Using Motivational Interviewing to Support Families (Pt.5) - Having Difficult Conversations

Speaker 1: 0:20

Welcome to the Peapod.

Speaker 2: 0:35

Right then, welcome back to the Peapod, the partnership podcast from the Somerset Safeguarding Children Partnership, and once again, I'm in a bit of a privileged position today where I'm joined in the studio by not one but two people and also kind of veterans, I think. Now to the PE pod in relation to motivational interviewing, and I'm really pleased to welcome back with us today Jackie Webb, motivational interviewer trainer, and Sharon, who joined us in our last episode where we sort of talked about how we can actually put mi into practice and and gave a brilliant demonstration for us. So welcome back both of you. Thank you very much for joining me again. Thank you so. Um, great, I know it was great kind of listening back to the last episode we did and um with yourself, sharon, and kind of talking through it, and I think it really brought it alive. Um, just kind kind of a quick reflection on that how did you kind of find it afterwards in terms of what we kind of talked about? Because what you talked about was genuine, wasn't it?

Speaker 3: 1:31

Yes, yeah, yeah, yeah, it was a genuine thing. It was troubling me and I was a bit stuck with it. And it was really interesting because I did exactly what I said I would do. I went home, I planned out what I was going to do on what days I was going to do. I implemented that and started going with a plan. But then I had and I think because I did that through having that in my conversation and really kind of focusing that in my mind like this is what I want to do.

Speaker 3: 1:58

When I did it and I start, and like week after week it went by I then realised and reflected that actually this wasn't as important to me as I thought it was and it helped me to get to a place to be comfortable with saying maybe I could do less and that's OK, and when I do less I could just work harder, and so I've dropped down on my running and I'm just focusing more on kind of strength training and when I go into strength training I just work harder at it and I feel a lot better.

Speaker 3: 2:32

And it's really interesting because I think I was ambivalent. I was kind of like, oh, should I, shouldn't I, I don't know what to do and through that MI conversation I think I was thinking like I must do this. Like conversation, I think I I was thinking like I must do this, like that must be what I need to do. But that was probably an idealistic version of it and through having that conversation it helped me to test it out, try it and then realize it wasn't. It wasn't as important or as high up as I thought it might be yeah and helped me to shift really interesting, isn't it?

Speaker 2: 3:03

I think quite often when we're kind of looking at change I don't know what you think, jackie, but sometimes we kind of have that view or we talk about yeah, we get a plan in place and brilliant, that's what we're going to do. And then, when it doesn't come to fruition in the way that we've been talked about we'd hope for, sometimes that sort of can be seen as a bit of a failure.

Speaker 1: 3:19

Yeah, definitely. I think it's important to think about the focus being fluid and needing to be revisited, because what you did is you went away and you did what you said you were going to do, but, in the doing of that, realise that wasn't what you wanted, and then you kind of got on and did what you did want to do. So I think it's important to remember that with our, with our service users or whoever we're having conversations with, is that the focus can change for the person.

Speaker 2: 3:51

So, um, like with everything in in mi, it's always worth revisiting that um and not assuming that the focus is concrete it was really interesting and really interesting sort of hearing from yourself just now, sharon, that, as you did just, would you say it just just to have from that that recording we. The focus is concrete. It was really interesting and really interesting sort of hearing from yourself just now, sharon, that, as you did just, would you say it just just to have from that recording we did last time just allowed you that that sort of space to kind of reflect, I guess, a bit more and really kind of pick it apart in your head, both part of the conversation and afterwards.

Speaker 3: 4:19

Yeah, I think there's we.

Speaker 3: 4:20

I think there's we've said it before, but there's so much power in somebody giving you that space, I guess, to, like you say, unpick it.

Speaker 3: 4:33

But there's also so much power in my thoughts being turned into a voice that I then hear, because that helps me to then break it down and process. And, and I don't know, this might sound a bit too dramatic, but that MI conversation kind of lived on in my mind and I kept going back and thinking about it. So when I was doing my plan, I was like this is what I said I wanted to do, am I really like, is this right? Is this what I really want to be doing? And so I was trying to almost refocus my own thinking about that, about that and um, and I now feel at a place where, um, because it might be, some people might think that that conversation could be a failure, because I tried the plan and it didn't work. But actually for me I feel like I've won or it's a success, because I now have a plan that is right for me and that I feel happy with and I'm not, I'm not fighting with anymore this is the right one for me right now.

