Suzan
Bekolay"If I could live my 30 year dental career over again, I would make my mistakes sooner"
Focused On One Big Thing...
facilitating behaviour change
Providing training and coaching for dental practices in the behavioural arts; moving people from thinking about it to doing it, without strong arming, manipulating or selling.
A special offer by invitation only for dentists surrounding the Edmonton area.
Motivational Interviewing
To effect change, the model is to teach people, put something in to them, motivate them, convince or confront them. In contrast, Motivational Interviewing (MI)draws out a person’s own thinking and valuing.
A proven guiding communication style used by psychologists the world over, MI is aimed at both provoking change and moving people to action; making choices for treatment beyond remedial care and insurance limitations; owning responsibility for action while freeing every team member to be nothing but authentic; the real deal.
Aesop's fable of the wind and the sun illustrates the distinction of MI and points to the failure of many communication styles.
The wind and sun observing a traveller challenged
each other as to which of them could be most effective in having the
traveller remove his coat. (Change behaviour)
The wind blew (an outside-in approach). The traveller clung tightly to his coat. Try as he might, the more the wind gusted, the more steadfastly the traveller held to his coat.
The sun asked for his turn. Beaming brightly the traveller was quickly warmed (an inside-out approach) and removed his coat. (changed the behaviour).
Obviously, if neither the wind nor sun made effort, nothing would happen.
Many people think "I should" but they don't. It's a considerable challenge for dental practices where the "no pain - no problem" syndrome seems pandemic.
Surpassing Questions
Some
promote the use of questions. To continually formulate
questions is not only difficult, it risks
putting
people
on guard as the probing occurs. The
created "reactance" can take on many forms including false agreement
just to
stop the uncomfortable feelings associated with
interrogation. Symptoms of reactance can
include, silence, distraction with humour for example, aggression,
defensiveness, redirection such as will my insurance cover it, and some times the classic..."you're the
doctor (you tell me what to do)"; often with the caveat ..." and
I'll hold you accountable if my (non-verbalized) expectations are not met."
So much for partnership. It's a red flag not the "go ahead"
one might think. Questions should be simple
building blocks used in a matrix of completely different skills.
Overuse is common and often preclude people feeling understood and
that's the opposite of what we want. Questions can be a
manipulative, directive style that is teaching them to understand.
The requirement to formulate questions puts a lot of pressure on professionals by having to continually come up with the next "smart" question. Fearing or sensing reactance, anticipating misunderstanding or being unsure as to where to go next, the fall back for professionals is often to withdraw in silence to just wait and hope or to change directions; usually to teaching more. In the end, the status quo prevails.
Beyond EQ
EQ (The measuring of EI; Emotional Intelligence) has value and gained popularity. More than enhance the ability to follow emotions, which is appropriate with intense emotional experiences, MI goes further having concrete objectives; triggering change and moving people to action.
Why "Education" Fails
Although well intended, "education" often embodies negative future forecasts which risks the patient perceiving threat; thus feeling strong armed. By teaching; using "perfect" logic a person can feel painted in to a corner or exposed for poor choice; thus feeling manipulated and sometimes defensiveness becomes the coping mechanism. In both cases, resolve is strengthened to not change. Where much communication training is about "dealing" with objections, MI is a strategy that actually prevents objections.
The Spirit of MI
Ambivalence is a stage that precedes all change. It's normal. MI skills help people get
unstuck; to resolve ambivalence as they process thoughts and feelings. In a conversational guiding style, MI is evocative, collaborative and respects autonomy.
Will you choose efficiency over effectiveness?
Even though it seems ridiculous that knowledge alone does not change behaviour, what might be the explanation for sound preventive treatment recommendations sitting in file cabinets?
What if potential in the existing client base is only dormant?
Since people go more where they feel understood than where they are taught to understand, what can you imagine happening if patients felt profoundly understood?
Though it might seem unlikely, what if your entire team embraced the opportunity to help patients give serious consideration to best and finest services because they know how to interact without feeling the least bit pushy; remain authentic?