An episode of Changing the Conversation podcast.
“I love those chapters that are about genuineness, hope and empowerment. Those were just so beautiful to approach in terms of how to have such goodwill towards those we serve.” Host Ali Hall and co-author Kristin Dempsey discuss their book Advancing Motivational Interviewing: An Experiential Skills Guide for Mental Health Providers.
April 13, 2026
[Music]
Ali Hall (Host) (00:06):
Hello and welcome to Changing the Conversation. I’m your host, Ali Hall, joining you from San Francisco, California, and our topic is Advancing Skills in Motivational Interviewing or MI. My guest today is Kristin Dempsey, a member of the Motivational Interviewing Network of Trainers (MINT), as am I, adjunct faculty at the Wright Institute in Berkeley, California, lecturing faculty at San Francisco State and therapist in private practice, who is also calling in today from San Francisco, California. Thanks, Kristin, for joining us today.
Kristin Dempsey (Guest) (00:39):
Yeah, thanks, Ali. It’s always great to talk to you. Thanks for having me.
Ali (00:43):
Thanks for joining on. And we have sort of a topic of shared interest today. We are the co-authors of a book that is being released as we speak, Advancing Motivational Interviewing: An Experiential Skills Guide for Mental Health Providers. It’s a super exciting volume, so I thought maybe we could talk a little bit, first of all, why this book, and maybe a little bit more about what’s in it and how can some of the ideas be helpful to folks.
Kristin (01:11):
Yeah. Thanks, Ali. You and I have talked about this so much. We’ve been thinking so thoughtfully about this book for such a long time. But as you know, and people who have listened to this probably know about us if they know anything about us, we spend a lot of time training Motivational Interviewing. And as you train in Motivational Interviewing, there’s certain things you always touch on in terms of some of the core ideas, which are really important because it all comes together in order to really have a successful conversation about change and growth, right? Whether that’s around the attitudes and skills that is important for practitioners to have, the actual skillsets that we use, the tasks that we’re performing, how to recognize and work with change talk. And it’s all great. And yet, you go into different situations, different teams, working with schools or community mental health or criminal justice or all these different places, there’s always this, “But what about this,” right?
(02:02): Folks are thinking, which is wonderful, and they’re thinking of the places of challenge, right, as they do this. They’re thinking about the most difficult situation they have. And I know there’s sometimes this thing, “Don’t think about the most difficult situation you have. That’s always going to be hard.” And yet, of course, people think about that because we’re wondering, “But will this work for this really tough situation? I don’t know if I can trust this thing. I have this really difficult thing that’s causing me challenge.” And I think you and I have certainly talked about this over the time. There’s certain conversations that keep coming up. “What about this? What about that?” And that’s really where the beginning of this book started. We started to collect those things that people are challenged with. The person who is maybe finding their power or not, they just don’t know what to say and they’re not talking.
(02:51): There’s silence or there’s someone who wasn’t their idea to be there. They’re showing up because they feel compelled to come, which is how a lot of folks see us, right? Or how do we expand some of our giving and sharing attitude, like creating more sense of genuineness or hopefulness in a session. And of course, there’s more that we’ll explore, but that’s really where it came from. It came from the people that we trained and their needs. If I told you this, I don’t think I have told you this, but our coming together with a table of contents was really enjoyable. It was really fun. It was really a great conversation that we had a number of times about, what do we put in this thing? There’s so many things. Like what’s really rising to the top? And I found that to be such an interesting conversation.
(03:41): I know we’ve returned to a number of times, but in many ways, it’s always challenging to write a book. But this really did write itself because of all the interest and engagement in the training community.
Ali (03:54):
Yeah. Yeah. Thanks, Kristin. I mean, and rarely do phrases “table of contents” and “fun” end up in the same sentence, but you’ve managed that. And I think you’re absolutely right. When we were comparing notes over many years that we’ve been taking notes of the places where providers feel stalled, where other trainers kind of wish they had a few stretches, we were shocked almost by the overlap. We were each hearing some of the same things and realized that these are common challenges that folks run into. And if they had some ideas around these could move through them or past them and sort of superpower or supercharge the work that they do with folks, whether as a trainer or as a provider to really be that next stretch that they need to take to be helpers.
Kristin (04:37):
Yeah, absolutely. I think what can happen is in this conversation or in this place of really trying to do application, it’s easy for us to get stuck. I mean, we have kind of a parallel process going on, don’t we, in many ways. And I think that came up also in the writing of the book. As I was writing about help seekers being ambivalent and thinking, “Well, what about us? In different ways that we’re ambivalent or places where people don’t want to show up or get stuck or what have you? How about places where we get stuck and don’t want to show up?” So, I think, I hope some of the things we talked about here really do start to explore that ability to come in and to loosen things up, to have some sense of curiosity, wonder, more flexibility when presented with challenge. Something you were saying, Ali made me think of this.