Speaker 1: 5:28

So and just picking up on something you said there really usefully, sharon um is very often we talk about trusting the process of MI and that often the change, uh, or the the conversation continues for the person afterwards, not necessarily in the moment. So you don't necessarily get someone to say I'm going to whatever it is, do it this weekend or whatever. I mean it's nice when that happens, but it doesn't mean that the change won't occur, because you described really eloquently there that the conversation continues in the person's head without anything to push against, because there's no suggestions from the helper to push against. There's nothing. It's all you've got is your own thoughts in your head and you can MR yourself.

Speaker 2: 6:18

I think just to kind of a bit of a disclosure, I think. But I think this is really interesting. But for those of you who listened to the last episode when we were doing the recording, what we didn't keep in the episode in the end was that there actually was one point relatively early on in the conversation where actually Jackie asked us to pause for a second and you just wanted to check in with Sharon around. Actually, is this something you know, that you're kind of looking to change, Because I think you picked up Jackie early?

Speaker 1: 6:47

on. There was something I thought there was a lack of clarity with the focus, whether or not. It was that you wanted to get back to your training, or whether you wanted to have a think about if you wanted to change the way you were exercising and and I again I kind of reflected on that and that was really interesting because I think you spotted something in me that perhaps I hadn't quite seen myself.

Speaker 3: 7:13

And then I kind of pondered on that but I went ahead with the plan because I had that in my mind. I'm going to give it a try. But then I kept going back thinking is this what I want? Am I clear about this? And it just gave me the space to think about it.

Speaker 2: 7:26

Well, we're gonna have a little, a little bit of a shift today and um, I think we're quite keen to pick up on on something that comes up quite often when we're talking about MI, and so far in the episodes we've talked about um, using motivational interviewing to support a change process. Yeah, all right. And I think one thing we're quite keen to look at is sometimes people say, well, that's fine, but sometimes you have to deliver messages, sometimes you have to say this is the way it is and that feels quite sort of, in a way, contradictory to what we've been talking about so far in relation to MI, but I know from conversations we've had actually it can very much complement using MI in those kind of situations. Is that fair?

Speaker 1: 8:11

Yeah, absolutely, and I know that Steve Rolnick would say one of the authors of MI that you know MI was born out of really difficult conversations. Actually, that's where it got its evidence base is working with people who didn't want to be there, who'd been made to come. So I suppose it's got that in its heritage. But I think first of all, it'd be worth thinking about what do we mean by difficult conversations? What are we speaking about here?

Speaker 2: 8:40

Because I just want to draw the distinction between difficult conversations, say, when there are risks or sensitive issues that we need to raise with people, as opposed to where we're getting frustrated with the person.

Speaker 2: 9:04

There's training, that's kind of around. You know, courageous conversations, this kind of thing, where actually I think you're right, quite often it's seen as actually these are challenging conversations because I'm finding them challenging, as opposed to like, say, actually we need to have a conversation about quite a difficult topic, you know, and like you say it's fine saying, okay, we need to kind of work to initiate change. But actually if you're in a situation there and then where actually somebody, just, for an example, poses a risk to a child and actually you have to say, for example, this person cannot be in this household, You're not kind of working as part of a change process to say, well, let's talk about this. And you're not kind of working as part of a change process to say, well, let's talk about this. And you know, look at that how we support that change, sometimes you have to say, no, we need to absolutely.

Speaker 1: 9:51

This has to be a bottom line.

Speaker 2: 9:53

Yeah yeah, so do you want to? Do you want to kind of pick that apart then for a second, in terms of sort of what you see, um, in terms of those distinctions around those, those kind of difficult conversations, yeah, definitely, and, sharon, please do chip in at any time.

Speaker 1: 10:08

So I suppose one of the starting points for this is thinking about different helping styles. So when I teach motivational interviewing, I talk about the difference between MI as a guiding style and other helping styles such as following, which is your kind of person-centred kind of way of working with people, and directing, which is more of a you need to do this, this and this, and then that will happen. So MI sits in this sort of middle ground we call guiding mostly when you're talking about change. That's exactly what you're doing, but at different points depending on what your job is. It's absolutely fine and you have to be able to step from one side or the other, depending on what's happening.

Speaker 1: 10:55

So just to take the following, for example sometimes you know if you go on a visit and someone's just had a bereavement, you might need to listen for a bit and you know shift your change agenda. That would be appropriate and you, being flexible in your response, you're not going to say, oh dear, that's a shame, have you got your drink diary? You're not. You know that's not going to happen. Equally, and especially in social work and other jobs where risks are discussed frequently, sometimes we need to be more directive in our approach. So it's thinking about how we maybe start from a point. If you're thinking about practising motivational interviewing, with your feet firmly planted in guiding but being ready to step from one side or the other depending on what's needed in your job, and if you've got a difficult thing you need to talk about, then you need to sometimes step to that side.

