My Post-Election Letter to Educators
Earlier this week, I had an amazing Montana educator tell me, among other things, about how the election results ignited fears for the future of public education. In response, I wrote the following piece. I know it’s a little intellectual, but that’s what you get from a college professor. I’m sharing this with you mostly because I think you’re all amazing Montana educators and want to support you in whatever way I can.
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In this moment, I’m aware that while some are celebrating this morning’s election outcome, others are experiencing despair, sadness, anger, betrayal, and fear. After an election like this one, it’s easy to have our thoughts and emotions race toward various crisis scenarios. If that’s what’s happening to you, no doubt, you are not alone.
We all have unique responses to emotional distress. If you feel threatened by the election outcome, you may have impulses toward action that come with your emotions. In stress situations, we often hear about the fight or flight (or freeze) response, but because we’re all complex human beings, fight or flight or freeze is an oversimplification. Although feeling like running, hiding, freezing, or feeling surges of anger are natural and normal, most of the fight or flight research was conducted on rats—male rats in particular. For better and worse, our emotional and behavioral responses to the election outcomes are so much more complex than fight or flight.
As humans we respond to threat in more sophisticated ways. One pattern (derived from studies with female rats) is called tend and befriend. Although these are also simplistic rhyming words, I translate them to mean that if you’re feeling stressed, threatened and fearful, it’s generally good to reach out to others for support and commiseration, to support others, and to gather with safe people in pairs or families or groups.
If you work in a school, I encourage you to be there for each other, regardless of your political views. For now, it will probably feel best to stay close to those with whom you have common beliefs. Eventually, I hope that even those of you with different beliefs can recognize and respect the humanity within each other. The most destructive responses to stress and threat are usually characterized by hate and division. The more we can connect with others who feel safe, the better we can deal with our own rising feelings—feelings that may be destructive or hateful.
Another complex thing about humans is that we can have a therapeutic response to focusing on our pain, grief, anger, and other disturbing emotions. There’s clear evidence that letting ourselves feel those feelings, and talking and writing about them, is important and therapeutic. But, in an odd juxtaposition, it’s also therapeutic to intentionally focus on the positive, to imagine and write about the best possible outcomes in whatever situations we face, and in looking—every day—for that which is inspiring (rather than over-focusing on that which is depressing or annoying). To the extent that you’re feeling distressed, I encourage you, when you can, to take time going down both those roads. That means taking time to experience your difficult and painful feelings, as well as taking time to focus on what you’re doing that’s meaningful in the moment, and whatever positive parts of life you can weave into your life today, tomorrow, and in the future.
My main point is that you are not alone. Many people, right alongside you, are in deep emotional pain over the outcome of the election. As you go through these bumpy times, times that include fears for the future of children, families, education, and communities I hope we can do this together. Because in these moments of despair and pain, we are better together.
Or, as Christopher Peterson said, “Other people matter. And, we are all other people to everyone else.”
You matter and your reactions to this immense life event matters. Please take good care of yourself and your colleagues, friends, and family.
All my best to you,
John SF
Love One Another . . . and
Like it was for many, last night and this morning were rough. Although some people may be celebrating, many are suffering.
One of my default responses to what I view as bad things in the world (including the election of a man who is sexist, racist, a convicted rapist, a multiple felon who recently publicly pantomimed an act of oral sex with a microphone, and who promised revenge to many people as an authoritarian president) is anger. Last night I was pissed and felt hateful . . . all night. Sleep didn’t happen much.
When growing up, my mother had a rule in our house. We could not use the word hate. She insisted. If we felt strongly, we could say, “I dislike that very intensely,” but “hate” was forbidden.
Because I had two smart, kind, and wonderful sisters and two loving parents, I don’t think I really understood that message until the middle of last night. Amongst my many awakenings and rushes of violent thoughts, I felt the hate . . . and then recognized that hate is exactly what the destructive and divisive forces in the world want us to feel.
We have many historical and current names for the great divider. Lucifer and Satan come to mind. I’m not much into traditional religion, but as my hate rose along with the awareness that I am, in part, a victim of someone who is gifted in stoking hate, I couldn’t help but wonder if perhaps this is the demonic. After all, what is the demonic, if not the stoking and spread of hateful thoughts and actions?
Those thoughts gave me pause. Being naturally oppositional, I don’t want to give the divider what he wants. Alternative ideas came into my brain, the main one being, “Love one another.”
Again, I’m not traditionally religious; I’m also not especially naïve. My interpretation of what may have been a “Love one another” spiritual message, is to do the loving with my eyes wide open and an excellent memory.
We all need to be wary, and protect ourselves, our friends, our colleagues, our families Although the labor activist Joe Hill said, “Don’t mourn. Organize,” I think we do need to mourn, grieve, commiserate, AND organize. At the same time, we need to find the right times and places and spaces for love. After all, what is the spiritual, if not the stoking and spread of loving thoughts and actions?
I wish for you, the time and space you need for dealing with your painful emotions as well as the opportunity to build a more positive future, together.
