Ep238 'Motivational Interviewing For Client Communication’ - Reflection with Daniel Williams

Music. Hey Phil, how are you doing? Welcome to episode 238 of the Sports Therapy Association podcast.

My name is Matt Phillips, creative on chatlive.com and as always this episode is being recorded eight o'clock on a Tuesday on the Sports Therapy Association YouTube channel. So we have reached the fourth episode of our new reflection series on the Sports Therapy Association podcast in which I invite a listener of the podcast onto the show to chat with me about a past episode of the the STA podcast that has particularly affected their daily practice as a soft tissue therapist.

There is about 234 to choose from. So if you are interested in being one of those guests, then all you need to do is choose one of those episodes. As long as we haven't talked about it yet, then feel free to contact me. Easiest way is probably matt at the sta.co.uk or hit me up on social media. And then basically, as long as you've got a good internet connection, a laptop, mic and webcam, then you come on for about 30 minutes and talk about

that episode and how it's affected you. It's as simple as that. As I've said before in previous shows, everyone feels great after doing it. Even if you're nervous, then hit me up on social media. We'll have a little Zoom call or something beforehand just to settle your nerves. And believe me, it's great for you as a confidence builder, as a personal development and all those sort of things.

You will feel better for it afterwards. And it can lead to great networking options and possibilities and help you branch out in your own business. So that's why we're doing it. In this episode, very shortly. I'm going to be joined by Daniel Williams, movement therapist and DNM and MI educator, who's going to be reflecting on episode 64, which was called Motivational Interviewing for Client Communication, which was recorded way back, way back.

This is great. Daniel's taking us all the way back to August 2021, where the guest was the marvellous Dr. Gary Mendoza. Before we bring up Danny, I'd just like to say thank you to last week's guests, who were Sarah Jones and Sally Martin of the ST School, who came in to reflect on episode 214, What Values Make a Professional Therapist, which was recorded back in September 2024, with guest Martin Christensen from Norway of the Friday Physio Confession podcast.

We had a great chat. It's all about professionalism. And do we sometimes go overboard a little bit by saying, we must never swear. We must always wear smart clothes. Does sometimes that risk the chance of not being fluid and reflecting the client or patient in front of us and maybe limiting communication? So there's a nice segue to tonight's episode, which is obviously going to be all about communication.

And if you have joined us live talking about communication, then do feel free to leave questions in the comments. If you do come in and leave comments and i can bring that up on the screen so nicky mansfield they said bonsoir mes amis.

Bonsoir that's nicky multilingual we are here us again murphy mbe is in here as well saying good evening all uh founder of the sta gary just come through the door as well who says good evening all hope you enjoyed the long weekend it was a long weekend wasn't it but it was it was cool good to see gary and other people coming to the door as well so yes fire away this is the reason to join live people ask questions as they're on your

mind get it done don't rely on making time to listen to the podcast later on. Now, take advantage of the fact we've got the guest and we're talking about it now.

Right. So there we go. Let's get on with tonight's show. I shall now bring up Daniel Williams, movement therapist and DNM MI educator. Music. Hello, Matt. You all right? Hello, everyone. I'm very well. Good to see you. I like seeing you. I love seeing you at therapy expo. I think a lot of people who have met you will agree that you're a lovely bloke and a great educator. So I really appreciate you giving us your time to be on the show. Thank you very much. Your beard's getting bigger every time.

I mean, it depends on that. But normally when I go to the bar, I'm just shattered and I've gone there for some social grooming. And I just sit back and go, yeah, yeah, just cut it. And I walk out with whatever they've done.

So yeah it's led to changes but for people who aren't aware of you and and the great work that you do with people like mike grice then uh yeah can you give us a little i know it's tricky especially with the amount of things you've got going on but give us a little elevator picture of what you do and where you are in the world uh yeah so i work out of a clinic in harbourne and i do like person-centered therapy where like movement therapy sort of

stuff from mike's movement therapy diploma that he did so very much centered around lots of exercise therapy people have some manual therapy and calming shit down building shit up basically lots of reglin and stuff as well so all that kind of merged into one to kind of provide as somebody with the person-centered care as much as we can always striving to do better and trying to pass on what i've learned to other people as well so hence why i've got into dnm and motivational interviewing

and stuff and everything i learn i try and learn from the best if i can and then And if I'm in a position where I can pass it on, then brilliant. If not, I'll learn a bit more. Fantastically put. What a great communicator, which is good because that's what you want the show to talk about. But yeah, that's really beautiful. And I would feel guilty if we didn't just mention what DNM is, if I need to honor Diane Jacobs and the great work that she's done in the past and continues to.

