As mentioned previously, there is a growing body of research and clinical literature that suggests that MI is transferable across cultures (Miller and Rollnick, 2013). It may be valuable in working with other populations as long as the clinician keeps the person seeking consultation in the center of the conversation, is genuinely curious about and respectful of this person’s culture, way of understanding the problem, and strategies for solving the problem. MI seems to be a good fit, in particular, with Native American values and ways of interacting with people. In Native American Motivational Interviewing: Weaving Native American and Western Practices, Venner, Feldstein & Tafoya (2006) suggest that MI might be a useful counseling style in working with Native American people if:
- You are a good listener
- You honor and hold a deep respect for clients
- You are warm and caring with clients
- You feel comfortable acting as an equal with clients
- You believe it is important to be genuine
- You believe that the answers and motivations lie within the client
- You accept and expect that clients will disagree with you and challenge you
- You understand that making a decision to change is often difficult
- You know that the process of change does not usually go smoothly, and often includes relapse
- You appreciate how complex people’s lives and motivations can be
- You are sensitive to the clients’ verbal and nonverbal behavior and are willing to change your behavior to see if that will help the client
- You are willing to take responsibility for your part in decreasing or increasing a client’s movement toward change in their drinking (not all of the responsibility)
Some of the adaptions that might be useful in working with Native American people include, opening a session with a prayer, grounding the use of MI in a ceremony, and using metaphor more frequently (Venner, Feldstein & Tafoya , 2006). For example, instead of using numbers to describe the readiness, importance, and confidence rulers it might be useful to use the following metaphors for change that are consistent with the idea of planting a seed:
You are not ready to make a change.
You haven’t prepared the ground for planting.
You are unsure about making a change.
A seed is in the soil but hasn’t been watered.
You are ready to make changes.
Your plant just broke through the soil.
You are making changes.
Your plant is ready to be harvested.
Source: Venner, Feldstein & Tafoya, 2006, pp. 46–47
While it may be useful to have some understanding of a person’s cultural heritage (e.g. understanding the importance of metaphor and connection to the earth for Native American people), the most important thing you can do to integrate MI into a counseling style that is culturally sensitive is to keep to the Spirit of Motivational Interviewing and maintain a curious, respectful and mindful stance, always keeping the person seeking consultation in the center of the conversation.
MI is a collaborative and directive approach to helping people change health risk behaviors. It is an evidence-based counseling approach and style of communication that has been widely used with a variety of mental health, substance use, and health-related behaviors and can be adapted for use in a wide variety of settings including mental health, substance use and co-occurring treatment settings, educational and correctional settings, and primary healthcare settings. In Motivational Interviewing, the key to behavior change is helping people express their ambivalence about change, trusting in their own wisdom about change, and respecting their ability to make choices that are consistent with their values.
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