Speaker 2: 11:54

Um, and you know, use your authority appropriately I'm just um, actually sharing, if I can just come to you for a minute, because I remember from from last episode when we talked, part of your role is about supporting new social workers and I think would it be fair to say, quite often, people who come into a profession, whether that's social work or any other profession. When you are looking to support people, we can have that view of actually I'm here because I want to support, I want to help. We can have that view of actually I'm here because I want to support, I want to help. Do you see?

Speaker 3: 12:34

that sometimes of that sort of creating a challenge, then sometimes where you have to, yes, you can have that supportive role, but also there are times where you have to be directive. Yeah, and I think it's something that's often spoken about and it's not just about so. You might have a relationship with a family where you're going in and you want to be kind and supportive and help, but then you might have that internal conflict of but I'm also an arm of the state. You know I might have to come in and say this isn't acceptable, this is a risk to the child. That's too much and I need to do something that makes me have to act in an authoritative way.

Speaker 3: 13:06

There's that component, but there's also kind of working within a multi-agency system. There are times where you might be working with families and you are guiding and following and helping and supporting, and other agencies may have a view that you, as a social worker, are the lead professional and you need to be taking more of an authoritative stance and should be doing a, b and c. So I think there's a definite um conflict there and and it's something that is talked about all the time, particularly in reflective supervisions about how that impacts you as a person and what you might say in return to kind of difficult and challenging conversations and how it makes you feel and how that might align with your values and your ethics and also carrying out the job of a social worker.

Speaker 2: 13:57

Yeah, and I'm just, as we're talking, kind of reflecting on my own practice now. I think when I first sort of came into working with with children, young people to start off with, and then in families, I think, if I'm honest, I did have that slightly idealistic view that I can come in and people are like oh Steve, you know Steve's great he's always so much better than all those others I've had before.

Speaker 2: 14:18

And you know, actually we really listen to him and but and I know I think as a result of that, on those, those occasions where early on I suddenly realized actually I've got to play different roles- yeah um, and, and, if I'm honest, I, early on, I think I probably found that quite difficult because I don't like to be the one that they go. Oh, he's. He said this at the other and I don't like him.

Speaker 1: 14:44

Yeah, I think that's a really human response, isn't it? That as human beings, we don't want people to dislike us. So it's something all social workers and other professionals have to bear in mind and, kind of right from the outset, being transparent with the people that we're working with about our jobs and that sometimes that is about helping them directly and they probably will, or hopefully will, appreciate that, and at other times you're going to have to focus on risks and that may not be as comfortable, and you still want to be able to have that dialogue yeah you know whether you know with both the hats on?

Speaker 2: 15:27

And I think there's a risk, isn't there, that we can end up avoiding those conversations?

Speaker 1: 15:31

Yeah.

Speaker 2: 15:32

Because it doesn't feel comfortable for us, or you know we don't want to make a potentially already slightly difficult situation even more difficult.

Speaker 1: 15:41

And I think we need to be clear that no one enjoys those conversations. Well, I don't think many people do, yeah, but it's something that is part of what we do, as much as helping people.

Speaker 3: 15:55

And I think there's something about so, when social workers first qualify, they wouldn't be allocated any families that are kind of more complex within child protection or within the court arena.

Speaker 3: 16:06

That would come probably six months after they've qualified. At least that would be the aspiration anyway, and I think so then, for newly qualified social workers and for anybody who might work outside of children's social care. We are working under the guise of with parental consent. So I think that also comes into it because sometimes, as you say, you might be new into your role and you want to build those relationships and you want to help people, but you also know they might say, actually I'm done, I don't want to work with you anymore. I don't, I don't, I don't want to hear what it is you've got to say, so go away. And then you might feel like, oh, I've not done my job and I failed a bit and and I feel like I could have done more, maybe I could have done it differently. So I think you might steer away from those more challenging, difficult conversations because you're wanting to try and keep that thread of a relationship and not really say the elephant in the room that could be glaring everybody in the face.

Speaker 1: 17:08

But everybody knows that it's there. And I think quite often when we employ an MI approach to these conversations, which I'll kind of outline in a moment we find out that oftentimes the person knows exactly what you want to say yeah you know and um yeah.

Speaker 1: 17:29

so I think the framework that really helps me think about difficult conversations and it does need adjusting a bit for difficult conversations is the way that we exchange information, so it's called information exchange. People listening might know person as the expert as the starting point, but it allows us to offer our own opinion or expertise as well.

