almost nothing.  I used to think that was a bad thing yet now, I find myself enjoying the online courses.

Why?  Because I get to know the trainees much better, they get a lot more of my attention than in a f2f course, we continue to roleplay on Skype, I am able to produce more audios and videos for training
and of course, the weather provides no problem when you are working from your computer.

The course evaluations are excellent because folks are getting a good deal for their training fee.  No airline, hotel, rental or per diems required.  Their employers seem to like saving money and thus are much more willing to pay for online.

Online/blended/Skype works!

Jacque

Hi folks:  We are offering a new Advanced Coding MITI 3.1.1 Course Online that begins 11/18/13 and ends 12/23/13.  Here is the info!

International Advanced Online MITI 3.1.1 Coding Training

November 18, 2013 through December 23, 2013

Trainer:  Jacque Elder, PsyD.

Cost:  $450.00

This Advanced MITI 3.1.1 Coding course will begin Monday, November 18, 2013 and end the week of 12/23/13.  I have deliberately scheduled the calls on Mondays to avoid direct contact with the holidays.

There will be two Skype calls per week, one at 10 am CST for non-North American folks. The other Skype call will be on Monday as well 6 pm CST. Please note both calls are on Monday in order to not interfere with holidays.

You only participate in one call per week.

Dates:                         Skype times: 

11/18/13                        10 am and 6 pm CST

11/25/13                        10 am and 6 pm CST

12/02/13                        10 am and 6 pm CST

12/09/13                        10 am and 6 pm CST

12/16/13                        10 am and 6 pm CST

12/23/13                          10 am and 6 pm CST

Goals of the Course:

This Advanced course is for the person who has formal coding training as well as coding experience. If you have found that you went through a MITI training and then never coded a darn thing, join the club.  I did not code until about 3 years after my coding training.  If you fall into this category, you are more than welcome and you should review your materials from your training. We will not be reviewing the bulk of the Manual as you have already been taught that.  If you haven’t gone through a formal coding training yet were trained by a noted coder or MINTie, you are also free to participate.  I just need to know about your training and the scope of your coding work.  This is a great training for research coding as well as feedback/coaching coding purposes.

The course will focus on "challenging" sessions that have baffled many of us as well as some "easy" sessions to code. Challenging sessions might be practitioners who meander around doing some good and then not so good MI.  We like challenges where the Global Ratings are all over the place and how we come to a resolution. We must take time to talk about the different between Simple and Complex Reflections. We will focus on what utterances are not coded, whether structure, personal disclosure or observation.  We have developed examples of Behavior Codes such as Giving Information, MIA and MINAs.

The focus is on full-pass coding.  We will be using no transcripts here.  We are happy to share some forms that we have developed that helps us code quickly while still providing written examples (if requested).  We would love to have participants submit a session of their own (could be role-play or real-play) and challenge us not only on our Behavior Counts but also on the Global Ratings.  John Novo did a great one for me and it is part of my regular training sessions now.

Most of the work is done on the learner's own time, and each will be provided with an online resource that is user-friendly.  On the site, there are 6 Modules representing the 6 weeks of the course.  Each Module contains PDFs, video on parsing, utterances, random start/end times, audio of training sessions that include transcripts (uncoded and coded just for one practice!) and other resources that may be used in Feedback and Coaching.  It is estimated that learners will work 3-4 hours per week on their own time in addition to the 90-minute weekly Skype calls.

How This Course Works:

Once registered and paid, the learner will be provided with a link to the website, a username and a password.  The learner will receive this information prior to the first Skype call scheduled.  We often provide it early so learners have a chance to look at site and downloaded printed materials.  It is expected that the learner will know the MITI 3.1.1 Manual as well as basic coding skills prior to the first Skype call.

Required for Course Learning:

·      Access to a computer with Internet.

·      Access to Skype either at work or home.

·      Computer with speakers and working microphone.

·      A printer to print out MITI Manual un-coded and coded transcripts.

·      A willingness to complete homework.  The trainees who learn the most in this course are those who have done their work

Participation:

The trainers will set up group weekly Skype calls (we are still mastering Skype ourselves) and all group members will be included in call so that anyone may join the call once it has started.  Audio sessions are played on the trainer’s computer and real time coding begins in Module 1 with the Behavior Counts and Global Ratings. 