What You Should Know About Motivational Interviewing (and more)
During my supervision this week, I noticed that the concepts and process of Motivational Interviewing came up several times. When students or professionals don’t know the basics of Motivational Interviewing (MI), I feel compelled to speak up. MI is a method, strategy, or philosophy that’s complex, nuanced, and essential. We should all know about and have MI skills. To feel the centrality of MI to counseling and psychotherapy, it helps to start with MI’s most fundamental organizing principle.
“It is the client who should be voicing the arguments for change” (Miller & Rollnick, 2002, p. 22).
If you contemplate this principle (and you should), then you’ll need to examine your own role in the change process. That’s because, if look at (or listen to) yourself, and YOU’RE the one voicing the arguments for change, you must stop.
If you don’t stop, then you may be contributing to your clients’ resistance to change.
MI ideas are challenging to our natural impulses. We want to tell clients how to be healthier, but our job is not to voice the argument for positive and healthy change; our job is to nurture their argument for positive and healthy change. This is where the nuance comes in. How can we, as interviewers (aka counselors or psychotherapists) create an interaction wherein the client is more likely to take the lead in voicing the arguments for positive and healthy change?
The answer to that question is complex, as it should be. In part, my answer today is to include an excerpt from Chapter 12 (Challenging Client Behaviors and Demanding Situations) of our Clinical Interviewing text. This excerpt starts with the topic of “Challenging Client Behaviors” or behaviors that clients engage in that counselors and psychotherapists often find challenging. The content includes a discussion of the concept of “resistance,” MI strategies, as well other ideas of our own and from the literature.
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Challenging Client Behaviors
As the client and therapist talk more and more about the solution they want to construct together, they come to believe in the truth or reality of what they are talking about. This is the way language works, naturally.
—Insoo Kim Berg and Steven de Shazer, Making numbers talk, 1993, p. 6
Not all clients are equally cooperative. Here are a few opening lines we’ve heard over the years:
- Do I have to be here?
- No disrespect, but I hate counselors.
- I’ll never talk to you about anything important, and you can’t make me.
- This is a shitty little office; you must be a shitty little therapist.
- How long will this take?
- How old are you? How are you supposed to help me if you’re still in middle school?
In our work with adolescents and young adults, we’ve directly experienced the pleasure (or pain) of being in interviews with people who want little to do with therapy, and nothing to do with us. We’ve had clients refuse to be alone in the room with us, others who refused to speak, a few who insisted on standing, and many who told us with great disdain (and punctuated with profanity) that they don’t believe in counseling.
The first part of this chapter is about interviewing clients who oppose the helping process. It’s also about the deep satisfaction of working with clients who slowly or suddenly shift their attitudes and become cooperative. When these clients eventually enter the room, begin speaking, stop swearing, agree to sit, and begin believing in counseling (and counselors!), it can be a profoundly rewarding experience.
Defining and Exploring Resistance
Freud viewed resistance as inevitable and ubiquitous. Following Freud’s lead, psychotherapists for many years considered virtually anything clients did or said as potential signs of resistance, such as
- Talking too much, or talking too little
- Arriving late, or arriving early
- Being unprepared or overprepared for psychotherapy
The Death (or Reframing) of Resistance
Many theorists and practitioners question the nature and helpfulness of resistance as a concept. In 1984, writing from a solution-focused perspective, Steven de Shazer announced the “death of resistance.” He subsequently held a ceremony and buried it in his backyard. Other theorists and researchers—particularly from culturally diverse perspectives—have followed his lead in viewing resistance differently (Adames et al., 2022; Chimpén-López, C., 2021). They view resistance as an unhelpful linguistic creation that developed because sometimes clients don’t want to (or shouldn’t) do what their “bossy” or oppressive therapist wants them to do (Ratts et al., 2016). In other words, resistance isn’t a problem centered in the client; it’s a problem created by therapists and the power dynamic this presents.
Around the time de Shazer was burying resistance in his backyard, William R. Miller was discovering that reflective listening, empathy, and encouragement with clients who had substance problems, outperformed confrontation and behavioral interventions (W. Miller, 1978, 1983). This discovery led to the development of motivational interviewing (W. Miller & Rollnick, 1991; Miller & Moyers, 2021). Motivational interviewing (MI) is now widely acknowledged as an effective treatment for health, substance, and mental health problems (McKay, 2021; Romano & Peters, 2015).
Resistance is Multidetermined
Unlike the early psychoanalytic position, resistance is neither inevitable or ubiquitous. But it’s probably not dead either. Instead, resistance (aka ambivalence or reluctance) originates from three main sources:
- Resistance from the client. Sometimes resistance is real, palpable, and originates from clients’ beliefs, attitudes, ambivalence, or internalized view of therapy as an oppressive situation (Adames et al., 2022). When resistance emanates from clients (regardless of therapist behavior), clients are usually in the precontemplation (not interested in changing) or contemplation (occasional transient thoughts of changing) stages of change (see Chapter 6 for an overview of the transtheoretical stages of change model; Prochaska & DiClemente, 2005).
- Resistance that therapists stimulate. Sometimes therapists behave in ways that create resistance rather than cooperation. Overuse of confrontation or interpretation can stimulate client resistance (Romano & Peters, 2015). Therapists who don’t examine and manage their countertransference biases toward particular client populations (e.g., teenage clients, reluctant clients, mandated clients, or clients from diverse cultures), or who perpetuate marginalization of diverse populations, are especially prone to creating client resistance (Ratts, 2017; Tishby & Wiseman, 2020).