Speaker 1: 18:04

So it sort of ticks boxes for me. So the first part of that would be so, say I needed to raise a difficult subject with somebody, let's say about the impact their drinking's having on their children, and up to now we've been having conversations about it but they're not really getting it. And you know, I feel like I need to have a bit more of a straight conversation. They don't think it's having an impact, say. So I might start off by with the first illicit or ask being. You know, just wanted to ask you what your thoughts were about the impact of your drinking on the children. What do you think? So I'm not going in there straight away which tends to get people's backs up with giving them being the expert and telling it allows the person to sort of explore, and sometimes doing that, you find you don't need to do your bit, depending on the person, because you can then sort of you start to hear maybe a little bit of well, I, I know I do need to cut down. Okay, you know, you've got a little bit of change. Talk there, you might be able. You know you don't necessarily always have to do the next bit. But let's say, say the person is saying it's not an issue. They're always in bed when I drink. They never see it. They're not impacted at all and you know they're pretty much always late for school because the person's hung over in the morning. They're not getting their homework done. You know there's lots of issues perhaps that the person is not being open about. So that's really when the next part is provide.

Speaker 1: 19:40

Now, the slight difference here is you wouldn't necessarily do the provide with permission, which you might do if you're just. You know, normally I'd say is it okay if I give you my take on that? Now, if I have to give this information, I don't want to run the risk of the person saying I don't want to hear it, do I? Because that leaves me stuck. But you can honour autonomy, so you can say so. First of all, it's really important to listen and reflect with complete acceptance what the person has said. When you've elicited, what do they think about? So not jumping in and starting to correct and say, well, I think differently, but really listen, okay. So you're feeling that you know your drinking's absolutely fine and the kids aren't affected at all, and so you're reflecting that back with no judgment. So the next part is um, um, I need to give you my opinion about what I think might be going on, and then I'd be really keen to know what you think of what I'm going to tell you. Right.

Speaker 1: 20:40

So then, you're honouring that autonomy by saying and I want to know what you think rather than just my words, better than your words, sort of. Thing. So then you give your opinion or express your concern and then immediately it's back to the person. What do you think? What do you think of what I've said? So you don't know what they're going to say and it's probably not going to be very nice, but the idea is to keep the dialogue going, is there?

Speaker 2: 21:08

a risk of, within that sort of process of that elicit-provide-elicit? Is there a risk within that of if it's not done correctly, sort of process of that illicit by illicit? Is there a risk within that of, if it's not done correctly, sort of setting up a situation to fail? I'm guessing what I'm thinking of is, you know, if you say to somebody, oh so you know, tell me how do you feel your drinking is going at the moment, and somebody's saying, oh, yeah, it's all fine and yeah, it's fine, the kids aren't affected, and you're you're, you then sort of say, yeah, well, actually, yeah, no, it's not, yeah you don't want to be disingenuous, so it's um, yeah, you, that could be a bit of a trap, couldn't it?

Speaker 1: 21:42

because it could make them feel you were setting me up there because you knew all along. Yeah, yeah, so it does need to be handled quite carefully so that you're um with the example I gave. Probably that would be all right, because you aren't. You're kind of being clear. What do you think the impact of your drinking is on the kids, rather than saying something like so the trap might be, um, so how do you think johnny's getting on at school?

Speaker 1: 22:11

right and you know, and they start saying you know, oh yeah, it's fine, yeah, he's getting on really well with his new teacher. Well, I've heard that's what I'm thinking yeah, I know it's a subtlety, but it's a bit different, isn't it? Yeah, so they're quite an important one, I think so yeah and again, like we said, in all these episodes, it's it.

Speaker 2: 22:31

on the surface things seem quite straightforward in terms of mi, but actually there's quite a lot of skill involved with it, and that's not to put people off, but it's to be aware of it, I think.

Speaker 3: 22:40

And I think that that would come in amongst a lot of other things that would have gone before that.

Speaker 1: 22:47

It doesn't just come out of nowhere.

Speaker 3: 22:49

So you would have already had quite a lot of conversations with that family, I would imagine, I would hope, and you would already have probably a plan or something along those lines and you would have that relationship to be able to then revisit. I guess, to think like, let's just kind of get together, and so what is it that you're thinking, what is it that you know right now? And this is what I'm thinking, and this is what I think I know right now, and what do you now think of that?

Speaker 2: 23:18

yeah, I'm sure there are times in in your career and your work you know, on a daily basis sometimes, where you're having to deliver some, some quite difficult messages. So, as opposed to kind of looking at change, actually you're having to say, yeah, I'm gonna, yeah, I need to be directive here, I need to give a message. So, for example, you know, if you're in a situation where you're having to talk to a parent, say, actually we're gonna have to start looking at proceedings of potentially removing your child, which is a really hard message I imagine to have to give, and how how do you kind of find that you use MI in that sort of situation?