                       

Trainer:

The trainer is Jacque Elder, PsyD.  She has been a member of MINT since 2000 when she went through her Train the New Trainer. She has extensive experience coding and providing MITI Coding Training for 7 years.  She is a Professor of Psychology at Dominican University, River Forest, Illinois.  She is a licensed therapist with clinical skills in Couple/family therapy, Eating Disorders and Family-Based Treatment, Substance Misuse, Moods Disorders, Treatment for Suicide Attempters and their Families.  She has trained many people in the MITI coding system and has coded hundreds of sessions for research projects and Feedback/Coaching.

Registration:

Registration can be completed on the Clinical Training Institute’s website at www.motivationalinterviewing.info. 

Click on “Enroll Now” for the MITI Coding Training.  Once you have submitted your Registration, you can pay for the Coding course via Pay Pal. 

The registration URL is http://www.motivationalinterviewing.info/enroll.html

Payment:

All payment is done via Pay Pal, which requires the learner to have a credit card.  If a learner needs to send a check instead, that is just fine.  The check must be received prior to the beginning of the course in order for the learner to access the Coding website.

Checks should be sent to:

Clinical Training Institute

313 Wesley

Oak Park, IL  60302 USA

Certificates of Completion are provided at the end of the course.

All learners must complete a Course Evaluation Survey in order to receive the Certificate of Completion.  Certificates are generally sent through electronic mail.

Questions:

Please contact Jacque Elder at jacelder@gmail.com.  That is the best way to contact me.  If needed, my cell is 708-717-8528 yet I am better at answering my email.  Sometimes, it is difficult for me to get to my phone.  Please use email and thank you!

MITI 3.1.1 Online Coding Training

Hello folks:  I have another online MITI 3.1.1 Coding Training coming up on 8/27/13.  All of the information that you might need is below.

Registration at www.motivationalinterviewing.info

Submit your Registration and then pay through Pay Pal.

Hope you can join us!

Jacque

Online MITI 3.1.1 Coding Training

August 27, 2013 through October 3, 2013

Jacque Elder, Psy.D. and Karen Grimley, LCSW

Cost:  $450.00

This online 6 week coding course is for those practitioners who have never or rarely used the MITI 3.1.1 Coding system.  All beginners are welcome, as well as those who would like to brush up on their coding skills.

Skype Calls:

The course includes 6 weekly Skype calls that are 90 minutes long.  Learners can attend one or the other or both.  One call is on Tuesday from 10:00 am to 11:30 am, Central Standard Time.  The other call is on Thursday from 6:00 pm to 7:30 pm.  The Tuesday call is for international learners though anyone in the course may join these calls.  All calls are recorded and then archived on the website so learners can download them and listen to them if they miss a call.

Dates of Skype Calls:

Tuesday 10 am, CST dates                                    Thursday 6:00 pm, CST dates

August 27, 2013                                                August 29, 2013

September 3, 2013                                                September 5, 2013

September 10, 2013                                                September 12, 2013

September 17, 2013                                                September 19, 2013

September 24, 2013                                                September 26, 2013

October 1, 2013                                                October 3, 2013

Alternative Dates:

We are aware that there are national and religious holidays that learners will want to participate in.  We will be mindful of this, and if needed, add another week (or call) onto the end of the course to make sure no one is excluded.                                                           

Trainers:

The trainers are Jacque Elder, Psy.D., and Karen Grimley, LCSW, both members of the MINT. Both have extensive experience coding and Jacque has been providing MITI Coding Training for 7 years. This is an interactive course with weekly face-to-face time via Skype.

Goal of Course:

The goal of the course is to learn the MITI 3.1.1 by focusing initially on the Global Ratings, then parsing/utterances/volleys and finally the Behavior Counts.  The course begins with short audios with transcripts and by Module 4; we are doing full pass coding in 5-minute increments and then the full 20-minute pass.  There are no transcripts used from Module 4 through Module 6 to increase the development of the "eagle ear" required to "hear" the Behavior Counts even in long volleys.