- Resistance as a function of the situation. Resistance may be a product of a difficult and uncomfortable situation, a situation or expected coercive interpersonal interactions that naturally trigger reactance (i.e., negative expectations and defensiveness; Beutler et al., 2011). Reactance is a well-established psychological phenomenon (Brehm, 1966; Place & Meloy, 2018): When people feel coerced or pushed, they tend to push back, resisting the perceived source of coercion (e.g., therapist). For most mandated clients and for many ambivalent clients, resistance to therapy is a natural, situationally triggered behavior (J. Sommers-Flanagan et al., 2011). Also, for clients with diverse ethnicities or societally-marginalized identities, therapy can naturally feel like the repetition of power-imbalanced colonization experiences (Gone, 2021; Singh et al., 2020).
We realize that framing resistance as multidetermined and natural (or burying it) doesn’t automatically make it easier to handle (J. Sommers-Flanagan & Bequette, 2013). To therapists, resistance can still feel aggressive, provocative, oppositional, and threatening.
It’s unrealistic to expect all clients—especially adolescents or mandated adults in precontemplation or contemplation stages of change—to immediately speak openly and work productively with an unfamiliar authority figure. It’s also unrealistic to expect clients for whom therapy is a new and uncomfortable experience to immediately begin sharing their innermost thoughts. If you use the word resistance, it’s helpful to add the word “natural.” Doing so offers empathy for the client’s entry into an uncomfortable situation and acknowledges the need for strategies and techniques for dealing with client behaviors that are too easily labeled resistant (Hara et al., 2018; Miller & Moyers, 2021). The central question then becomes: What clinician behaviors reduce natural client resistance and defensiveness?
Motivational Interviewing and Other Strategies
In their groundbreaking text, Motivational Interviewing, W. Miller and Rollnick (1991, 2002, 2013) described a practical approach to recognizing and working with client resistance. They emphasized that most humans are ambivalent about personal change because of competing motivations. For example, a client may simultaneously have two competing motivations about smoking cigarettes:
- I should quit because smoking is expensive and unhealthy.
- I should keep smoking because it’s pleasurable and gives me a feeling of emotional control.
Imagine yourself in an interview situation. You recognize your client is engaging in a self-destructive behavior (e.g., smoking, cutting, punching walls). In response, you educate your client and make a case for giving up the self-destructive behavior. W. Miller and Rollnick (2002) described this classic scenario:
[The therapist] then proceeds to advise, teach, persuade, counsel or argue for this particular resolution to [the client’s] ambivalence. One does not need a doctorate in psychology to anticipate what [the client’s] response is likely to be in this situation. By virtue of ambivalence, [the client] is apt to argue the opposite, or at least point out problems and shortcomings of the proposed solution. It is natural for [the client] to do so, because [he or she] feels at least two ways about this or almost any prescribed solution. It is the very nature of ambivalence. (pp. 20–21)
In MI, resistance is framed as natural ambivalence about change. Consider this from a physical perspective. If you hold out an open hand and ask someone else to do the same and then push against their hand, the other person usually pushes back, matching your force. During a clinical interview, this process happens verbally. The more you push for healthy change, the more clients push back for staying less healthy (Apodaca et al., 2015).
This leads to the central MI hypothesis for resolving client ambivalence and activating motivation:
This points toward a fundamental dynamic in the resolution of ambivalence: It is the client who should be voicing the arguments for change. (W. Miller & Rollnick, 2002, p. 22, italics added)
But how can clinicians help clients make arguments for change?
MI practitioners refer to clients voicing their own arguments for change as change talk. When clients voice their arguments against change, it’s called sustain talk,because clients are arguing to continue or sustain their unhealthy behaviors. The central hypothesis of MI is that the more clients engage in change talk, positive change is more likely to occur.
MI has relational and technical components. The relational component involves embracing a spirit of collaboration, acceptance, and empathy. Embracing the relational component is crucial, if only because clients who report greater secure attachment to their therapists, also report less resistance (Yotsidi et al., 2019). The technical components include intentional evocation and reinforcement of client change talk (W. Miller & Rose, 2009). In practice, it’s difficult to separate the relational and technical components, and it’s likely more efficacious when they’re delivered together anyway. As you work with reluctant, ambivalent, or so-called resistant clients, you’ll need to make sure your Rogerian person-centered hat is firmly in place, while simultaneously using good behavioral skills to evoke and reinforce change talk.
Using Open Questions, Opening Questions, Evocation, and Goal-Setting Strategies
Open questions are fundamental to MI. However, W. Miller and Rollnick (2013) cautioned asking too many questions, including open questions:
A simple rhythm in MI is to ask an open question and then to reflect what the person says, perhaps two reflections per question, like a waltz. Even with open questions, though, avoid asking several in a row, or you may set up the question-answer trap. (p. 63)
Miller and Rollnick (2013) recommended loosely following their two-to-one waltz metaphor; the point is to do more reflecting than questioning. They offer a stronger warning against repeated closed questions, noting, “Chaining together a series of closed questions can be deadly for engagement” (p. 63).