Speaker 3: 23:55

Very similar to what Jackie was explaining. Really, I think I might have talked about this in the previous podcast but I had worked specifically with a mum who actually was having difficulties with alcohol and we've been working together for quite a while and we had a very transparent relationship. We had all of the kind of spirit of MI and we were working really well together. But that you know the nature of substance misuse. You know it's not a smooth kind of trajectory is it?

Speaker 3: 24:22

And there are bumps along the way, and I think one particular bump was alcohol use had really increased and that meant that mum wasn't able to safely care for her baby anymore and her baby needed to go to another family member.

Speaker 3: 24:41

While we initiated proceedings, and and also, if you were, if to kind of put you in the context of that, this mum was really poorly and she was drinking a lot of alcohol. So to have that conversation with someone when they are that poorly and under the influence made things even more harder. Um, but because we had the backdrop of this relationship where we she knew that I would be straight with her, she knew that I would really value and listen to what she said to me, she would know that if she was able to say do you know, sharon, I need it to be like X, y and Z for me to get there that I would do all that I could to make that happen, because I knew that that would be the best possible chance of that actually happening. So when we had to have that conversation of saying you know, mum was able to say I know I'm not in a good way.

Speaker 2: 25:38

Right.

Speaker 3: 25:38

And I know that I need some help. And then I was able to say I completely agree. And I think, from my side of things, whilst you go and get that help, the only way that we can see moving forward is if your child isn't in your care right now, and that's really hard. I can't even begin to imagine how that feels. But I have to be honest with you and tell you where I'm coming from, and then you know, the conversation carries on and and even I used MI about.

Speaker 3: 26:14

Well, about a month or so ago, and that was in a really difficult situation in A&E, having to do a separation between a mum and a baby, a newly born baby, and everybody was kind of skirting around the issue.

Speaker 3: 26:28

There were police there, it was all really tense and nobody again. The elephant was in the room and I had never met this mum before, so I didn't have the relationship to fall back on. But actually she looked up and said so what's the plan then? What's everybody going to do? She wanted to know, she wanted to know, and so, without knowing this mum, I was just able to say I can't tell you what's going to happen all the way down the road, but what I can tell you right now is that you're not going to be able to take your baby home, and I can't again begin to imagine what that's like, but I hear that you need to know that yeah, and I know it's going to be my next question because I think I can I can completely understand, actually, if you've laid the foundations of the relationship as you're talking about in the first example.

Speaker 2: 27:19

There then actually I was going to say an easy process. I don't mean it, yeah, and it wouldn't be easy, I'm sure. But actually there are the foundations there where there is an understanding, there's a relationship where you can have that kind of um, you can have those directive conversations, but have that understanding as part of that conversation, whereas actually, if you're, if you've never met somebody, if you don't have those foundations of that relationship kind of yeah, whether you could still use it. So you know there's something something nice examples, aren't they?

Speaker 1: 27:47

so two very different examples and, like the importance of the transparency and thinking about the basis for this relationship with the first example and, like you said, this isn't something just to whip out you know there's a context for the MI with that relationship with the first one and, at the same time, the second conversation. You had to get that relationship as such, as it was really quickly, yeah, and the honesty was important and so was the empathy.

Speaker 3: 28:24

Yeah, and I don't know if this is MI or not, but I really felt a need to completely, kind of fully give myself to that mum in the hospital. She needed to see me and feel me and I couldn't shirk away from it in any moment because she was terrified and she just needed to know. And I, you know. So, like everything about MI, sits really comfortably with those conversations, because you have to be completely and utterly genuine.

Speaker 3: 28:55

And you know, those police officers were there because they thought it was going to be a really, really difficult situation and actually what happened was that she went quiet for a minute and she said that's not going to happen. Again, I kind of emphasised with that, reiterated the position of what needed to happen. Um, again, I kind of empathized with that, reiterated the position of what needed to happen and she she, I can't say accepted it, but she, she was processing it, she was processing it and actually there was no, there was no kind of drama, there was nothing went wrong. It went as smoothly as these awful things can do, and I think that was in part because she needed that clarity of like, this is what's going to have to happen right now.

Speaker 1: 29:42

She also needed that care from you didn't she? Yeah, and as you were talking, it really struck me that you were um, really in the moment, really focused.

Speaker 2: 29:53

Yes, and you can see, like in that conversation, actually if you hadn't approached it in the way that you did, potentially could have gone very pear-shaped very quickly, oh yeah. And I'm just thinking, you know, when she said, well, that's not going to happen, actually you could have an instant response saying, well, it is. Yeah. Sorry but it is, and this is what we're going to have to do and we're going to have to, you know, and suddenly things erupting very quickly.

Speaker 1: 30:20

So that actually plays in very nicely with something I was going to hope we would talk about in terms of difficult conversations is how we respond to discord. So that's something used to be called resistance but now called discord in MI.