Most of the work is done on the learner's own time, and each will be provided with an online resource that is user-friendly.  On the site, there are 6 Modules representing the 6 weeks of the course.  Each Module contains PDFs, video on parsing, utterances, random start/end times, audio of training sessions that include transcripts (uncoded and coded) and other resources that may be used in Feedback and Coaching.  It is estimated that learners will work 3-4 hours per week on their own time in addition to the 90-minute weekly Skype calls.

How This Course Works:

Once registered and paid, the learner will be provided with a link to the website, a username and a password.  The learner will receive this information prior to the first Skype call scheduled.  We often provide it early so learners have a chance to look at site and downloaded printed materials.  It is expected that the learner will have read the MITI 3.1.1 Manual prior to the first Skype call.

Required for Course Learning:

·      Access to a computer with Internet.

·      Access to Skype either at work or home.

·      Computer with speakers and working microphone.

·      A printer to print out MITI Manual un-coded and coded transcripts.

·      A willingness to complete work done on own time so that learner is prepared for Skype call.

Participation:

The trainers will set up group weekly Skype calls (we are still mastering Skype ourselves) and all group members will be included in call so that anyone may join the call once it has started.  Audio sessions are played on the trainer’s computer and real time coding begins in Module 2 with the Global Ratings.  We review the Global Ratings in the Manual in Module 1.

Registration:

Registration can be completed on the Clinical Training Institute’s website at www.motivationalinterviewing.info.  Click on “Enroll Now” for the MITI Coding Training.  Once you have submitted your Registration, you can pay for the Coding course via Pay Pal.  The registration url is http://www.motivationalinterviewing.info/enroll.html

Payment:

All payment is done via Pay Pal, which requires the learner to have a credit card.  If a learner needs to send a check instead, that is just fine.  The check must be received prior to the beginning of the course in order for the learner to access the Coding website.

Checks should be sent to:

Clinical Training Institute

313 Wesley

Oak Park, IL  60302 USA

Continuing Education Units (CEUs) and Certificates of Completion:

30 CEUs are available at no additional cost.  They are provided for Licensed Clinical Social Workers and Licensed Clinical Professional Counselors through the Illinois Department of Professional Regulation.

All learners must complete a Course Evaluation Survey in order to receive the Certificate of Completion which has the CEUs noted on it.  The Certificates can be sent to the learner via electronic mail or US Mail or both.

Questions:

Please contact Jacque Elder at jacelder@gmail.com.  That is the best way to contact me.  If needed, my cell is 708-717-8528 yet I am better at answering my email.  Sometimes, it is difficult for me to get to my phone.  Please use email and thank you!

Compassion: How will we measure it in MI?

Hello folks:

I just am now getting through the 3rd Edition of Motivational Interviewing by Miller and Rollnick.  I feel like a lazy student.

I was excited to read that another new Global Rating has been added and that is Compassion.  I am curious to see how Moyers et al will develop a Likert scale as well as Verbal Anchors for this skill.  How is compassion measured?  How is it manifested?  Compassion furthers separates MI from most of the other counseling skills even though we are all helpers.

I find that I must examine my own motives for why I would want to be compassionate.  I used to think I was, as I was always involved in Social Justice issues, went out of my way to provide pro bono services in MI, and taking the time to mentor new MI practitioners.  Yet why was I doing it?  Was I doing it to look good to the rest of the world?  "Look at me!  Perhaps I should be canonized as a saint!"
In retrospect, I was wanting to be compassionate for all the wrong reasons.

For me, compassion is present when I have a willingness to help/assist in some way without people knowing that I have been compassionate.  Anonymity may be essential in some cases.  I read somewhere that the greatest way to share gifts is to give them anonymously and never know how the other person reacted.  To give gifts/assistance without expectation of being thanked or acknowledged is very hard for me.  To be giving in this way means that I will never feel the glow of "What a good person I am."  I like that glow.  Yet my motives are way, way off.

I agree with Bill and Steve that compassion is what brings us helpers into the helping profession.  And in looking back, I became a therapist because I wanted to "help people".  Yet what good is helping if the rest of world isn't around to tell you what a fabulous person you are.

