More on “Motivational Interviewing” as a Method for Workplace Change Leadership

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Back in December, I wrote about a method called “Motivational Interviewing” (MI), something I learned about from a social worker who was also at the Lean Startup Conference. It's funny how these worlds intersect sometimes.

I saw parallels between people being addicted to food, drugs, or what have you (the reason the MI method was created) and people being addicted to old behaviors in the workplace (such as blaming others, not planning, or jumping in to be the hero). I recently ran across Ron Oslin, who is an internal Lean coach at CapitalOne. He has been using the MI method and has trademarked the phrase “addicted to the status quo.” It's apt.

I've chatted with Ron and will be doing a podcast with him soon.

Here is a video webinar of Ron giving a great overview of Motivational Interviewing:

You can find more resources at his website: One System / One Voice.

I recommend an article that he had published in the AME publication, Target: “Addiction to the Status Quo” (PDF)

From the Core Text

I've been revisiting the core text I've read on Motivational Interviewing, the book by Miller and Rollnick. If you think in terms of the ADKAR change model, I have Awareness of the method, desire to use it, and a bit of knowledge. What I don't have yet is Ability and Reinforcement, which would come through the practice of these methods (in the workplace, not a clinical setting).

I've been going through my Kindle highlights from the book and will share a few of them here:

“The path out of ambivalence is to choose a direction and follow, to keep moving in the chosen direction.”

Ambivalence is a state where a person can say things like “I want to quit smoking” or “I know I need to stop giving answers to my employees instead of letting them think,” but the mind also gives reasons WHY they should continue the old behavior. There are short-term benefits, such as smoking being relaxing to the person or the manager thinking they need to solve that problem right now and they don't have the luxury of developing others and their problem-solving skills.

As Lean thinkers, are we, at times, addicted to our old ways of doing things, such as “you always have to start with 5S?”

Hear Mark read the post (learn more about the podcast series):

In MI, the role of the therapist or coach is to get the addict to articulate reasons why they should change… and to have those self-directed positive statements about changing outweigh the statements about keeping the status quo.

Change is a process, not an event (as we learn in my workshop). Ron summarizes the MI process well in this PDF. In MI, you don't tell people to change and you don't tell them why they should change… or how they will change. You're trying to be supportive and evoke it from the person who is deciding to change.

As Ron summarizes, “Five key communication skills used throughout MI are asking open questions, affirming, reflecting, summarizing, and providing information and advice with permission.” Some of that will be very familiar to a Lean thinker or somebody who has learned to coach in a Lean way.

The phases of the MI process are engaging, focusing, evoking, and planning.

Engaging

As I've learned in my practice of Lean, relationships matter. This is true in MI or as a Lean transformation facilitator. You can't just jump into giving recommendations (and maybe you shouldn't give answers or advice in most settings… or until the time is right). The authors advise against falling into the “expert trap” — and consulting clients often want you to rush into giving them answers.

“The first of four basic processes in MI is to engage the client in a collaborative working relationship.”

And the authors say:

“Because in MI we differentiate engaging from the process of establishing goals (focusing; see Part III), we define engaging as the process of establishing a mutually trusting and respectful helping relationship.”

I think the same relationship building is necessary, more broadly, with Lean or Kaizen (continuous improvement). Leaders need to build trust… they need to understand their team members, rather than just mandating that everybody improve.

Focusing

This reminds me of the Toyota methodology of “practical problem solving,” where you often work to narrow the scope of the problem that you're wanting to solve.

“Focusing is the process of becoming clear about goals and direction in MI, providing the foundation for subsequent evoking and planning to help lift this burden… Even in seemingly simple situations, though, direction and goals can quickly become complicated.”

There are three styles of focusing in MI:

  1. Directing (the coach “gently makes a recommendation” to see how it's received) – “as a default approach for promoting client change it has serious limitations,” say the authors.
  2. Following (“what would you like to talk about today?”)
  3. Guiding (“Guiding promotes a collaborative search for direction, a meeting of expertise in which the focus of treatment is negotiated. The client's agenda are important, and any limitations inherent in the context are taken into account. The clinician's expertise is also a possible source of goals.”)

Evoking

It's hard to get past the status quo… as the authors say:

“The discomfort of conscious ambivalence can lead one to stop thinking about it or to resolve that the status quo really isn't all that bad after all, or at least that there's nothing that can be done about it. That, of course, perpetuates the status quo.”

In the evoking phase, the MI coach is evoking the client to engage in “change talk,” which includes preparation talk:

  • Desire (“I want to get Lean”)
  • Ability (“I'm able to start engaging employees in continuous improvement”)
  • Reasons (“Employees will be more engaged and we'll improve quality and our performance as a result”)
  • Need (“We really need to try something different”)

From that, we can move to mobilizing change talk:

  • Commitment (“I will start rounding and asking about problems and ideas every day”)
  • Activation (“I'm ready to try this today”)
  • Taking steps (“I got some Kaizen cards printed up”)

“This process occurs in MI by literally talking oneself into change.”

The authors advise:

“If you hear change talk, do more of what you've been doing. If you encounter increasing sustain talk and discord, try something different. An advantage in learning MI is that once you know what to listen for, your clients will provide immediate, ongoing feedback to help you improve your skills.”

Only once the client / patient has convinced themselves to change and to take action can you then go into planning the change. I see a lot of Lean facilitators jumping right into Planning… this causes problems and what seems like “resistance” when you haven't built relationships and trust, then you haven't framed the problem, and when you haven't gotten the client to articulate a need for change that's deeper than “the boss told me to.”

More to come… you might also want to check out my change management workshop that incorporates an innovative and interactive computer simulation… learn more here.


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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.

1 COMMENT

  1. Ron Oslin is doing a webinar this month for LEI on this topic.

    Register Here

    Turns out, most people can’t change! They’re “addicted” to the status quo, a non-chemical compulsion similar to addictions to running, watching TV, playing videogames, or using smart phones.

    “Our research shows that about 25% of the population is open to examining and altering their assumptions to truly change behavior,” says Ron Oslin, lean coach and leadership therapist at Capital One Bank. “Approximately 75% of the population will exhibit the characteristics associated with addiction to the status quo.”

    For them, efforts to persuade, reason, motivate, influence, sell, convince, cajole, or coach in the traditional ways actually increases resistance and lowers the rate of change. Traditional coaching methods just won’t work on most people.

    In contrast, motivational interviewing, used by therapists and counselors, is about arranging conversations so people convince themselves to change, based on their own values and interests. Best of all, it works with and enhances your existing coaching techniques.

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