Speaker 2: 30:34

I think you talked about that in the first episode A little bit. Yeah, you talked about rolling with resistance and how that's not really used to.

Speaker 1: 30:39

Yeah, the terminology now is dancing with discord, but if rolling with resistance sort of fits for people, it's the same thing. But it's that sense of having to almost bypass our natural instinct to defend ourselves or our decisions or our agency or whatever, which is exactly what you did there, sharon. You didn't get, didn't do. What you would be tempting to do is to reiterate your own position, and instead it's rolling with going, with leaning into the person's position, whatever that might be. It's like that's really upsetting for you. You don't want your baby removed or whatever. It is. So acknowledging that you're, which is different to saying I understand, because with the best will in the world you don't. No one could understand what that would be like. But it's empathy, isn't it? It's really coming alongside and also still being clear.

Speaker 2: 31:44

She didn't think you're colluding with her when you were empathic yeah, I think it is really tempting that just like, say, reinforcing your own position, and go well, actually I've already told you how it is, so I'm just going to kind of reinforce that a bit more and then you've got these barriers, so it's so, it's still so, you still kind of it's still about a journey. Is that? Would that be the right you know into, even when you're delivering some quite difficult messages? And from the examples you gave, even though it was very directive, it was, you know, it is the way it was, but actually as part of that there was still that relationship in it, even though you'd never met this lady before.

Speaker 3: 32:20

Yeah. So the spirit of MI is always with you, I think. So all of those components still remained with me. And I guess another point I'd maybe share is everything within me wanted to go at 100 miles an hour. I just wanted it over and done with, because it was a horrible thing. I knew that we were going to have to do this thing. Everyone was kind of waiting for that moment. And so inside, if I'd have just gone with my natural self, I probably wanted to have got it out of my body as fast as I possibly could. But actually thinking about how I needed to be, I needed to be slow, I needed to be calm. How I needed to be, I needed to be slow, I needed to be calm and I needed to really sit with how.

Speaker 2: 33:04

That mum was right in that moment, because you can't rush something like that in the example that you gave there and you talked a moment ago, jackie, about a kind of that, that process of illicit provide, elicit, and, would you say, in order for this to work, you always have to kind of stick to a kind of solid formula no, definitely not.

Speaker 1: 33:25

I mean that that's the framework I sort of have in my thinking, and then you would adjust it to every conversation. So no, nothing about MI is rigid so you have to be instinctual, because it would just have been weird for sharon to ask that woman what she thought you know, wouldn't it?

Speaker 3: 33:46

you know, the woman would have probably, yeah, been not very happy with that question, and it would have been disingenuous and really insensitive, I think, in that moment, because, because it was obvious that we were in a really tricky, difficult, horrible place, and to then ask that mum to kind of share with me how she was thinking and what she might think needed to happen next, I just think would have been a painful thing to have asked.

Speaker 1: 34:14

Oh, definitely, yeah, insensitive. And that can apply to lots of conversations where you think actually I don't need to elicit first. You know, I'm just thinking back to conversations I might have had where I might have said I need to talk to you about that police report last night. You know that might be your starting point, but then of course the person might not be very happy and then you have to go into that, responding to the discord and getting alongside again to keep the conversation going. So we're still keeping the direction and the conversation going, hopefully. I mean that's what you want. It's still not necessarily going to feel like the person's not going to thank you, are they?

Speaker 2: 34:57

No.

Speaker 1: 34:57

No, but at least you might keep the dialogue going and you've got more chance of coming to some sort of resolution.

Speaker 2: 35:07

If you can do that, I think yeah, and again, I'm just going back to the example that you gave, I think, just recognizing that that's not the end of the journey. No, although it was a very difficult situation actually, probably for that mum, for that child, that was the start of the journey, because this isn't going to be just your child's removed, that's it. That's the end of it. Actually, that's the start of quite possibly a long process of support put in place, because ultimately, the aim would be, wherever possible, to reunite. Yes.

Speaker 3: 35:39

And I think you're always mindful of that, no matter what role you work in. You're setting a tone, aren't you really? And how are we going to be with each other? What are we going to give to each other? How are we going to respect each other? How are we going to navigate the bumps in the road? Because, as I said, said earlier, there's always going to be them. You know, we, we work. We work when there's a difficulty, when there's a challenge, when there's a change to be made, and and that doesn't come easily if it did, we'd all be out of jobs. So, um, how are we gonna, yeah, how are we going to navigate that together?

Speaker 2: 36:13

it's interesting because often we sort of talked about avoiding conversations and I think I've lost count of how many children or young people or parents have said to me look, I just want people to be straight with me yeah and yet that's the thing that quite often we try and avoid, isn't it?