Compassion also means never giving up on someone.  It is difficult to be around folks when they are suffering yet we do ourselves a great injustice by avoiding them and telling people "I am setting clear boundaries."  What boundaries surround suffering?  What boundaries surround folks wanting to make a behavior change and feeling helpless/hopeless about it?

I also believe that I have to be open and experience compassion before I can be that way with someone else.  I thought I was being compassionate.  I was self-righteous and self-absorbed.

I am perfect in my imperfections.  I strive to still maintain the "pathological optimism" that Bill Miller talks about and I am working on being "relentlessly compassionate".  This is the hard work.

Gosh, Motivational Interviewing changed my life...

It has been 13 years since I went through my Train the New Trainer in Quebec with Bill Miller, Terri Moyers and David Rosengren.  I look back on that experience as the most acute case of Impostor Anxiety I have ever had.  I had read the book, watched the 6 hour video and because of ordering that video set, I ended up on a mailing list from CASAA.  A brochure advertising the TNT came, and I thought "Well, I think I meet some of this criteria and if not, they will turn me down."

They did not turn me down and my Impostor Anxiety skyrocketed.  I sat in that training room for 3 days and not a minute went by when I did not think the MI Police were going to come in and bust me for impersonating an MI practitioner/trainer.  I was so quiet and scared in that training that Terri Moyers jokes that she doesn't think I was really there.  At this point in my life, folks must notice me and at that time, they did not.

Thank the Lord and pass the basket.  I am grateful to the MINT and most of all to all the very cool people I have met, been trained by or have trained.  I just got back from Manhattan, Kansas, where I did a one day "MI Booster" along with a MITI Coding Booster.  That group rocked.  For the first time in years, I did not use PowerPoint.  I admit that I am PPT Dependent.  Perhaps that will be in the DSM-V, if it ever comes out.

That freed me up professionally and personally.  I used to worry not only about whether I sounded like I knew what I was talking about but I would also worry about whether there were boogers in my nose or if everyone would judge me for having gained 30 pounds in the last year.  I guess I am not so important that folks focus on my body or my nose.  We talked about the recent changes in the MI world, as well as other interventions and research that is going on in the field of Behavior Change.  We did experiential stuff, watched YouTube and focused on skills acquisition.  You do not need PPT for acquiring and tweaking skills.  Can you imagine that?

Technology is great only when it works.  In the past 3 years, I have come to accept that I require human being contact.  I had been doing a great deal of teaching and training online, and had developed some skills along that line.  It just is not as fun as being with human beings.  I still offer online trainings, and right now am focusing on online MITI 3.1 Coding trainings as the demand for that is high right now.  I went through my MITI Coding training with Jen Manual Knapp several years ago with Glenn Hinds in Derry, Ireland.  I sensed that it would become more popular as it seemed as though it taught the MI alphabet so I could finally understand the MI "book" or technique/philosophy.  I wanted to learn it because I wanted to get better at MI.  I thought my Impostor Anxiety would go away completely yet that only happens when I don't let my ego get the better of me.  I have a friend who says "Keep your pedestal close to the ground so it won't hurt so much when you fall off."  Ouch and right.

I am so OK with being imperfect.  I only ask that if you do see a booger on my nose that you let me know.  I love people who tell me my zipper is down or there is a booger on my nose.  They are the bestest people.

Now, I am embarking on another chapter of a new skill acquisition.  This weekend, I will be going through the first of two weekend trainings of EMDR (Eye Movement Desensitization Reintegration) and I have not read the books yet.  I am going because I was a "naysayer" of EMDR for the last 15 years until I recently experienced 2 sessions of EMDR myself with a seasoned EMDR practitioner.  I still am unclear as to what happened in those sessions.  It reminded me of "Wakeful Dreaming" back in the day of Ericksonian hypnotherapy.

All I know is that EMDR helped me shift in a way that I could barely hope for, let alone predict that it would do me any good.  I just know that the useless stuff in my head seemed to go away.  I may be the only person who has a hamster running around on a wheel inside my head (especially at night) yet other people have told me they have hamsters, too.  I named mine "Jacque Hamster", and I learned to invite her to take a break from her very busy day and lay down to rest on a cool bed I made for her.  She sighs and goes to sleep, and so do I.