When opening sessions with clients who may be unenthused to see you, you should use positive, strength-focused, empathic, and non-blaming opening questions:
- What brings you here today and how do you hope we might help? (Miller & Moyers, 2021, p. 95)
- What would make this a helpful visit?
- If we have a great meeting today, what will happen?
- What needs to happen in here for our time to be productive?
Open questions and opening questions are especially good tools for evoking clients’ strengths, hope, and solutions (McKay, 2021). Not surprisingly, reluctant clients tend to be more responsive when therapists pursue strengths, rather than pathology. Evocation is a technique used to help clients speak to their resources and strengths. Miller and Moyer (2021) view evocation as inherently containing the message: “You have what you need, and together we’re going to find it (p. 93”). If you’re using open questions to bypass natural resistance, you should aim toward evoking client change talk.
Consider the following example of using a variety of questions to facilitate change talk in an emergency room setting (M. Cheng, 2007, p. 163, parenthetical comments added):
Clinician: What would make today’s … visit helpful? (Clinician asks for goals.)
Patient: I want to kill myself, just let me die… (Patient states unhealthy goal/task.)
Clinician: I’m sure you must have your reasons for feeling that way … What makes you want to hurt yourself? (Clinician searches for underlying healthy goal.)
Patient: I just can’t stand the depression anymore and all the fighting at home. I just can’t take it. (The underlying healthy goals include coping with depression and fighting.)
Clinician: … so we need to find a way to help you cope with the depression and the fighting. You told me yourself that there used to be less fighting at home. What would it be like if we found a way to reduce the fighting, have people getting along more? (Clinician uses past hope to focus on future goal)
Patient: A lot better, I guess. But it’s probably not going to happen. (Client expresses little hope)
Clinician: Okay, I can see why you’re frustrated and I do understand that probably the depression makes it hard to see hope. But I believe that there is a part of you that is stronger and more hopeful, because otherwise you wouldn’t be here talking with me. (Clinician externalizes unhealthy thoughts or behaviors as being part of the depression and tries to help the patient rally against the depression.) That hopeful part of you said that your mood used to be happy. What would it be like if we could get your mood happy again?
Patient: A lot better I guess.
Clinician: Just to help me make sure I’m getting this right then, what would you like to see different with your mood? (The clinician reinforces the client’s goals by having the client articulate them.)
Patient: I want to be happy again.
Clinician: And at home, what would you like to see with how people get along?
Patient: I want us to get along better.
Clinician: Let’s agree then that we will work together on finding a way to help people get along, as well as help your mood get better. How does that sound? (Clinician paraphrases patient’s healthy goals.)
Patient: Sounds good… (Patient agrees with goals.)
In this example, Cheng (2007) illustrated how to help patients articulate goals and potential benefits of positive change (change talk). Although the process began with a negatively worded question—“What makes you want to hurt yourself?”—Cheng listened for positive, health-oriented goals. This is an important principle: Even when exploring emotional pain, you can listen for and resonate with unfulfilled positive goals contributing to that pain.
Using Reflection, Amplified Reflection, and Undershooting
Throughout this text, we’ve emphasized nondirective interviewing skills: paraphrasing, reflection of feeling, and summarizing. Research on MI supports this emphasis, showing that these reflective techniques are powerful tools for working with resistance (McKay, 2021). W. Miller and Rollnick (2002, pp. 100–101) provided examples of simple reflections that reduce resistance:
Client 1: I’m trying! If my probation officer would just get off my back, I could focus on getting my life in order.
Therapist 1: You’re working hard on the changes you need to make. Or,
Therapist 1: It’s frustrating to have a probation officer looking over your shoulder.
Client 2: Who are you to be giving me advice? What do you know about drugs? You’ve probably never even smoked a joint!
Therapist 2: It’s hard to imagine how I could possibly understand.
Client 3: I couldn’t keep the weight off even if I lost it.
Therapist 3: You can’t see any way that would work for you. Or,
Therapist 3: You’re rather discouraged about trying again.
When therapists accurately reflect client efforts, frustration, hostility, and discouragement, the need for clients to defend their positions is reduced.
Reflections also stimulate talk about the constructive side of ambivalence. While supervising graduate students in counseling and psychology as they conducted hundreds of brief interviews with client-volunteers, we noticed that when student therapists made an inaccurate reflection, the volunteer-clients felt compelled to clarify their feelings and beliefs in ways that rebalanced their ambivalence. For example:
Client: I’m pissed at my roommate. She won’t pick up her clothes or do the dishes or anything.
Therapist: You’d like to fire her as a roommate.
Client: No. Not that. There are lots of things I like about her, but her messiness really annoys me.
This exchange shows the interviewer inadvertently overstating the client’s negative view of the roommate. In response, the client immediately clarifies: “There are lots of things I like about her.”
As it turns out, the interviewer accidentally used an MI technique called amplified reflection (W. Miller & Rollnick, 2013). Amplified reflection involves intentionally overstating the client’s main message. W. Miller and Rollnick wrote: “As a general principle, if you overstate the intensity of an expressed emotion, the person will tend to deny and minimize it, backing off from the original statement” (p. 59).
