Structured Practice with Coach

''The following exercises can be used to develop most any complex skill in motivational interviewing. They can work in strengthening closing skills, but could be used with earlier skills as well.''

Abstract: This is a structured dyadic practice exercise, with the addition that there is a trainer or coach observing and participating in the process.

Overview: Trainees pair up for the exercise and are given structured tasks, often as speaker and listener, or client and counselor. The trainer/coach/director provides clear instructions, and then the dyadic exchange begins. The coach interrupts the action at appropriate points to suggest changes.

Guidelines: Assign trainees to work in threes, with one assigned the role of coach (unless there are enough trainers to work with each dyad). Give clear instructions to the coach to be relayed to the other two participants. Instruct the other two participants to work as if they had not heard your own instructions, and to do only and exactly what the coach instructs them to do.

(Alternatively, take the coaches aside into another room and give them the instructions out of hearing of the other participants.) Each participant in the dyad should have a clear role assigned by the coach. Participants may also be instructed to make some mistakes, or wander off the task at times. When the action begins, the coach allows the conversation to run as long as seems productive and on-task, and interrupts to provide suggestions, “rewind” the action to redo a particular interaction, “fast forward” to a later point in the interview, etc. The coach may also jump in and model the responses to be learned.

Example(s): Choose enough coaches so that there will be one per dyad and instruct them in how to give instructions for the exercise. The structured practice, INTEGRATING REFLECTIVE LISTENING given above under “Structured Practice” is a good example. In this case, the coach would give instructions to the listener and speaker, with the listener’s task to be responding solely with reflective listening. The coach then ensures that the listener is indeed offering reflective listening, and coaches for fine points like voice inflection, question vs. reflection, level of reflection, etc.

Notes: The coach may learn the most from this exercise, because it involved tracking process, providing guidance, and fixing errors.