Talk about stream of consciousness.  Yikes.

I just bought the 3rd edition of the MI book and am looking forward to reading it though it will have to wait until after I read the two required EMDR books that must be completed in 6 days.  I better order them on Amazon.

I will be done teaching full time at Dominican University in May of this year, and am hoping to find another full time job.  I would love to teach/train/do clinical work and who knows where I will end up. I think I would be very good as a greeter at WalMart, and that may be where I end up.  All work is honorable.

Online MI and MITI coding trainings

Hello all:
Thanks to those of you who have responded and accepted my blogs invites!  I cannot believe it took me so long to figure those out.

Above is our website and we have 2 trainings coming up beginning next week, 2/13/12.  We may push back the start dates as I was soooo late getting the info out.

Online Intro to MI
2/13/12 until 3/25/12
$300.00

Online MITI 3.1 Coding Training
2/13/12 until 3/25/12
$300.00

If you know of anyone interested please pass the info along.  Mucho appreciated!

Jacque

Back on the radar screen

Greetings to everyone:

Though I have had this blog up a long while, I could not figure out why people didn't post back.  No wonder!  I neglected to send out into to folks that might want to respond.  I had to play around with this in order to figure it so please feel free to not respond or delete the invitation if you would like.  I have decline invitations as times myself.

I am teaching full time in the Psychology Department of Dominican University in River Forest, IL on for this Spring 2012 semester.  I will be done by mid-May 2012 and am allowing myself to enjoy the luxury of full time salary, benefits and the fantastic students and my faculty colleagues.  MI is not known within my department (perhaps a wee bit) and the department has fantastic research rooms, technology and every student takes 2 research courses for the undergraduate major.  There are computers everywhere with SPSS on them, and they all have to do some sort of research project during both courses.

I have around 500 cases of raw secondary data from all the coding and training I have done, with Baselines and end of training/course sessions as well that I finally will be able to load in. There are 4 Research Assistants there (and this is undergraduate!) with lots of free time.  I am blessed!

Had my left hip replacement on 12/13/12 and am moving around like a champ, though I am still on my cane.  Although I had planned to get lots of prep work done for my 4 courses I am teaching, I am exactly one day ahead of them.  I have taught 2 of them before (Intro and Abnormal) yet the other 2 courses (Child and Adolescent Psychology) are new ones. 

I am still doing a great deal of coding and online courses in MI and MITI Coding, yet the face to face training has dried up.  Everyone's has so that is no big surprise.
Regards to all!  Jacque

Back in the saddle again!

Hello world.  Just trying to catch up after a medical problem that put me in the hospital for over a week.  I am grateful to be alive and healthy.

I have been doing a great deal of coding for several research projects, as well as feedback/coaching for practitioners in healthcare, probation and mental health.  I begin teaching in the Marriage/Family Therapy program at Northwestern University, and the Family Institute has been so gracious to me.  Many thanks to Doug Breunlin and Bill Russell for continuing to be my cheerleaders.  I also begin teaching a similar course in the Community Counseling masters program at Argosy University in Schaumburg, IL and a big shout out to Dale S., my chairperson there.  And Dan Beach, Chair of the Psychology Department at Dominican University, you are the bomb, dude.  I truly am grateful for all of your support during this very trying last 18 months of my life.  I know that I am not only in writing (typing) that you all have continued to see something in me that has provided the optimism much needed, as well as the part time work.

Teaching these courses allows me to continue my own research in teaching Motivational Interviewing, as every student provides a baseline session of MI, receives feedback/coaching and then provides another session at the end of the course.  This has allowed me to see what differences, if any, we can see with or without Feedback/Coaching vs. just numeric feedback.  It is a tremendous amount of work on the part of the students, and I know what courage it takes to let someone hear and code one's own clinical work.  Bravery of this type is in short supply among practitioners and they are to be commended.

I love my students.

