Motivational interviewing (MI) is an evidence-based practice that is used in individual or group settings to help clients identify and mobilize change in their lives using their own internal motivators. In the most recent edition of Motivational Interviewing: Preparing People for Change, authors Miller and Rollnick (2013) discuss a concept captured by the German word Menschenbild, which is defined as one’s attitude towards humans. Whether one utilizes MI or any other type of therapeutic methods, it is critical for social workers and other helping professionals to take a step back and reflect on their own personal Menschenbild. How we view humans underlies and informs how we approach and interact with our clients.
So just what is Menschenbild? Below are some aspects of how we may think about our clients or people in general.
- Are people good or bad?
This question gets at the notion of how we think about human nature. Do we see our clients as autonomous, capable people who will ultimately want to make good choices for themselves or do we see them at people who will lie, manipulate, and cheat “the system” every chance that they get? Do we see them as incapable of making healthy choices without strong incentives or consequences? Are there some types of clients who are motivated and others whom we think will just never change?
Sometimes social workers make comments about their clients in private that reflect this latter opinion. Thinking that one’s clients are incapable of change can be a signal of burnout. Work is approached as needing to put up one’s guard with clients to avoid being taken advantage of. Interactions can become a contest of wills.
Humanistic psychology and methods, based on the work of Carl Rogers, proposes that all humans want and are capable of striving toward health or well-being. This does not mean that we are blind or naïve about certain behaviors or situations. What it does mean is that we provide hope and look for the internal motivators that clients may have buried deep inside that makes them want to be better/healthier people.
- Can people change?
Social workers often work with clients who have multiple and chronic problems. Similar to one’s view of human nature is this question as to whether there are certain people or types of clients who just cannot change. Sometimes when we have “difficult” clients, we label them as being “in denial”, being “resistant”, or as having a lot of “excuses” or “rationalizations”. The problem is about them. The practitioner then may be ready to throw up his or her hands and throw in the towel. If we lose hope, imagine how our clients feel.
Again, humanistic methods propose that all clients have the ability to change. Yes, they may have so many problems that it seems impossible, especially to them. Our job is to have hope and to “lend hope” to clients that change is possible (Miller & Rollnick, 2013).
- What is my role, as a social worker, in the change process?
I teach undergraduate social work practice classes and it is exciting to work with beginning social work students. One of the common behaviors that I observe is that in role-plays in class, students immediately begin to give advice to the “client” and fix the problem under discussion. This gets at the view of human nature that our clients do not have the ability or knowledge to solve their own problems. If they did, they wouldn’t need a social worker, right? Thus our job is to ask the right questions (diagnose) and come up with the solution (treat), very much in line with a medical model. We are the “experts” and our clients come to us for our expertise—which is sometimes very little, in beginning practitioners.
On the other hand, again based on humanist models, is that belief that yes, while we are experts in our field, clients are the experts on their own lives. They possess the knowledge and skills to solve their own problems. If we truly believe this, then we don’t give advice or assume we know what is best for them. We work to evoke it from them and have a discussion about their thoughts and ideas. We are more of a facilitator and partner in the change process.
There are other aspects of Menschenbild. These are three key concepts that I find useful in the classroom when teaching about Motivational Interviewing. As both undergraduate and graduate students discuss client scenarios and case vignettes, I encourage them to go back to these concepts and reflect on their own beliefs and how they impact their practice.
Anecdotally, students and practicing social workers have shared with me over the years about how learning and using MI has radically changed how they interact with clients. It has reduced the tendency toward burnout as the need to change or fix a client has been let go of. Trusting and believing in clients somehow seems to provide more energy. As a teacher, using the humanistic concepts and methods of MI have impacted how I interact in the classroom and in my individual discussions with students. What that change is will be a subject for another blog.
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Preparing people for change. (3rd Ed.). New York: Guilford Press.
Dr. Melinda Hohman is a professor at the School of Social Work and teaches courses in social work practice and Motivational Interviewing.