So yeah, to give us a little, we won't talk too much about it, but what is DNM? Dermoneuromodulation. So basically it is a fancy way of saying skin, nerve and change.

She had to give it a word for something. It's just an explanatory model for touch and manual therapy and more of a neurocentric approach in what she has come up with the evidence that she collated and put into a book so it's all out of control so if you ask her for all the references she'll freely give them all over to you so she's not holding anything back behind a payroll apart from a book she'll probably give it away free if she could so she

would do and she now amazing for anybody who hasn't or doesn't follow diane jacobs and it's well worth following still very active on social media often just to comment on the state of the world today but yeah look up we often often our papers are quoted around the work she's done with people like jason silvanel a real yeah legend in in manual therapy and someone who yeah you should definitely read to people so yeah and daniel is teaching her course dnm dermoneuromodulation

which is a deserves an episode in itself at a later date which would be great but we don't have time for that because tonight it's all about this about dr gary mendoza who was with us a while ago back in august 2021 obviously you've taken over his course which we'll go into in a moment but what was it about that course or that particular episode and motivation of interviewing which you think is important for soft tissue therapists who may be listening

tonight so yeah i watched it when it came out and i watched it again over the last couple of days just to refresh myself and give me some stuff to talk about and stuff like that. And there's lots of things on there. But the thing that attracted me to it in the first place sounds like a 90s dialogue. The broken. Back in time, man. Yeah. But yeah, the thing that attracted me to a motivational interview was there was always something...

The especially with gary and what he was putting out initially anyway because i did i did his course before the sta chat so i'd already done his course by the time that came out so i was kind of looking at the sta chat with open eyes a little bit and it different to somebody who's never heard of it and then watched the sta chat so i appreciate that but it was always there was always something difficult for me when you we've probably all been through it especially

if you've been through the pain side stuff in the bps model where your pain side's education vomited on someone and they have, nah like sorry so you're saying it's all in my head and you're like no no then you're backtracking from there and then you don't get that client adherence when they're coming back and they're not doing their exercises or they're not doing they're not helping themselves or anything like that you're trying to spout stuff at them and throw be

an operator rather than an interactor with them and it very much is the more i looked into motivational interviewing that it was a communication version of dna so you've. Got the dna which kind of very much the.

Physical manual therapy that the touching and therapy version of interacting with the person but the the communication and the the side is very much person-centered from that angle as well so it's kind of sort of it made sense to me to do that and think about it and engage my clients before we made a plan and then go forward and evoke what their actually reasons are for coming here because we just presume or take it on face value asking closed questions and

not listening enough so i always knew there was something there and the reason was that i didn't get the outcomes i wanted i thought i was good and then then you kind of get humbled and you're like well why why am why aren't i helping people change or why aren't i help people get but why aren't i helping people get better when there's got to be another way it's got to be something i'm missing there and i think that's what drew me to that and then but that's what gary says in

that episode is that he says you can he was he's been a personal trainer for however many years but exercise is a swear word and you say to somebody to exercise that it has negative connotations to them whereby if you're just playing games with them or something that you might have elicit a different response or gamify the rehab exercises for some people and it's just being person-centered and treating the person in front of you so there's lots of things that episode brought up with

Gary that he didn't say on the course and actually elaborated on in that chat a little bit more as well. That's really interesting. I really like your link between DNM, which kind of, rather than just touching an arm or a leg or doing something with soft tissue, you involve the rest of the person through the neural system. That's great. But I hadn't thought of that connection with, that's what motivational interviewing is.

You know, you're actually involving the person behind the words and painting off the layers and allowing them. Very cool connection. And you're teaching both. I get it now. I get it. It makes so much sense.

Also another thing which you mentioned which i think is really important is you kind of blase you kind of said oh i noticed that my outcomes weren't that good but i reckon that's something which a lot of clinicians don't do do you think that's part of the problem not everybody notices their failures in fact they probably subconsciously purposely sweep them under the carpet don't they so have you experienced that do you find that's a problem with therapists.

Yeah probably i think you you have that confirmation bias where you you believe that if a patient doesn't come back to you you've fixed them probably and you just sweep under the carpet and go no it's done that's good now but what you don't know is the amount of people that have come to other therapists or people like us and have gone i went to this person didn't help me i went to this person didn't help me and so i'm hoping you can do something different and that's where again it's

like good communication and actually asking the client what they've done in the past and what they haven't and stuff like that can get you to the root of oh well if that therapist has tried that and that didn't work i'm not doing that i'm going to try a different approach and go down there and that's just effective communication between you and you and the client but yeah i think there is a confirmation bias between that and wanting to fix someone and when you if you are wanting

to fix someone you're setting yourself up for failure because when you don't do doing the things that you do there is an always an element of a flare-up happening and then that kind of knocks their confidence in you and then your engagement with that person and that rapport gets a knock a little bit and they'll go well you told me this and you told me you'd be done in four four sessions and it's been eight or something or you strung me along for a year and so But, but as Gary,

I remember Gary saying to me once it's like, always tell them on the first session that there are going to be flare ups. And then when they occur, you can turn around and go, I told you there's going to be flare-ups and there's going to be flare-ups with your pain or there's going to be setbacks. And when we planned it in the first stage, we knew we were going to have to plan through them and go back and take a recheck and reassess, then go forward again.

