An episode of Changing the Conversation podcast
Jess Sneed and host Ali Hall discuss how Motivational Interviewing strategies are the same and different in online and chat-based settings compared to in-person interactions.
October 15, 2024
Ali Hall, Host (00:05): Hello, and welcome to Changing the Conversation. I’m your host today, Ali Hall, joining you from San Francisco, California. I’m a member of the Motivational Interviewing Network of Trainers, or MINT, and a MINT certified trainer.
(00:20): Our topic today is using motivational interviewing in chat-based settings. My guest today is Jess Sneed, calling in from Orlando, Florida. Jess is an MI trainer and facilitator, and member of the Motivational Interviewing Network of Trainers, or MINT.
(00:39): Welcome, Jess. So glad you’re here.
Jess Sneed, Guest (00:41): Thanks for having me, Ali.
Ali (00:43): Okay. Chat-based settings. Say more about that, please.
Jess (00:48): The topic really came to mind as something that was important and different. As a result of my time working with a mental health startup that provided 24/7 online chat-based MI coaching. I started that work, started doing MI in that setting. I really hadn’t thought much about it, about how it was different. It was just something that we were doing. The more I talked to folks, and the more telehealth started to gain traction, and folks were accessing coaching services and meeting with providers in that format, it became clear that there’s some unique experiences with that chat-based or web-based platform that were unique to doing MI, versus doing MI in person settings.
Ali (01:59): Okay, great. You’re really talking about bringing MI spirit online. And yet, it’s unique. What would you say is most special or different about it?
Jess (02:09): A lot of what we do with the spirit of MI in in-person settings is our body language, it’s our tone, it’s our facial expressions. A lot of that gets lost when you don’t have a person sitting in front of you, when you’re just communicating via web chat or even text. Bringing the spirit online, what I found in training folks to use it in those text-based settings, is that you have to do things a little more intentionally, and maybe even emphasizing certain things a bit more to fully convey the spirit.
Ali (02:55): Yeah, that’s really interesting. I think you want to be genuine and demonstrate your genuineness. You may be able to know whether that’s landing or not if you can see the person, and you know if it’s landing if they can see you. Here, you don’t have that input. How do you do that?
Jess (03:16): Exactly. Especially one of the things that we talk about, or one of the skills that we really emphasize in MI is using reflections. Simple reflections versus complex reflections. What we found is that in text-based, web-based settings that you really have to use complex reflections to go deeper. Those simple reflections in in-person settings, you might be able to get away with paraphrasing. But when a person has the ability to scroll back up in the chat and re-read what you wrote, using more simple paraphrasing didn’t work well. Folks started calling us out and saying, “Oh, you’re just parroting what I’m saying.” Or, “You’re just prettying up the language. I don’t feel like I’m getting anything.” That was a big difference of making sure that folks were really, at least our coaches were really using more complex reflections to dig deeper.
Ali (04:32): That’s really interesting because simple reflections can get into a cul-de-sac pretty quickly. You can track along with folks. You can show people you’re hearing them, as maybe they’re sharing a larger narrative with you. But it sounds like really moving the conversation forward, creating some momentum in a way that doesn’t feel parroting, you’re going to go with complex reflections.
(04:58): At the same time, at least from a training perspective, that can feel like a really difficult skill for folks to do. That’s not always the easiest thing. Some people seem more natural at it than others, or trust it more than others. How do you help someone who really is in chat-based settings get more comfortable and be willing to step out in complex reflections?
Jess (05:22): I think it takes practice. One of the resources that we have available that we sometimes don’t think about, but it was always fun to point out to people, is that so much of our conversation with friends and family members is, at least from my generation, is text-based. What I recommended to folks was practice your complex reflections when you’re talking to friends and you’re talking to family, and you’re texting. They tell you about their day, and where in-person you might get away with a nod or, “Yeah, that’s so tough.” Text-based, you have the opportunity to say, “Wow, it sounds like your day was really terrible.” Or, “It sounds like your day was amazing,” and really digging deeper. That was an opportunity for folks to practice in a low stakes way. I think when you’re learning something new, low stakes is always nice.
Ali (06:31): Yeah, that really makes sense. Amplifying, getting a little bit more comfortable with that, or maybe reflecting a piece of this or a piece of that, rather than going straight on with a simple reflection. That’s great.
(06:44): This idea too, about how many times have we felt misunderstood with a tone of our text or an email. How do you help people with that? Getting the tone right when there’s no inflection, when we can’t read someone’s voice. If you can solve that, you will solve most human discord. People who get offended, or misread, or feel misunderstood with tone, how do you do that?