When used intentionally, amplified reflection can feel manipulative. This is why amplified reflection is used along with genuine empathy and never includes sarcasm. Instead of being a manipulative response, it’s the therapist’s effort to deeply empathize with client frustration, anger, and discouragement. The following are amplified reflections. Scenario 1 involves a mother of a child with a disability and her ambivalence over whether she can take any time for self-care:
Client 1: My child has a serious disability, so I have to be home for him.
Therapist 1: You need to be home 24/7 and turn off any needs you might have to get out and take a break.
Client 1: Actually, that’s not totally true. Sometimes, I think I need to take some breaks so I can do a better job when I’m home.
Scenario 2 involves a college student with ambivalence over giving herself the time and space to grieve her grandmother’s death.
Client 2: When my grandmother died last semester, I had to miss classes and it was a total hassle.
Therapist 2: You don’t have much of an emotional response to your grandmother’s death—other than it’s really inconveniencing you.
Client 2: Well, it’s not like I don’t miss her, too.
Amplified reflection is an empathic effort to fully resonate with one side of the client’s ambivalence; it naturally nudges clients the opposite direction.
It’s also possible to use reflection to understate what clients are saying. W. Miller and Rollnick (2013) refer to this as undershooting. They advocate using it to encourage clients to continue exploring their thoughts and feelings:
Client: I can’t stand it when my mom criticizes my friends right in front of me.
Therapist: You find that a little annoying.
Client: It’s way more than annoying. It pisses me off.
Therapist: What exactly pisses you off about your mom criticizing your friends?
Client: It’s because she doesn’t trust me and my judgment.
In this example, the therapist uses an understatement and then an open question to continue exploring what hurts about the mother’s criticism.
Coming Alongside (Using Paradox)
Intentionally undershooting or using amplified reflections are subtle ways to move client talk in particular directions. A less subtle form of this is paradox. Paradox has traditionally involved prescribing the symptom (Frankl, 1967). For example, with a client who is using alcohol excessively, a traditional paradoxical intervention would involve something like, “Maybe you’re not drinking enough.”
Paradox is a high-risk and provocative intervention. We don’t advocate using traditional paradox. Interestingly, Viktor Frankl, who wrote about paradox in the early 1900s, viewed paradox as operating based on humor. It’s as if clients unconsciously or consciously understand the silliness of behaving in a destructive extreme and consequently pull back in the other direction. Frankl’s formulation might be viewed as working with ambivalence in a manner similar to MI.
W. Miller and Rollnick (2013) discuss using paradox to address resistance, but refer to it as coming alongside. Similar to amplified reflection, coming alongside is used with empathy and respect. The difference between amplified reflection and coming alongside is that in the latter the therapist makes a statement instead of a reflection. Here are two examples:
Client 1: I don’t think this is going to work for me, either. I feel pretty hopeless.
Therapist 1: It’s certainly possible that after giving it another try, you still won’t be any better off, so it might be better not to try at all. What’s your inclination?
Client 2: That’s about it, really. I probably drink too much sometimes, and I don’t like the hangovers, but I don’t think it’s that much of a concern, really.
Therapist 2: It may just be worth it to you to keep on drinking as you have, even though it causes some problems. It’s worth the cost.
Using coming alongside requires authentic empathy for the less healthy side of the ambivalence.
W. Miller and Rollnick (2002) commented on the difference between using coming alongside as compared to traditional paradox:
We confess some serious discomfort with the ways in which therapeutic paradox has sometimes been described. There is often the sense of paradox being a clever way of duping people into doing things for their own good. In some writings on paradox, one senses almost a glee in finding innovative ways to trick people without their realizing what is happening. Such cleverness lacks the respectful and collaborative tone that we understand to be fundamental to the dialectical process of motivational interviewing. (p. 107)
Paradoxical techniques should be delivered along with basic person-centered core attitudes of congruence, unconditional positive regard, and empathic understanding. Paradox shouldn’t be used as a clever means to outwit or trick clients, but to explore the alternative outcome out loud with the client and allow them to respond.
Using Emotional Validation, Radical Acceptance, Reframing, and Genuine Feedback
Clients sometimes begin interviews with hostility, anger, or resentment. If clinicians handle these provocations well, clients may open up and cooperate. The key is to keep an accepting attitude and restrain from lecturing, scolding, or retaliating if clients express hostility.
Empathy, emotional validation, acceptance, and concession can elicit cooperation. We often coach graduate students to use concession when power struggles emerge, especially when working with adolescent clients (J. Sommers-Flanagan & Sommers-Flanagan, 2007b). If a young client opens a session with “I’m not talking and you can’t make me,” conceding power and control can shift the dynamic: “You’re absolutely right. I can’t make you talk, and I definitely can’t make you talk about anything you don’t want to talk about.” This statement validates the client’s perspective and concedes an initial victory in what the client might view as a struggle for power. MI therapists refer to this as affirming the client.
Empathic, emotionally validating statements are also important. If clients express anger about you or therapy, a reflection of feeling and/or feeling validation response communicates that you hear their emotional message. In some cases, you can go beyond empathy and emotional validation and join clients with parallel emotional responses:
- I don’t blame you for feeling pissed about having to see me.