But you've already done that from the start. You've addressed it. So it's within your plan from the start. So you're not pulling the wool over their eyes. You've been completely open with that person. That's really good. And I'm sure tonight I could have like one of those bingo checklists of great things that Gary said, speaking about motivational interviewing. And that was indeed, yeah, one of them. I've forgotten about that one, actually.

Because we seem to, we go through phases where we think maintenance is an ugly word. And when the client does get ill again, we kind of say, oh, we have to come back in for more. And straight away, the client's like, oh, what are you talking about? So yeah, it makes perfect sense. And it's lovely because I think we'll have a few of these tonight in the show.

It has tiny little tweaks of the way you work, which can just save so much headache and also improve your business plan, you know, and make it so much easier and take responsibility away from you. So that's really cool. For people who are listening and have never heard of MI, or maybe they have, and they've heard kind of a bastardized version, because there's a little bit like any kind of tool, there's different versions out there.

But you've studied, not only with Dr. Gary Mendoza, but you've actually studied with one of the co-founders in person. Tell us a bit about that. That's been great for you. Yeah. I mean, as soon as I found out that Gary was retiring, which was a bit early on, I suppose, compared to when he put it public, I asked him if I could take over and do different things. And I'd read the book, done all that stuff. And he mentioned to get in touch with Stephen Rolnick. He's based in Cardiff.

And I started doing courses with him. So he does in-person courses once a year, one beginner, one advanced, all in person for two days.

And he's, yeah, brilliant lovely bloke like i've uh did did a couple of the courses myself and then got asked to go back and help him assist on the courses as well so i've done several several assists with him one was just being cameraman and so i still learn a lot having your mouth closed yeah yeah yeah so i get a free lunch so yeah i'll video for a bit but yeah no he's uh going to just join for a drink with that and it's fantastic the the fountain of

knowledge and the stories that he has like some of the stuff he's constantly so he is wanting to retire within the next couple years and pass things on to orla who orla adams who is a fantastic dietician in cardiff as well and she's a member of mint their motivational interviewing network of trainers and she is she's awesome and she runs most of the courses now to be honest and steven's just there kind of lending an ear doing different things and and being there because he's him

and then orla is fantastic though and she does deliver it in such a brilliant way so she will be taking it over going forward which is which is brilliant but yeah it's just nice to get those different approaches because they've been working for years with MI and how fluidly it starts comes off their tongue even when she's presenting and he's presenting it's you can tell and you can nitpick things so and see oh that's MI that's

there that's that's the style of communication that MI is and you can start seeing it in everyday conversations. But yeah, then they recommended me to go and do a MIDI coding course. So I did that last year as well, where starting at 10 o'clock at night, like online with some Americans over, so it was on, I think it was Pacific time as well. So it was a fair way. I wasn't the worst. There was a couple of guys in Hong Kong and they were like wee hours in the morning.

So I did not want to be them. But what that was, the MITI coding is basically what they used to prove that motivational interviewing works in an environment. So they had to come up with a system to research it. So all the research and evidence that's produced for MI is based on this MITI coding system. So if you want to look that up, that's really cool. And you can score people's conversations. So that's what we would do.

And that's what Gary's done as well beforehand is when you would put your homework in for him and your video of your conversation, he would run it through transcription and then pick up and score. Like that's an open question. That's an affirmation. That's a reflection. That's a simple reflection. That's a complex reflection. And then work out the ratios between it. And then there's certain ratios. I can't remember off the top of my head.

To make it an mi compliant conversation uh and that is that was full on that was four days of like six hours at a time so sitting on my bum in front of a computer i see being a manual therapist and in the gym most of the time i did not appreciate that so you've you've you've dropped a few kind of words and terminology in there which i'd like to get into for people who haven't heard of mi before people who are in the comments don't forget make the most of this and ask some

questions if any of you have any experience using techniques for motivation interviewing them do feel free to share that if you've got any questions maybe we've got daniel here who is trained with the one of the co-founders of the whole technique anyway so i'm sure daniel will be able to answer or if not he'll spin it back around to you and you'll have the answer which is amazing which would be great but yeah so so some of the things you mentioned what are

the what are the what is the core element of motivational interviewing what's it about so it's it's it's a style of communication rather than a technique so it's it's more it's more about being empathetic and authentic to yourself as well as other people so you're actually trying to find their motivations for wanting to change and it's it's very person-centered so that's why it works so well with dnm as well and it's it's basically guiding

to elicit and strengthen motivation to change in in a nutshell. You don't want to be persuading or trying to fix them. And that is one of the things that a couple of the changes that have happened from the third edition since Gary's podcast that he did to the fourth edition book that came out last year. There's been a few changes in language, which we'll go over in a little bit, hopefully.