Speaker 2: 36:30

and I think, um, again, I've slightly lost count of how many people have said to me well, I didn't, I didn't want to say that to them because actually we've got a really good relationship and I didn't want to break that relationship down, whereas actually that's converse to what people are telling us and how we would want to be treated. I certainly say for myself. Actually I would want somebody to be straight to me and I don't know, have you got any advice around that?

Speaker 1: 36:55

No, and I think it's also remembering that these are professional relationships and I think one of the things I talk about in MI training is the distinction between rapport and listening. So in MI we don't do this sort of building rapport in the same way as perhaps you might if you're making a friend, and I think that's the difference is, you know, some people sort of struggle with that. So if I say to somebody so you don't need to find a mutual topic you can talk about, you know, like the weather or what you watched on TV last night or a football game, in order to build a relationship, so you're building rapport, you are the relationship, but by listening. So I always sort of say you know, yeah, I might still, you know, from the walk, from you know the waiting room to the office or whatever, I might have a bit of chit chat with somebody Once I'm in the office.

Speaker 1: 37:56

Now it's I'm listening, and when I mean listening I don't mean just always listening. I might be asking questions or whatever, but it's like that people respond and they kind of know where they stand with you because you're not behaving like a friend. So I think I've rambled a bit, but it's that distinction between I'm not your friend. I can be friendly and kind and compassionate, but we know where we stand. And.

Speaker 1: 38:24

I wonder if sometimes we get a little bit confused about we know how to build a relationship with a friend. How do we build a relationship with a parent at the school or a service user?

Speaker 3: 38:37

I was just going to add to that.

Speaker 3: 38:38

Quite often I will have a conversation with newly qualified social workers around boundaries and kind of our professional selves and how we need to be, I guess, with others.

Speaker 3: 38:49

And quite often when newly qualified social workers and others are allocated to families, they'll find it really hard to close because they've built this relationship and they've been on this journey and actually they feel like they're almost part of the family because they've done so much work together that they almost don't want to leave them. And we'll kind of in supervisions, we'll have discussions around remembering the places that we, the positions in which we hold. So if you asked lots of families, I imagine if you kind of did a straw poll, they might say I don't want a social worker in my life, I don't want to have a pastoral worker from school allocated to my child, I don't want to have an attendance officer. You could have the best relationship, the best professional relationship with that family and you might feel that you're getting on really really well and they'll be really bereft when you leave. But ultimately this family do not want, I would imagine, professional services to be involved with them forever.

Speaker 1: 39:58

I think also, there's probably something a bit wrong if they do Well.

Speaker 2: 40:03

I was going to say that, yeah.

Speaker 1: 40:05

One of the things that I really like about MI is I always say to people don't expect thanks, don't expect cards, because the part and that is you take your ego out of it, because it's not about you being clever, it's about like you, like Sharon last time being left thinking, but you weren't thinking, wasn't Jackie marvellous? You were thinking about yourself.

Speaker 3: 40:29

I did think that Well, yeah, of course.

Speaker 1: 40:31

But you know you shouldn't. And often what the thanks you get is when someone says to you I don't need you anymore, I know what I'm doing and that's, in a way, what I want to hear. So if I was supervising a new social worker, I wouldn't want to hear I can't close this family because they still need me. It would be they don't need me. Isn't that great?

Speaker 3: 40:55

and I think it's just making sure or just allowing for that conversation, that exploration, to be had within supervisions or whatever kind of position you hold, whichever agency. It's about understanding the role in which we sit and and actually we've got a job to do and we need to do our job, and that is quite often just to provide a space for people to voice what it is they really want to be happening and to empower them in their own lives rather than to feel dependent on services.

Speaker 2: 41:27

With anybody sort of going in to a conversation where you know that this is going to take place. I know I need to go three o'clock this afternoon. I'm going to have to go out and see this family and I'm going to have to have this conversation. Have either of you got any sort of tips around that, and is it useful to kind of you know, sort of go over what you need to say, kind of almost pre-rehearse it? Or is that not helpful because you're then kind of going in with prejudgments, or if you could kind of give any top tips to anybody, I think?

Speaker 1: 41:55

probably it would be similar for any MI conversation is to set your intention, is to think about you. Know what it is you're going to do. Take a few deep breaths, slow down. You were talking about slow down. Remind yourself to listen, and you know all those things that you, for any MI conversation I think, would probably help you to, and you know you talked about slowing down and I think that's so important, isn't?