Jess (07:18): That takes a bit more practice. I think with text, we can be a little bit more intentional. It takes some awareness of word choice, I think, and the way that you even structure your sentences. There’s, I think a commonly held belief now, again amongst my generation, that we don’t end that last statement with a period. That feels too final. Even if you’ve used periods throughout your text, that last sentence, you leave the period off so that it softens it. Versus if you put a period, that feels final. I’ve even had friends message me and say, “Jess, are you upset with me?” I’m like, “No, no, just proper punctuation.” It took a little bit of navigating that.
(08:14): But we do understand that there are nuances in tone. All caps is yelling. Even if you can’t hear the other person yelling, when you see that text message and you see all caps, you think, “Oh my gosh, this person is emphasizing this for some reason.” Maybe they’re yelling, or maybe they’re excited. It really is teaching that and helping folks navigate that, especially folks who maybe aren’t comfortable with text or don’t do a lot of texting. Emphasizing that to them, that, hey, sometimes punctuation might get misread. Or sometimes, all caps doesn’t mean excitement. Sometimes it means a person’s really upset. I think, again, being more intentional about understanding what that means.
(09:10): And, because we don’t have that face-to-face interaction, where I can tell that someone’s excited if they’re smiling and their eyes are wide and they’re loud, versus they’re loud and their face looks very stern, or their eyebrows are furrowing. In text-based settings, we might even need to ask. There’s a nice moment of humanness and being transparent to ask for clarity, or to provide clarity to someone. There’s a little bit more work that we need to do on our end as providers when we’re having those conversations. To say, “Hey, I want to make sure I understand you. I noticed that you used all caps and I want to get it right. Are you feeling upset, are you feeling angry? Maybe you’re feeling excited. Help me understand.”
Ali (10:04): That’s great. We should really dig more into our interest and curiosity, and feel a sense of humility putting it out there, as the well-intended people that we are, to want to understand. I appreciate the tip because I’m an enthusiastic, emphatic person known to put a lot of exclamation points. I’m going to be more mindful with my text-based punctuation at this point. I’m going to be really mindful.
(10:31): I think too, text can often invite us to be more concise with our speech and get out of the way for the other person. What thoughts do you have about that?
Jess (10:40): I think it’s great. Again, one of the benefits to being able to self-edit in a text-based setting means that we can get out of our own ways. We can maybe not ask the question about the thing that’s interesting but not important to the conversation, or to the client that we’re working with. I think it allows us to have a richer, more purposeful, and more direction-driven or direction-oriented conversation because we don’t have some of the meandering that we might in in-person settings.
Ali (11:18): All right. We should be mindful too, of being good editors before we hit send. With speech, how many times have we wanted to put the toothpaste back in the tube and it just won’t go? Here, we actually have a chance, “This is what I’m intending, thinking of writing. Is this really what I want to send? How is it going to land?” Maybe sometimes, looking for and taking the thorns out of our words before we hit send, if it’s a difficult or challenging conversation even. How is this going to be experienced? We have a chance to think about that a little bit.
Jess (11:55): I think, again, it goes back to word choice and word placement. You asked about genuineness a little bit. One of the things that we do in in-person settings is that we have the ability to nod our head, or to be in the presence of someone in a physical space and our body, our tone, our facial expressions convey, “Hey, I’m here with you.” We do that in text-based settings by being intentional with our words, with our word choice in self-editing.
(12:37): One of the things that I think comes up often in text-based settings, especially in service spaces, is people want to know that they’re not talking to a bot. That’s a level of genuineness that often gets called into question. “Hey, am I talking to a person or am I talking to a robot?” One of the things that I know I’ve encouraged folks to do in those settings is to almost do the human thing that you would do in-person. If someone says something that makes you think, I might start off my sentence with a, “Hmm. Here’s how that landed.” Or, “That’s something that is really thought-provoking.” I might bring in some of those modifiers and those ways that I might be in a space with another person, and try and convey that in text form.
Ali (13:33): Right. I was thinking a little bit about how, when we’re in-person, we might lean forward. We might have an expression, something that encourages people to keep speaking. We also use those verbal encouragers. Or, “Hmm.” Those kinds of things. You’re thinking spell them out a little bit. Yeah. Go ahead and spell them out because there are ways of showing people that we are there. It softens the exchange a little bit.
(14:05): I guess too, it also gets us out of some of the unconscious verbal habits we might have. To start every reflection with so. Or, okay, or hm. If we overuse those things, it’ll show up pretty quickly in chat. Or when we end every sentence with, “Right?” We’ll see that in print and we’ll be able to delete that out.
(14:35): Okay, concise. A lot of people in chat, in text use emoticons, emojis. What do you think?
Jess (14:45): I love them. I think if there was ever a place for us to use that, emoticons, we emote. In a text-based setting, we don’t have the ability to see a person’s facial expression so I think emojis are a great way to bring that in.