But yeah, there's a few things there. So it's not about trying to fix people, which perfectly sort of integrates with the Operator Interactor paper that Jason Silvanel and Diane Jacobs did on how we should approach manual and physical therapy. So it kind of, yeah, it kind of works together, very person-centered. You don't want to be telling someone what to do. It's very much sort of guiding them, working with them.

And a quote that Steven Rolick always uses is, you want to be dancing with them, dancing with your client rather than wrestling.

If you're wrestling with your client, you're fighting against them you're trying to change them forcefully if you're dancing with them you're guiding them through and you're leading them in a different way that's very nice i didn't realize that was his i used that in a podcast i was on the other day and i said i can't remember where i heard this but now i know so thank you of course it came from me so many of the girls do,

but yeah no it often is that imagery which really helps the coin drop for for yeah therapist thinking how, I don't know if I'm putting you in the spot here, but could you give us like a working example, maybe, something of how maybe some of our listeners do do something when a client comes in to how maybe they could tweak it a little bit to open the door to what you're talking about?

Yeah. I mean, one thing that has drastically changed my practice recently, actually, is because this was all great, but it was the introduction of transcription software and AI.

So using an app that you it records your your conversation and then will give you the transcript afterwards and it can use ai and put it into your physio notes if you want to for quick and easy access to those added into your software just make sure they're right but it gives a perfect example of being able to record your conversation with someone be present with them and look them in the eye and face them instead of being like that and oh yeah what was this and

yeah asking very closed questions so one thing that mike grice he told us to do from the very start so he's been from a teaching background utilizing a lot of this stuff anyway it just made his practice a little bit more and every and ours as well but yeah he told us from the very start is to get the pre-screening forms out there and if you're getting pre-screening forms with the closed.

Questions already done then when you're in with the room with them you can start asking open questions and start to engage with them straight away instead of have an interview process that feels more like an interview rather than an actual conversation and a collaboration to help them and that's that's profound i think and just to clarify for people who aren't aware what do you mean by an open question so an open question draws out thoughts and ambivalence

to So you're asking an open-ended question that is not a yes or no. So a closed question is yes or no, or certain answers where you're asking for their name or something like that. Or are you male or female or anything like that? What is, how cool are you? These sorts of things and close questions where you typically get a yes or a no response. And they're very close. They will usually close a conversation, but an open question will open that conversation to more elaboration on their part.

So if you wait and hold space, they will usually give you more than you think as well. So that is one thing that you can all, or introduced straight away with anything is just hold space. Hold back, count to four or five or whatever you feel is comfortable for you before you say anything when your client has stopped speaking. Because more often than not, like as Gary mentioned before several times, if you hold that space, you feel awkward, but they'll feel awkward.

And what do you want to do when it's awkward you want to talk so if they've got something to say they'll probably elaborate it especially men like men will usually start to elaborate a little bit more if you give them space and time to actually talk so so let's put this into just to give our listeners an idea so someone's come in i don't know they're presenting pain around about achilles or something like that so give an example of a closed question which you might people listening

might direct to that patient or client if they've come in with pain around there what might a close question be and then how what would be a better open question which would open up okay does it hurt on the.

Achilles tendon itself okay so obviously yes or no yes yes or no okay yeah yeah so you're asking those sorts of questions does it hurt here does it hurt does it hurt if you do this does it hurt if you do this very close question if you if you're asking an open question you're asking where does it hurt? And then they will elaborate and say, well, it hurts here. And they might go, well, it hurts here, here, and here. And they might give more information.

So the information that you get from asking a closed question is very limited because you're only getting the information that you are seeking. But if you ask an open question, you might get information that you wouldn't even thought of that drives that conversation into a different area and goes, oh, well, that opens up so many more doors. The amount of times I talk to, I'm not perfect, but by all means it's driving to be as best as we can and we'll continue to do so.

But yeah, it's very, the amount of times I come up with it and go, oh, I should have asked that then. Should have asked an open question there. and then you you ask it anyway afterwards and you just drive the conversation and they take that conversation in a different route so you go hard that's that's thrown at all i didn't know that.