Jacque

Guided Imagery Audio to relax to by Jacque Elder and Scott Hughes

Here is a lovely relaxation audio that Scott Hughes and I created so please help yourself and feel free to share with anyone.  Here is the link and I believe you can download it for your own use.  Scott was feeling a wee bit tired so I said "Let's go do some meditation for you to help you rest."

This is the result, and Scott did the beautiful music.  My dog, Laura, is snoring in the background yet I don' t know that you can hear her little doggie sleeping sounds.

A College Education for Free? I love it!

I was reading The Economist Magazine when an article titled "How to make college cheaper" caught my eye, of course.  Having just read that tuition in the UK just skyrocketed and yet Germany decided to not make students pay any tuition in some parts of the country, this article was something I knew I had to read.

The University of the People is a free online university and the link is noted above.  It looks great.  I have applied to be volunteer faculty yet they already have 2,000 volunteers and only 1,000 students.  It is a global university, using the internet to offer free (minus a small admissions fee and some $ for teachers grading exams, etc) yet all in all, you can get a Bachelor's degree in Business, Economics or General Studies.

I hope they pick me.  I love people who do stuff like this.

Jacque

"Can't Get a Break"

This is a standard patient roleplaying the struggles of "trying to do the right thing" with a felony conviction blocking his way of becoming employed.

I hope you enjoy it.  The standard patient ( a good buddy of mine, paid and signed release) did a wonderful job, I thought.  He made the session so easy....

Jacque

Reading "Being Wrong" book

Last week, I finally finished the book Being Wrong,  which I highly recommend.  The book focuses on the "good" vs "not so good" things about how we make mistakes (assumptions) and how transparency about talking about our mistakes actually has the opposite effect that most people think.

For instance, the author has a chapter on all the lives that are lost in hospitals, due the medical error and the "thin blue(green) line" that is evoked when any practitioner makes a mistake because of the fear of legal liability.  She states that doctors and hospitals that acknowledge their mistake, and especially apologize to the patient and their family are sued 80% less than those who don't!  What a novel idea!  There is a beauty in transparency, as it speaks to our core values of honesty and integrity.  It is amazing what a simple apology can do in terms of impact upon the person to whom the harm has been done.

She also writes about using the language of uncertainty, which in MI is "asking permission" or using what a student of mine called "wiggle room".  "What, if any, ideas do you have about making this change if you decided to?"  "You will know if you are ready, and that is if you decide to do it at all."  "You are making a decision to not make a decision, and you know yourself best."  I have found that adding the "if any" is powerful.  For instance, "What are the not so good things about smoking cigarettes, if any?"  "What things have you done in the past to change this behavior, if any?"  That removal of certainty (expertness) opens up for collaboration and autonomy.  And we just cannot assume that they have done this things, or experience "not so good" things.

This is especially true in "Looking Backwards".  I cannot assume that folks have a positive experience that they can resource, and as a result, using the "if any" gives me my wiggle room.  As an Ericksonian hpnotherapist, Erickson was know for his strategic use of language, making sure that we start with the hypothesis that we do not have a crystal ball and cannot make assumptions about the patient's inner world or life experiences.  This is especially true with working with poor people.  They live in neighborhoods where it is not safe to go out and take a walk so pressing them to do so can be offensive.  They don't have money for fresh foods, and there has been a great deal of media attention on "food deserts", which are always located in disadvantaged neighborhoods.  I don't think they have a Whole Foods or Traders Joe's on the West Side or the Englewood neighborhoods of Chicago.  I haven't seen one so if someone knows of one, let me know.  And Oak Park does not count as the west side of Chicago.

Great book, easy to read and I learned a great deal about my willingness to "f**k up" as the author so succinctly puts it.  She wants it to be OK to do that, rather than hiding it and creating the constant "imposter anxiety" we all may experience either all the time or just some times.