- I hear you saying you don’t trust me, which is totally normal. You don’t know me, and you shouldn’t trust me until you do.
- It sucks to have a judge require you to meet with me.
- I know we’re being forced to meet, but we’re not being forced to have a bad time together.
Radical acceptance (RA) is a principle and technique based on person-centered theory and dialectical behavior therapy (Görg et al., 2019). RA involves consciously accepting and actively welcoming all client comments—even odd, disturbing, or blatantly provocative comments (J. Sommers-Flanagan & Sommers-Flanagan, 2007a). Here’s a case where a client began a session with angry statements about counseling:
Opening client volley: I don’t need no stupid-ass counseling. I’m only here because my wife is forcing me. This counseling shit is worthless. It’s for pansy-ass wimps like you who need to sit around and talk rather than doing any real work.
RA return: Wow. Thanks for being so honest about what you’re thinking. Lots of people really hate counseling but just sit here and pretend to cooperate. I really appreciate your telling me exactly where you’re coming from.
RA can be combined with reframing to communicate a deeper understanding about why clients have come for therapy. One version of this is the love reframe (J. Sommers-Flanagan & Barr, 2005).
Client: This is total bullshit. I don’t need counseling. The judge required this. Otherwise, I can’t see my daughter for unsupervised visitation. Let’s just get this over with.
Therapist: You must really love your daughter to come to a meeting you think is bullshit.
Client: (softening) Yeah. I do love my daughter.
The magic of the love reframe is that clients nearly always agree with the positive observation about loving someone. The love reframe shifts the interview to a more pleasant and cooperative focus.
Often, when working with angry or hostile clients, there’s no better approach than reflecting and validating feelings … pausing … and then following with honest feedback and a solution-focused question.
I hear you saying you hate the idea of talking with me. I don’t blame you for that. I’d hate to be forced to talk to a stranger about my personal life too. But can I be honest with you for a minute? [Client nods in assent.] You’re in legal trouble. I want to be helpful—even just a little. We’re stuck meeting together. We can either sit and stare at each other and have a miserable hour, or we can talk about how you might dig yourself out of this legal hole. I can go either way. What do you think … if we have a good meeting today, what would we accomplish?
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The chapter goes on and on from here, including content on dealing with clients who may be delusional, as well as substance abuse interviewing.
Also, if you want more info, here’s a nice article, albeit dated, where Miller and Rollnick write about 10 things that MI is NOT.
My 12 Minutes of Fame in South Korea
Last week I had my Andy Warholian 15 minutes of fame in South Korea. Actually, it was only 12 minutes and 27 seconds, and as some historians note, Andy Warhol may have never actually said the 15 min of fame thing. But, pushing the silly details aside, the truth is: I got over 12 minutes of fame on a South Korean radio station! “How cool is that?”
My answer is, “Very cool,” partly because I was on a very cool English-speaking South Korean radio station and radio show: The Morning Wave in Busan (BeFM 90.5). Before I went “live” on the air, I listened to Kathryn Bang, the radio host, interviewing someone about college students selling their ADHD meds and voyeurism and some singing/dancing and a Bruno Mars song that’s popular in South Korea. Wow. That was an amazing line-up.
If you’re interested, The Morning Wave has a recorded video of my appearance. The focus of the interview was our “Happiness for Educators” course. I got the gig because the radio station tracks The Conversation, where I had a publication pop back on October 11.
Here’s the link to the YouTube video.
Just in case the link doesn’t load to the right moment in the show, the interview with me starts at 1:27:50 and ends at 1:40:17 . . . although the whole show is worth a listen/viewing!
Exploring Your Eudaimonic Belongingness Sweet-Spot at West Creek Ranch
[Moon Rise at West Creek Ranch]
This past week I spent four days at West Creek Ranch, where I was forced to eat gourmet food, do sunrise yoga, experience a ropes course (briefly becoming a “flying squirrel”), watch a reflective horse session, dance away one night, hike in the beautiful Paradise Valley, and hang out, converse, and learn from about 25 very smart/cool/fancy people. Yes, it was a painful and grueling experience—which I did not deserve—but of which I happily partook.
On the first morning, I provided a brief presentation to the group on the concept of belonging, from the perspective of the Montana Happiness Project. Despite having shamefully forgotten to take off my socks during the sunrise morning yoga session, and having anxiety about whether or not I belonged with this incredible group of people, they let me belong. They also laughed at all the right moments during my initial mini-comedy routine, and then engaged completely in a serious reflective activity involving them sharing their eudaimonic belongingness sweet-spots with each other.
If you don’t know what YOUR eudaimonic belongingness sweet-spot is, you’re not alone (because hardly anyone knows what I mean by that particular jumble of words). That’s because, as a university professor, I took the liberty of making that phrase up, while at the same time, noting that it’s derived from some old Aristotelean writings. Yes, that’s what university professors do. Here’s the definition that I half stole and half made up.
That place where the flowering of your greatest (and unique) virtues, gifts, skills, talents, and resources intersect (over time) with the needs of the world [or your community or family].