(05:22): I was reading a book, it’s actually kind of a well-known trade paperback, but it’s about working in psychotherapy. And the person who was writing for first person is a therapist, and they’re going through some of their internal monologue, again, without mentioning who this was. But the way they were talking and thinking about the person they were sitting with, there was all of this tension and all this, “Why are they doing this or why are they doing that?” And just this grind, that energy of, “I have to master this person in some ways.” I actually found it really hard to read. And I was thinking, “Wow, how difficult it must be to be doing this job and not approaching it with curiosity.” And I think that’s certainly something we’ve tried to instill throughout training we do and then what we’re writing here about how to come in to a certain situation and just break it down, just open it up, just kind of be curious about all the things that we’re seeing and how we’re responding in various challenging and not so challenging situations.
Ali (06:14):
I’m glad you mentioned that. And it’d be probably fair to say that this book does not have a bunch of suggestions about laborious, burdensome, time-consuming, power struggling things that providers and trainers should be doing with folks. And our aim, I think that the outset was to really address the burnout and the distress that providers and trainers feel, recognizing that time constraints are real, that the people that they serve are showing up with complex needs, sometimes with very few resources, and really how to help folks use all of their strengths and make a couple of stretches to have those kinds of conversations that are really going to not only be easy to have and produce some incredible outcomes so that our time together with those we’re serving feels really well spent and that the kinds of self-explorations that we’re helping those we serve have, those self-explorations are going to continue when that conversation is over, opening things up and setting things in motion so that the person can really move forward.
(07:11): Speaking of table of contents, you probably have a couple of favorite chapters. It’s hard to pick your favorite children out of the 12, but if you could, which are you happiest with?
Kristin (07:21):
Well, what I would say is I like the fact of the different personalities and the way they function differently. And so, some of ours are more about how to help with clinician presence. So, I love those chapters that are around genuineness, hope and empowerment. Those are just so beautiful to approach in thinking about just how to have such goodwill towards people that we’re serving and to really position ourselves and themselves in a situation of change and growth that’s so hopeful.
(07:50): I think the hope is really one of my favorites and also just our own genuineness, like how we’re showing up. And I think a lot of clinicians are always trying to think about how to do that well. How to be truly present and authentic is such an important piece. And then we also have some of our chapters that really function in such a way to help folks practice getting out of binds, how to reframe and work with people’s attitudes like when folks come in and they don’t want to be there and to be able to have goodwill for folks in their situations and what brings them in and their context.
(08:21): I like the situations too where we’re having tough conversations, like how to broach differences in our relationships, how to think about the external pressures that people are under and the context that make their lives challenging. There’s so much more, but I realize I’ve given you probably at least three or four different chapters there.
Ali (08:40):
Like you, I love the hope chapter. I think we need that more than ever these days. And it seems to resonate for a lot of folks when we talk about hope. One of the particular aspects of the hope chapter I like that I thought was really interesting is the piece around trust.
(08:56): We ask a lot of times that our clients, we want our clients to trust us, and yet sometimes we have trouble trusting them. And how do we actually elevate that? And we have a couple of activities around trust, which I thought are kind of interesting. There’s some specifics in each of the chapters that get into activities and dive into the topics, either help us practice or there are things that we can do with folks. Another of my favorites, honestly, is the first one, the level set chapter. And one of the things I like about the level set chapter is we wanted to offer sort of a state-of-the-art of MI because some folks have heard about it, learned about it some time ago, maybe not have had access to current training or have even had an opportunity to read what’s latest in MI.
(09:43): So, we kind of survey, where has MI been and where is it now on the day of print? And though some of those level set and includes a glossary of terms and sort of brings everyone up to date about it, which also then allows folks to access the rest of the material and advancing skills. Even if they don’t feel that they’re at an advancing level, they can dive into some of those specific topics just by engaging in the level set.
Kristin (10:10):
Yeah, I love all of that. And I’m glad you’ve mentioned the level set. And there’s something else you mentioned that I do appreciate, which we haven’t talked about. It’s kind of right there, which is the title of the book, this idea of Advancing Motivational Interviewing. We’ll have people ask us, “Will you do an advanced Motivational Interviewing?” And it’s like, “What exactly is that training?” Coaching and feedback is what advances someone’s skill in Motivational Interviewing, but we’re always advancing. And I tell that to people all the time, I’ll never consider myself advanced in Motivational Interviewing. There’s always so much to learn and I keep practicing. So, I think this is another great resource for keeping that practicing going, especially when you don’t have a whole lot of time where you’re trying to address maybe a particular challenge in your work.