Many thanks.  Jacque

Starting to use the MISC 1.1

I am finally taking the leap and trying out Lisa Hagen and Terri Moyer's MISC 1.1, which Lisa assures me is very easy to use!  I will be finding out today as I practice with it for the first time.  The MISC 1.1 codes for Change Talk and Sustain Talk, using full pass coding, only one has to code the entire session instead of a random 20 minute segment.
I am looking forward to using this, as the MITI only codes the practitioner, and the MISC 1.1 tracks the presence and absence of what is going on with the client.  This fits in well with Scott Miller's Feedback Informed Treatment, though his feedback (SRS: Session Rating Scale) gives much more specific feedback to the practitioner and is easy peasy.Registration for Advanced MITI 3.1 and MISC 1.1 Online Coding Training.

Harm Reduction in the Brickyard of Chicago - Greg Scott and Jacque Elder

click here to listen to show

This was a show on NPR that my friend, Greg Scott, a sociologist from De Paul, asked me to join in as the "addictions expert".  I know the host was expecting a Treatment As Usual (TAU) practioner yet that ain't gonna happen.  I met Greg through Chicago Recovery Alliance, the US's largest mobile needle exchange where I am a volunteer and Captain of their Chicago AIDS Foundation Team.

Never thought I would get to see the inside of WBEZ, and it was beautiful.  I loved our "experts", one woman and two men who lived in the Brickyard, a illegal homeless shantytown in Chicago.  It has since been bulldozed.

Greg has some great videos on You Tube so search for Sawbuck Productions and Greg Scott.  It is very graphic video of folks shooting up heroin yet the Change Talk as he talks to them is lovely.

Brickyard Residents and Drug Counselors Address Treatment Options

Brickyard Residents and Drug Counselors Address Treatment Options

Helping folks learn MI

It took me several years to find out what the mystery was about in learning MI.  I wish I could write that I do perfect or even really good work often yet I don't.  I like being in kindergarten, getting cookies and milk, and naps and recess!  So, I don't mind letting other people hear and code my work as I learn something every time I allow my work out there.

When I was at The Family Institute, we used to have to do "live sessions" and those are more vulnerable than taping an audio session with a client.  I made mistakes yet I watched my peers make mistakes as well, and it level the playing field.

I think Change Talk is becoming increasingly important, and I introduce early on in my trainings.  Learning what is sounds like, learning what Sustain Talk is and what to do with it.  If Change Talk is the jewel in the crown, I need to be polishing that jewel every chance I get.  Change Talk is language that indicates Desire, Ability, Reason or Need to change.  "I like my drinking and I ain't giving it up but those hangovers are killing me!"  Ding, ding, ding! "Tell me more about those hangovers. They don't sound fun at all."  First there is Identifying Change Talk, Eliciting it if need be, Reinforcing it with directive questions or a reflection (I tend to use questions), and then taking it some where.

I was telling my students at Argosy that we do want to create cognitive dissonance if they are in our office for some reason, and yet doing it gently and carefully is an acquired skill.  My own agenda sneaks out at times to this day, as (here is some Freud here), I have counter-transference.  With them all!  And some I like more than others.  Yet, I have this willingness to approach each one with an open mind, and what a lovely thing when they allow us to enter their word.  I am becoming more curious and adventurous in my personal life, and it is seeping into my clinical world, affecting my empathy so that I am listening more (duct tape over my mouth).

I am working with a couple that is considering splitting up, and I am grateful  for having experience with being both the dumper and dumpee.  The dumper has all the power and so extra loving-kindness is what I give to the dumpee.  There is just something about getting dumped that taps into every abandonment issue you have had since you popped out of your mom's uterus.  It taps into "Who will be my mommy?" or "My Daddy" or as Pema Chodron puts it "There is no babysitter."  What, no babysitter?  That sure burst my bubble, and working from that awareness now means I have a different perspective than I used to.  Things don't get better very quickly.  Getting sober is hard work and takes a long time.  Getting fit through exercise - long time, hard work!  If behavior change were easy, I wouldn't have a job.

So, Change Talk is the word for the day, and we have an advanced coding course coming up  this week and next where we are also going to try out the MISC 1.1, which codes...Change Talk!  I am excited about checking out the perspective of the client, especially with my training I am doing with Scott Miller on Feedback Outcome Treatment.  The MISC coding results may give us an idea of what the client is thinking about the session.  What a novel idea.

Does learning the MITI 3.1 Coding system increase practitioner skills?