Yeah i enjoyed that i've watched actually knowing this episode was coming up i wanted to watch a video of steven volnick that i hadn't heard before and i found one he was talking to crossfit i can't remember how long ago it was it wasn't that long ago because he was talking about getting to sport and parenthood and stuff like that but yeah he was kind of he made the point of the beautiful thing about MI is because you are practicing not talking and like putting your hand

over your mouth maybe or whatever things that Gary said and giving that and giving the responsibility for the actual person you're talking to to talk then it does give you time to kind of think during that as well as clocking what they're saying but to kind of think how's this going oh that's interesting that we've just done they just opened up so you can actually practice it whilst you're doing it and see how it goes and

rather for people who are stressing out thinking oh my god what have I got to do next It's not like a conversation where you're talking and thinking, what am I going to say next? You've got plenty of time now to actually sit back and then think, oh, that's interesting. And it takes a lot of the pressure, which I think is a good point. Really, yeah. So great. And I liked what you said about the thing about pausing is what normally happens if you do give a pause and then they continue?

What's kind of different about what they then come out with? It's usually more in depth. You're going to get that surface level conscious kind of response that they've been thinking of. It's on their minds. That response of that question, they're probably straight away, they're going to give that. If you wait, they have to start delving into their own subconscious little bit and start to think, oh, he wants more. Oh, actually, yeah, is there more?

And they start to do that. so they'll start to be in their own head and go whether this is is happening in their own head and they've got it in a voice or not it's it is a story for another day but it's they start to give more information basically is that is the outcome they start to give more in-depth.

Information that will draw out thoughts or different ambivalence from different areas that we can start to latch on to and go oh i'm going to drive that conversation that way instead that was interesting what you just said there let's go down there that's more interesting or i want to know more about that and then when you reflect back on that you can gain more information into that area of things which is something that they probably

wouldn't have thought to give and the amount of times somebody would come up and go oh i don't know whether it's relevant but this isn't this and how many times is that hugely relevant and then you go okay and then you can sort of steer that conversation into that a little bit it makes them think so i guess part of appreciating how this works is realizing that i mean maybe does it help to first of all understand that to help this person it's not going to be all with your hands you're not

going to be i mean a lot of that is important and involved maybe for reasons you didn't think but in order to appreciate, the success that am i can give you do you have to have already kind of thought, that patient has got a lot of the answers. I put a lot of more power in the subjective rather than the objective. Is that something which helps to get the point of MI? Yeah, I think so.

I think for me, the role of MI is just being present with that person and authentic and empathetic with the person in front of me.

And that's the sort of spirit of MI they talk about and it's it's different things for different people you have that but you have that collaboration and authenticity and stuff like that it's very person-centered at the whole of it so you are dealing with the person in front of you and if you can engage with that person they're going to give you so much more information than just a closed question that you or that you're writtling off on your form so yeah i think it's sort of it

allows for just more effective communication as well because you could go through a whole hour of just a normal conversation of closed questions seeking the relevant information that you want but with certain guided questions and not in a technique but a style of just get dancing with the client in front of you you can gain and elicit elicit that information that you require without knowing that you require it in a very short time and then you can sort of get to those motivations of why

they want to change It's very difficult for us with MI because. Well, not difficult, it's easy for us in one way, because we've already got a certain amount of buy-in. And MI was originally sort of developed for people with addictions that don't want to change. So a lot of these things with MI are built up around trying to get people to change when they don't want to and trying to evoke those reasons for change out of them.

For us, I find that it just helps us develop that buy-in a little bit more, evoke more reasons to change why they're here and more of an emotional reason why they want to do the things they want to do. Well, I can't do this. I can't lift my head up. Well, why?

What's the reason behind that what's the function behind that and again we always told that's because i can't play with the grandkids or something can't get down on the floor can't do my sport, it's more of an emotional attachment to that and then they're going to have more of that buying when they go and do their rehab exercises or are they are they ready to change or they're ready to change something in their daily life or their load management whereby that that's

going to affect their pain or rehab or whatever because clearly something it is a load management issue there's something's been amiss and that that's probably caused that load versus capacity to be a bit at whack and getting them to pull back and go let's have a look at your load have a look i had to do this today with somebody literally plan their week out and go what are you doing in the week because something's clearly not

right with your recovery or something like that and this is a flare-up that has happened about six months down the line so dealing with a flare-up so coming back with that and i literally had to tell him today i told you six months ago with this would happen and this is what we're going to do like i said we plan we strip it back and then we go forward again, yeah it's a tough pill to swallow but you could see on his face going yeah you did yeah you do.