Ali (10:54):
Yeah. The idea that ING words are very important. They suggest that the process and the progress and the continual journey is more important, especially in places where there is no destination, but there’s always just the next conversation that we might have or the next step in our own personal and professional development as we emerge. One thing I found difficult a little bit or a lot in writing down ideas was it’s hard to know what’s done and when it’s enough. But like you say with the journey of continuing, life goes on, MI goes on. If we could reopen the book and write two or three more chapters, where do you see am I going?
Kristin (11:35):
I love that question. It’s really important. And I think one of the things I also end up talking a lot about is thinking about MI as part of what we do as part of our toolkit. Practitioners are out there doing psychotherapy or case management or various aspects of leadership. There’s core skills that people have. And to continue to work on the integrating MI seamlessly into the daily work, it’s a way of starting to have these conversations about change and growth. People are showing up all the time, “I don’t know exactly what to focus on. I feel so many ways about it.” All of that is the core work of Motivational Interviewing, and that shows up everywhere in all of our lives. So, I think that ongoing sense of this is a core engagement strategy that we integrate being very process-oriented. There’s times when it makes a lot of sense to be engaging and helping people focus and be looking for change talk.
(12:26): And there’s going to be times in someone’s conversation where someone is ready to do something. They’re ready to make up their first step. How do I know when that’s happening? How big of a step is it? And in case, maybe we’re going a little bit back to Motivational Interviewing again. So just that fluidity, being like water a bit, right? How we can reengage and refocus and basically use this in a very process-oriented kind of way.
Ali (12:48):
And I agree with you as I see conversations, as I hear people talk, as I listen to what’s going on in training, it really is this search for… And Bill Miller has talked about this, always looking for the simplicity that’s on the other side of complexity. And that may really be process-oriented and being in the ebb and flow to really feel the pulse of a conversation to know where to go and what’s most helpful instead of where we’d rather be with someone. As you say, blending MI with other ways of working with folks so that it’s not just compartmentalized or a provider feels like they’ve got to switch off that one light plate and move on to another, but maybe MI is the light that fills whatever room that we’re in.
(13:29): And I’m going to guess that you probably feel the same way, tell me if you do. This idea about to the macro level or structural concerns, particularly structural trauma that folks experience and approaching conversations with that structural context in mind and not just from an individual burden to change perspective. I think that’s going to be a huge area of growth for MI.
Kristin (13:52):
I think so as well. We have many situations where people are making choices and participating in behaviors that on some level looks as if they are doing that out of their own free will. They want to, they’re enjoying or whatever it might be, or they just can’t stop themselves or what have you. But then we start taking in context. We can start saying, “Wait, there’s a function of this behavior.”
(14:12): There’s a function of this behavior because they don’t necessarily have other solutions or other options or they’re reinforced in particular ways to do what they’re doing. So, think of examples of times when people might not be following up on certain appointments or they might not be starting or stopping certain behaviors. We think about this a lot in substance use disorders. Being able to really think about what way does a particular substance use function to help someone get through life to be able to think about that person, not just as someone who’s struggling with their own individual demon, so to speak, which is often the way it’s framed in terms of standard substance use case formulation at times, but more like, what’s the function of this behavior for the person and how to really understand that from their perspective and join from that and to think perhaps of options that are not just individual bound but also community bound.
Ali (15:05):
And too, providers and trainers bringing a sense of interest and curiosity and humility to be with the person and explore in a partnership way, with them, some of the various things that can be going on before we decide what we’re going to do and how we’re going to do it together in a shared way, spending some time really caring for the whole person as a person, which also comes with constraints and contexts that the person lives in, in communities in real ways. Yeah. Thank you for that, Kristin. And thank you so much for joining us today for everything you do as well in making this world a better place.
Kristin (15:42):
Yeah. Thanks, Ali. It’s always a joy to talk with you and to talk about Motivational Interviewing. It’s just such an inspirational and meaningful way to work. And we’re talking a lot about how it’s helping help seekers, but I think it also really helps providers to have this approach that keeps us well and keeps us engaged in the work that’s sustainable.
Ali (16:01):
Yeah, I think you’re absolutely right. And well, let’s keep the conversation going then. To our listeners, also please join us next time on Changing the Conversation.
Lee Locke-Hardy (producer) (16:15):
Visit C4innovates.com and follow us on LinkedIn and YouTube for more resources to grow your impact. Thank you for joining us. This episode was produced by Lee Locke-Hardy and Christina Murphy. Our theme song was written and performed by Peter Hanlon. Join us next time on Changing the Conversation.
[Music]
Listen to other episodes in the “Motivational Interviewing” series.