I hope you take a moment to reflect on that definition and how it is manifest in who you are, and how you are in your relationships with others. If you’re reading this blog post, I suspect that you’re a conscious and sentient entity who makes a positive difference in the lives of others in ways that are uniquely you. Because we can’t and don’t always see ourselves as others see us, in our University of Montana Happiness course, we have an assignment called the Natural Talent Interview designed to help you gain perspective on your own distinct and distinctive positive qualities. You can find info on the Natural Talent Interview here: https://johnsommersflanagan.com/2023/12/26/what-do-you-think-of-me/
And my West Creek presentation powerpoint slides (all nine of them) are here:
You may have missed the main point of this blog post—which would be easy because I’m writing like a semi-sarcastic and erudite runaway loose association train that’s so busy whistling that it can’t make a point. My main point is GRATITUDE. Big, vast, and immense gratitude. Gratitude for the Arthur M. Blank Family Foundation (AMBFF) and our massively helpful program officers. Gratitude for our retreat facilitators. Gratitude for the staff at West Creek Ranch. Gratitude for the presence of everyone at the gathering. And gratitude for the therapeutic feelings of belonging I had the luxury of ruminating on all week. My experience was so good that I’m still savoring it like whatever you think might be worth savoring and then end up savoring even more than you expected.
Thank you AMBFF and Arthur Blank for your unrelenting generosity and laser-focus on how we can come together as community and make the world a better place.
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*Note: At the Montana Happiness Project, we do not support toxic positivity. What I mean by that is: (a) no one should ever tell anyone else to cheer up (that’s just offensive and emotionally dismissive), and (b) although we reap benefits from shifting our thinking and emotions in positive directions, we also reap similar benefits from writing and talking about trauma, life challenges, and social injustice. As humans, we are walking dialectics, meaning we grow from exploring the negative as well as the positive in life. We are multitudes, simultaneously learning and growing in many directions.
Notes on My Favorite New Article
It can be good to have an IOU. I knew I owed my former student and current colleague, Maegan Rides At The Door, a chance to publish something together. We had started working on a project several years ago, but I got busy and dropped the ball. For years, that has nagged away at me. And so, when I read an article in the American Psychologist about suicide assessment with youth of color, I remembered my IOU, and reached out to Maegan.
The article, written by a very large team of fancy researchers and academics, was really quite good. But, IMHO, they neglected to humanize the assessment process. As a consequence, Maegan and I prepared a commentary on their article that would emphasize the relational pieces of the assessment process that the authors had missed. Much to our good fortune, after one revision, the manuscript was accepted.
I saw Maegan yesterday as she was getting the President Royce Engstrom Endowed Prize in University Citizenship award (yes, she’s just getting awards all the time). She said, with her usual infectious smile, “You know, I re-read our article this morning and it’s really good!”
I am incredibly happy that Maegan felt good about our published article. I also re-read the article, and felt similar waves of good feelings—good feelings about the fact that we were able to push forward an important message about working with youth of color. Because I know I now have your curiosity at a feverish pitch, here’s our closing paragraph:
In conclusion, to improve suicide assessment protocols for youth of color, providers should embrace anti-racist practices, behave with cultural humility, value transparency, and integrate relational skills into the assessment process. This includes awareness, knowledge, and skills related to cultural attitudes consistent with local, communal, tribal, and familial values. Molock and colleagues (2023) addressed most of these issues very well. Our main point is that when psychologists conduct suicide assessments, relational factors and empathic attunement should be central. Overreliance on standardized assessments—even instruments that have been culturally adapted—will not suffice.
And here’s the Abstract:
Molock and colleagues (2023) offered an excellent scholarly review and critique of suicide assessment tools with youth of color. Although providing useful information, their article neglected essential relational components of suicide assessment, implied that contemporary suicide assessment practices are effective with White youth, and did not acknowledge the racist origins of acculturation. To improve suicide assessment process, psychologists and other mental health providers should emphasize respect and empathy, show cultural humility, and seek to establish trust before expecting openness and honesty from youth of color. Additionally, the fact that suicide assessment with youth who identify as White is also generally unhelpful, makes emphasizing relationship and development of a working alliance with all youth even more important. Finally, acculturation has racist origins and is a one-directional concept based on prevailing cultural standards; relying on acculturation during assessments with youth of color should be avoided.
And finally, if you’re feeling inspired for even more, here’s the whole Damn commentary:
Here’s a new article published in The Conversation
Happiness class is helping clinically depressed school teachers become emotionally healthy − with a cheery assist from Aristotle
John Sommers-Flanagan, University of Montana
Uncommon Courses is an occasional series from The Conversation U.S. highlighting unconventional approaches to teaching.
Title of Course
Evidence-Based Happiness for Teachers
What prompted the idea for the course?
I was discouraged. For nearly three decades, as a clinical psychologist, I trained mental health professionals on suicide assessment. The work was good but difficult.
All the while, I watched in dismay as U.S. suicide rates relentlessly increased for 20 consecutive years, from 1999 to 2018, followed by a slight dip during the COVID-19 pandemic, and then a rise in 2021 and 2022 – this despite more local, state and national suicide prevention programming than ever.