It's almost like it was it was almost like yeah but but i did everything right and you're like yeah sometimes i told you like at the start like you sometimes you can do everything right even myself and you still get injured you still get flare-ups just like life and then but that doesn't mean we can't strip it back and build it back up again and see what happens yeah it's it's it's very.

Powerful to be authentic with that person effective communication i think and it just guides you in your whole practice is the essence of it, really. I guess I like the way you mentioned exercise and persuading somebody to actually do their exercises or rehab program that you set them or maybe try and get more sleep or eat better or any, there's going to be a behavior change.

I think that's one of the big things, isn't it, about going from a level three where you're not working with injured people. And then as soon as you move to a level four, level five, then you are going to have to look beyond the calming down of the nervous system, calming the shit down, like you say, with the Greg Lehman sort of stuff.

And obviously that does normally involve a behavior change of some form and it could be loading so and also we know that one of the biggest problems is lack of adherence to exercise and i often talk about this and when i'm reflecting on my own practice but and i'm hoping there's some listeners out there who maybe even today have thought oh that bloody patient doesn't do their exercises how the bloody hell they're thinking

they can get better if they don't give the exercises that i give them and i think a real good coin drop moment that i had and it was because of somebody else or something I've read or what I saw on a course was like, if they're not doing the exercises, that's got something to do with you. Maybe they didn't understand the importance of it. Maybe you gave them too much. Maybe you didn't consider the fact that they really aren't going to go to the gym.

So I think once a therapist pulls that blame down, back to themselves without taking too much responsibility, but realises, hold on, I didn't get that across to them properly. And that's what the communication is, isn't it? As well, it's kind of a two-way thing. So if you are a therapist out there who's blaming patients for not doing exercises, this is what we're talking about. Because that person might not be ready to make that change. And this is what MI is all about.

It's about trying and leading them down that road through their objections and stuff, and then eventually being ready to plan a change in that. So great stuff. And we've got a few comments here. Nicky Clare-Emmanuel, thanks for joining us live, Nicky. She has said, huge key term there, the power of holding safe, healthy healing space for open, more revealing space questions. The type of assessment makes a huge difference, definitely.

Yeah, great point. That's holding safe. And there's so many techniques that Gary came out with as well, isn't there, about. I liked what he talked about, the writing reflex. Let me, you tell me about the writing reflex. I'm sure that's something you talk about a lot in your course? Yeah, so the writing reflex is actually something that's been changed. Oh my God. Yeah. In the fourth edition, it's actually been changed from the writing reflex because it was...

They've tried to change a lot of the language in the fourth edition to more general terms so because it's it's going from a more of a superior sort of um healthcare or medical sort of standpoint where they've got these jargonized sort of words and these things to simplify it all so it can be used across the world in different environments because it is being used in teaching and loads of areas in in counseling and stuff and if if the client as well as the therapist can understand what is what is

happening it's a lot easier so this actually goes nicely onto those those changes of what has happened from 2001 to now so the fourth edition came out last year and the writing reflex has been changed for the fixing reflex okay makes sense oh it makes more sense yeah because we are trying to fix someone we're trying to that thing instead of trying to write it and it means the same but it just makes a little bit more sense so it really just means we're we want to jump to fix people rather

than collaborate and understand their motives behind it so yeah you do want to fix someone even if they didn't ask you to that yeah they've come to you for help yeah and you instantly want to try and fix it but i know from my girlfriend if i try and fix every problem she has no he doesn't like that she somehow she doesn't like me providing solutions and so i have to kind of ask her does she want solutions or does she want to be listened to and oh you don't put it that way do you yeah not that.

Way but i was gonna say listen love what do you want a solution.

I'll just be to sit back and listen to you roundabout way i won't tell exactly but yeah i hope she's not listening yeah probably is no in my love but yeah i'm hoping listeners can understand that yeah the writing reflex or the fixing reflex like telling somebody straight because you're sitting there thinking i know the answer to this this is what i did on the course i can solve this situation and boom like you said earlier vomiting it out but that's a problem with education, isn't it?

Not on Mike's courses, Mike Grice, obviously, and forward-thinking courses, but traditionally, courses still.

Think they're empowering you by putting you up there as somebody who's got all this knowledge and then as soon as a client comes to the door all you've got to do is offload that knowledge and that's what makes you a great therapist but it's so not that is it no no. No and that's the thing i think when you're providing technique-based courses as well which mi isn't a technique it is a protocol as in like you have these paths and that is what another change that's come up as well on in lmi is

that it's no longer called processes that you go through they're called tasks that you can jump in and out of so it isn't a process where you have to engage then you have to go to the next level then you have to go to the next level up.