(15:04): Another way that I enjoy doing it, if it’s possible, is with, and I might get called out for this, GIFs. There’s a debate on whether it’s [pronounced] JIF or GIF. But I think those are also really nice ways to bring in that expression. I think all of those were ways for us to bring in the emotion that is lost through text-based settings. I am all about the emojis.
Ali (15:29): All right. I love that. I’m glad I don’t have to stop using them now. Because I’ve been thinking about complex reflections, and how amplifying is one thing, over or under emphasizing. But also, the use of metaphor. It sounds like we can liberally bring those in.
Jess (15:46): Oh, yes. Metaphors are great. I think they are under utilized in in-person settings. We do tend to lean more toward, I think, one certain type of reflection. Metaphors have a great place in text-based and offer us, again, a visualization where we would get lost. If someone is really struggling to make a decision, if you say, “It’s almost like you’re walking a tightrope,” that makes up for something that we might lose in an in-person setting. I love that. I love metaphors as well.
Ali (16:30): Great. I was curious a little bit. When we are in-person with someone, or on screen with someone and can see them, as a person seeking services, we get a lot of cues about our provider. We may make assumptions about our provider, but we can see where they are, what they’re wearing. Do they seem comfortable living in their body? We size people up a little bit visually. And here, that piece isn’t there. Or maybe we either trust more or trust less, I don’t know which, when we can’t see people.
(17:07): How does it work with self-disclosure, or trust issues, or trust ruptures? Yeah. How does all that work, differently than it might in-person?
Jess (17:20): One of the benefits that I have noticed in a text-based setting is that, at least for clients, sometimes it offers them a little more freedom in that anonymity. Especially if it’s text-based, and you can’t see them. But there is the added level of, “I don’t know who I’m talking to. I don’t know if they can understand.” Like you said, that sizing up.
(17:45): I think at the heart, that’s the way that I’ve always seen it. When people ask, “Do you have kids?” Or if they identify as someone from a marginalized community and they want to know if I also identify that way. I see that as a moment of them trying to understand, or them trying to connect. They want to know if I can understand their perspective. I think self-disclosure is always tough so it should be used with discretion.
(18:16): One of the things that I used to train folks on is self-disclose maybe more generally. Pick up on that piece about you want to know if I understand, because often that’s what is at the root. Then turn it back to the other person to say, almost in a way, “It’s not about me. This is really about you.” I might say, “Well, no, I don’t have kids. But it seems like you want to know that I can still empathize with you as a new parent. What is that experience like?” I’ve gotten a chance to self-disclose, so I don’t leave that person hanging. But I haven’t it made it so much about me that now we’re off-topic. I get a chance to turn it back to that person. Hopefully, that’s enough.
(19:04): I think you’d also asked about ruptures. One of the things that is really tough in a text-based setting is to know when something landed with a client and the microwave went off, and they just needed to go get their tea. Or something landed in a way that didn’t feel great, and they put their phone down and walked away. We don’t have a great sense of that. But one of the things that we can do, again, is be intentional and say, “Hey, I noticed we stopped chatting for a little bit. You’re quiet on your end. I want to know how that last statement landed for you and what it’s bringing up for you now.”
(19:45): I think we even have to be more intentional with the way that that silence shows up. And maybe leaving room for folks to think. Sometimes folks will say, “I’m just thinking. What you said made me think.” But sometimes, it really is that maybe we’ve touched a nerve. Or we’re at a sensitive topic and they are like, “Hey, I need a break.” They haven’t said that, it’s on us to check in with them and find out a little bit more about what’s going on.
Ali (20:14): Right, the importance of silence. The thing that happens between notes of music that actually make a beautiful song. When we sense that there may be something, calling out and saying, “I noticed that,” or, “I’m curious about,” and letting the person let us know what they feel comfortable saying.
Jess (20:32): Yeah. I think it goes back to something that you said earlier, which is we really dive into the curiosity on our part because we don’t know for certain which way it went. But we can be curious about it and ask.
Ali (20:49): Yeah, and hold that space. That’s beautiful. Well, thanks for the great work that you do, and bringing us some really wonderful ideas. I think as more of us move into chat-based settings and want to be effective, this is stuff that we can do with those we serve. It can also be something that really supports all of our relationships in life and in work. Thank you, Jess. Thank you so much for joining us today.
Jess (21:13): Thank you for having me. It’s been a really, really great experience.
Ali (21:17): To our listeners, please join us next time on Changing the Conversation.
Erika Simon, Producer (21:22): Visit www.c4innovates.com, and follow us on Twitter, Facebook, LinkedIn, and YouTube for more resources to grow your impact. Thank you for joining us. This episode was produced by Erika Simon and Christina Murphy. Our theme song was written and performed by Peter Hanlon. Join us next time on Changing the Conversation.
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