I consulted my wife, Rita, who also happens to be my favorite clinical psychologist. We decided to explore the science of happiness. Together, we established the Montana Happiness Project and began offering evidence-based happiness workshops to complement our suicide prevention work.
In 2021, the Arthur M. Blank Family Foundation, through the University of Montana, awarded us a US$150,000 grant to support the state’s K-12 public school teachers, counselors and staff. We’re using the funds to offer these educators low-cost, online graduate courses on happiness. In spring 2023, the foundation awarded us another $150,000 so we could extend the program through December 2025.
What does the course explore?
Using the word “happiness” can be off-putting. Sometimes, people associate happiness with recommendations to just smile, cheer up and suppress negative emotions – which can lead to toxic positivity.
As mental health professionals, my wife and I reject that definition. Instead, we embrace Aristotle’s concept of “eudaimonic happiness”: the daily pursuit of meaning, mutually supportive relationships and becoming the best possible version of yourself.
The heart of the course is an academic, personal and experiential exploration of evidence-based positive psychology interventions. These are intentional practices that can improve mood, optimism, relationships and physical wellness and offer a sense of purpose. Examples include gratitude, acts of kindness, savoring, mindfulness, mood music, practicing forgiveness and journaling about your best possible future self.
Students are required to implement at least 10 of 14 positive psychology interventions, and then to talk and write about their experiences on implementing them.
Why is this course relevant now?
Teachers are more distressed than ever before. They’re anxious, depressed and discouraged in ways that adversely affect their ability to teach effectively, which is one reason why so many of them leave the profession after a short period of time. It’s not just the low pay – educators need support, appreciation and coping tools; they also need to know they’re not alone. https://www.youtube.com/embed/ZOGAp9dw8Ac?wmode=transparent&start=0 This exercise helps you focus on what goes right, rather than the things that go wrong.
What’s a critical lesson from the course?
The lesson on sleep is especially powerful for educators. A review of 33 studies from 15 countries reported that 36% to 61% of K-12 teachers suffered from insomnia. Although the rates varied across studies, sleep problems were generally worse when teachers were exposed to classroom violence, had low job satisfaction and were experiencing depressive symptoms.
The sleep lesson includes, along with sleep hygiene strategies, a happiness practice and insomnia intervention called Three Good Things, developed by the renowned positive psychologist Martin Seligman.
I describe the technique, in Seligman’s words: “Write down, for one week, before you go to sleep, three things that went well for you during the day, and then reflect on why they went well.”
Next, I make light of the concept: “I’ve always thought Three Good Things was hokey, simplistic and silly.” I show a video of Seligman saying, “I don’t need to recommend beyond a week, typically … because when you do this, you find you like it so much, most people just keep doing it.” At that point, I roll my eyes and say, “Maybe.”
Then I share that I often awakened for years at 4 a.m. with terribly dark thoughts. Then – funny thing – I tried using Three Good Things in the middle of the night. It wasn’t a perfect solution, but it was a vast improvement over lying helplessly in bed while negative thoughts pummeled me.
The Three Good Things lesson is emblematic of how we encourage teachers in our course – using science, playful cynicism and an open and experimental mindset to apply the evidence-based happiness practices in ways that work for them.
I also encourage students to understand that the strategies I offer are not universally effective. What works for others may not work for them, which is why they should experiment with many different approaches.
What will the course prepare students to do?
The educators leave the course with a written lesson plan they can implement at their school, if they wish. As they deepen their happiness practice, they can also share it with other teachers, their students and their families.
Over the past 16 months, we’ve taught this course to 156 K-12 educators and other school personnel. In a not-yet-published survey that we carried out, more than 30% of the participants scored as clinically depressed prior to starting the class, compared with just under 13% immediately after the class.
This improvement is similar to the results obtained by antidepressant medications and psychotherapy.
The educators also reported overall better health after taking the class. Along with improved sleep, they took fewer sick days, experienced fewer headaches and reported reductions in cold, flu and stomach symptoms.
As resources allow, we plan to tailor these courses to other people with high-stress jobs. Already, we are receiving requests from police officers, health care providers, veterinarians and construction workers.
John Sommers-Flanagan, Clinical Psychologist and Professor of Counseling, University of Montana
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Tomorrow Morning in Ronan, MT: A Presentation and Conversation about Strengths-Based Suicide Assessment and Treatment
Tomorrow morning, three counseling interns and I will hit the road for Ronan, where we’ll spend the day with the staff of CSKT Tribal Health. We are honored and humbled to engage in a conversation about how to make the usual medical model approach to suicide be more culturally sensitive and explicitly collaborative.
Here are the ppts for the day:
Strengths-Based Suicide Assessment with Diverse Populations — The PPTs
Tomorrow morning (Wednesday, October 2) I have the honor and privilege of being the keynote speaker for Maryland’s 36th Annual Suicide Prevention Conference. So far, everyone I’ve met associated with this conference is amazing. I suspect tomorrow will be filled with excellent presentations and fabulous people who are in the business of mental health and saving lives.
I hope I can do justice to my role in this very cool conference.
Here’s a link to tomorrow’s ppts:
John Sommers-Flanagan 