To the next level and then oh i'm allowed to plan with them now it's like no you might have to go back and forth up and down tasks at different point so you might have to go back to engaging because you you get a bit of discord with them and you have to engage them again because you found something that they didn't like or they have created some discord in the conversation or you've created some discord in the conversation that has resulted in you need

to engage them back again and invoke more out of them so and that might have to happen over several it's not in one session this could happen over weeks this could happen over months so during your calming shit down phase where you might have to provide more manual therapy than you would like to to get them loaded and stuff you might have to engage a lot more and manual therapy can be a perfect part of communicating engaging

with that client i feel to get that by and get them on board and then you can start to evoke the reasons for change later on it doesn't have to all be done in that session not that first session it's it's developing that rapport with someone that communication over time but yeah it's if you're teaching a technique, a how-to, one, two, three, four, five, you do this step, this step, this step. You're trying to fit people into a box where they're not wanting to be in a box.

So if you get taught the tasks or the methods behind it, you can apply that or what you know everywhere to that person individually.

So I think that's where that person-centered approach for any course that you're doing if you know the prop the the methods and the process behind it basically you can you can help them a lot more because you don't have to be stuck you can actually you can go on a different path with them if you need to you you freedom basically to do oh i'll do a bit manual therapy today with you if you want if somebody comes in and they're requesting

acupuncture or something oh i've had really good results with acupuncture before i don't normally do acupuncture But I know for that engagement, I would probably do it.

And that's fine because I know that if they have really good results with it and they want a bit of dry needling and I'm qualified to do it and they love it, That gives me the opportunity to engage with them, talk to them, get them going, and give them a bit more of what I think they probably need to get better and plan their rehab more effectively. So be it. That's fine. And if it helps calm shit down so they can build it up, brilliant.

Well put. That's great. And you're still, for people who are worried, just still being evidence-informed. Because there's like 300-plus RCT papers showing how that sort of thing. I think, I think I can't remember, you might know actually, but I think it was somebody who's worked with Stephen on occasions, names escape me, but she was involved in a study about empathy. And I think it showed quite clearly that that was the one. Yeah.

How, how empathy can often affect patient outcome much more, be much more of a key factor than knowledge and experience and skill. But it's not that easy, is it? I think, and I wanted to make sure we're coming, I'm trying to make these shorter, these podcasts, but you know what, it's such an interesting listening to you and the topic.

But i think um for listeners out there there's often this case because we're in we're in this business we kind of presume that we are good listeners because we work every day with loads of people but there's so much which we could do better than there which doesn't necessarily come naturally it's nothing to be ashamed of but give us some examples of that.

So things where we're overconfident our listening skills and then things little things which we could do better to become better listeners which unless we are taught by yourself or somebody or read about it we wouldn't even imagine doing yeah yeah i mean i think that's the thing you do think you're you're good at communication i thought i was even doing mmi and you just get to that point of uh sort of the dunning-kruger effect where uh

you you are confident in what you're doing and then you get humbled a little bit like oh oh yeah that's i'm not as good as i thought or you get into a situation whereby you're talking about different things and different styles of communication and coming back to those core principles if it's the person in front of you you're trying to communicate with so. Be curious. And one thing I learned from a girlfriend actually recently is seek to understand.

I think that's from Franklin Covey, I think it is. And if you, that's not from MI, but something different, but it encompasses it better as an overall thing is if you seek to understand, which is very much in the spirit of MI anyway, you're trying to understand the person in front of you and not show how good you are at communicating and listening.

Because that is one thing that i learned especially on top of it like thinking i knew a lot and you learn something new every day but yeah if you seek to understand in every conversation you have you're going to ask more open questions because you're going to seek more you're going to seek more information from that person in different ways and then you understand and reflect back so it perfectly sort of melds melds back into mi and what you would do in those processes so another

thing that you could do is the the old school old school well the third edition it was illicit provide illicit but that has been changed to simply ask offer ask so you're asking for permission to give information and then you ask again you offer and come back so you're basically sort of asking for permission for things so it's which is really weird to do in a general conversation like try.

Your family or uh you loved ones because they'll turn around and go what the hell are you talking about so it's it's it's very very difficult to like throw those in but simply asking if and i've tried to do this with my personal relationships as well like i'll start and i'll start doing it i'll start giving information straight away i'll be like this explaining a situation and i'll cut myself off and go, do you even want to know?

For instance, I was talking about a car and I was talking about diesel engines and petrol engines and spark plugs versus glow plugs and stuff. If, And I was talking to my girlfriend the other day and literally I started really, oh, the difference between this and this.

And I went, do you actually want to know why that works? And she goes, no, not really. She's just a lucky woman. So that saved me rabbiting on for half an hour about something that you didn't care about. Because actually, I didn't really care. I didn't want to talk about it. I just felt the need to talk about it.