Speaker 3: 42:29

it earlier on in my career. I would really be quite nervous driving to a home visit, thinking, oh my goodness me, I'm going to have to tell them this and I wonder how they're going to be about that and I wonder if they're going to be cross with me. So all of those things would go through my mind and I might actually say out loud what I think I want to say, because it would help me process in my mind what that sounds like, how that lands. Is that all right? Is that not all right? I'd be thinking about my last visit and had I done everything that I needed to do? Was there anything that I needed to pick up? So I'd be thinking about all of that stuff.

Speaker 3: 43:03

But quite often I would then get into the home or wherever it was that I was due to meet with the family. And I'll still be like that now. And there's something for me about, as Jackie said, having your intentions. About, as Jackie said, having your intentions, so knowing what you need to definitely cover, but also allowing and giving permission to that space to evolve, without me having too much of an agenda or a sway on it, really, because actually I need to allow a lot of that conversation to come from the people that I'm there to listen to.

Speaker 2: 43:36

It shouldn't just be about what I need to say yeah, you can't predict what they're going to say and if you do try and predict it too much and it doesn't go that way, then it will throw you because it's not the narrative you've got in your head.

Speaker 3: 43:47

Yeah, and how many times? Maybe it's just me, but how many times have you been anticipating how a conversation is going to go and you'll be like, oh, my goodness me, it's going to be awful, like what we're talking about. In the hospital there there was a lot of police officers.

Speaker 3: 44:02

It was okay it was fine, you know as fine as it could be. And then there could be other times when you think, oh yeah, this is just going to be a light-hearted conversation about x, y and z and it could really escalate. So you, you can't ever really tell, can predict.

Speaker 1: 44:15

No Long time ago, when I was a probation officer, I remember I thought, oh no, I've got to have a really difficult conversation because the person on probation had disclosed something about his wife's mental health that meant that she was a risk to their baby, and I knew that I needed to do something about that, and so I needed to tell him that I needed to make a referral, etc. And I thought, oh no, it's all going to be awful, he's going to kick off. He had violent offences on his record and he was relieved.

Speaker 3: 44:51

So you never know, do you? That was something I was going to say actually about when we talk about relationships and maybe not wanting to say the elephant in the room or having that challenging conversation Quite often. So I used to work in a school previously and I used to be a parent and family support advisor and I would have a lot of adolescents come to me to talk about lots of different things, and very often when they would come and tell me something that was worrying them, they'd say Sharon, please don't tell anybody, don't break my confidence, I don't want anybody else to know this. And what I very quickly worked out was that they came to tell me that because actually they needed me to help do something about it, and so there's something in my mind that I always hold on to when people offer this information to you, even if they say I don't want you to do anything with it, the very fact they've told you probably means they do want you to do something with it and they're worried about the consequences.

Speaker 1: 45:49

Yeah, yeah, the thing is I think we talk. Somebody recently on one of the one day courses said to me that they wanted tips and tricks. Somebody recently on one of the one-day courses said to me that they wanted tips and tricks. Okay, MI isn't a tip or a trick, so we're sort of giving some little bits to think about here on these podcasts. But I think you know, when you start learning and practicing MI, it's a journey for each individual and you can learn the sort of principles about it and they help guide what you do next.

Speaker 2: 46:21

Thank you very much, both of you. It's been great having you both in again today, and I think it really brings it to life. You know sort of talking about these examples because it is a difficult world out there. There are difficult conversations we need to have. That can be challenging for us to have those conversations, but I think you know it's been really good to demonstrate actually how you can have some quite direct conversations with people but still do that with empathy with understanding um and using those principles of of mi to to actually be part of that journey.

Speaker 2: 46:55

So thank you very much good to see you both again and, uh, yeah, hopefully talk to you again soon, as always.

Speaker 2: 47:03

if you'd like to find out more details on the topics discussed in today's episode, as well as to find links to book on Jackie's motivational interviewing training, please go to the SSCP website at somersetsafeguardingchildrenorguk or by following any of the links in the episode description.

Speaker 2: 47:22

If you enjoyed listening to the Peapod, we'd really appreciate it if you took that little bit of time to follow or subscribe using your chosen platform or, even better, leave a review and let other people know about it. It really does help to spread the word and, talking about spreading the word, don't forget to tell other people about it and encourage them to join us here as well. If you have any questions or comments arising from today's episode or would like to be involved in future episodes, we'd love you to get in touch with us at thepeapod at somersetgovuk. Once again, I'd like to givea huge thank you to my guests today jackie Webb, mi trainer and consultant, social worker, sharon Ricketts and, of course, as always, I'd like to thank you for listening. My name is Steve McAbee and I'm the training manager for the Somerset Safeguarding Children Partnership, and I look forward to you joining us again next time at the Peapod.

Speaker 1: 48:16

Let's work together to help keep children safe.