So it's interesting how I think Dr. Gary Mendoza points out in the episode as well, and I've heard Stephen Wollink talk about it in videos, is when you do a course in MI or something, then you will find that you can, not always, but there are situations where you can use it in life and you'll see the advantages of it. It is something I found. I did Gary's course.

He did say, you know, for your homework, it's probably not ideal to practice this with a loved one or a wife because it can lead to arguments because it's kind of, what are you trying to get at? What are you trying to unpeel? They really don't want to be unpeeled because they think you've got a vested interest. It's important not to get that dynamic.

But I think what you see in work and in other areas of life with friends and colleagues when there's not that kind of invested interest, and it's cool. Yes, suddenly you think, oh my God, that person's really opened you up and talked to me and enjoying it.

And they ask me if they want to see me again. you know it's like i've got a second date wow how did that happen so it's um it's cool i think it's really beneficial which brings me on i just wanted to address cecily i see here it's a really good question from cecily as always cecily who is going to be on the show as well reflecting later on in the season so she says when learning about mi do therapists struggle to leave their ego behind and be open to their clients responses i'm not sure ego

is the word i want to use but what did she say Hopefully, you get my gist. Yeah, it's a good question. Good question, yeah. I don't know. It's a really weird one because a lot of the training that I've done with MI initially, because I did Gary's course early 2001, I think, And then I asked him to sort of do one with Mike and the MTE crowd and the first therapist one that he was talking about with on that podcast that he did before that we're talking about today.

So I actually haven't done a course or been on very many courses myself with MSK therapists or sports therapists or anything. So I don't know.

When I've been on courses, it's mostly been with talking therapists, psychotherapists, counselors people in leadership roles that teach mi in management and project management or to communities so they're learning mi across the board but i i don't know because it's weird because mi and those sorts of people because you're wanting to help people and be the whole spirit of it is be your authentic self and be empathetic i think it attracts very often empathetic people non-egotistical people

anyway to want to try and learn that so that would be my take on it is that whenever i've been on a course in person especially with that amount of people from around the world come to see steven like it's it's just full of really nice people that are aren't really egotistical i don't know but i wouldn't have if you're if you're looking to go and go to a force in mi you're probably not egotistical you probably like you were talking about

matt already questioning why you have failed in something you've said for those outcomes to not be so if you're already thinking about that you're already thinking about doing a course with mi you're probably already looking at the things that you lack in and you already wanted to improve on that so probably not egotistical.

Good answer yeah it makes sense i think cecily rather than ego because if you're in health care i mean there are some people who are more educators who are kind of guru driven and stuff but in health care like like um daniel says you're probably already you know altruistic person and empathetic and stuff but i think more than the ego it's more that fixing or yeah fixing response or writing response that you really have to you struggle with you because

you've been trained to solve that problem you know to be the fixer and it's so difficult and literally as Gary was saying sometimes putting your hand over your mouth when they're talking you know or even just digging your fingernail into your finger which is what I do sometimes when even if I've got a guest I'm not giving tricks the trade away here but if someone's saying something and I'm like I really want to answer this quickly and put my two cents in just stick your nail

into your finger so it starts hurting and that will remind you you know it's all about listening and wait and blah blah blah so So there are tricks to it, but I think that's the biggest surprise, Cecily. And knowing you, who are a wonderful speaker, you're very eloquent, you're very honest and up front and heart on your sleeve, a beautiful person to be involved in therapy. I think sometimes that will be a challenge because you've got so much to give, you know, like a lot of us.

So, yeah, holding back until that moment comes, until, you know, they've unpeeled enough layers. But Cecily, yeah, you'd be great at it. It'd be really useful for you for those reasons.

Cool. Oh, well, look, 8.52. The idea is you're going to wrap things up at 8.47. But it's such a great topic. And I really want listeners. I mean, it's a bit different this week because I mean, the great thing about this podcast is you are giving courses in this. You've spent time with the co-founders and you've been developing your own techniques and you're a great educator anyway with the DNM side of stuff. So yeah, tell us about that. When can people...

Look out for courses and how do they kind of sign up? So it's been since Gary retired last year, so I was helping teach on his courses before that anyway, helping teach with Stephen recently over the last couple of years to just really sort of get confident in teaching it, to be honest, and yeah, try and move forward. So I'm trying to put some dates in now, to be honest. So he's trying to do some online workshops and put some dates in.

So I've already put a few feelers out. the only thing that i've got in concrete is the glasgow one so it's the second and third of august and that's an in-person two-day course where we'll be actually doing lots of stuff like we did on steve's course and stuff like that so lots of group tasks and stuff i am actually doing a short intro to mi in bournemouth the sta south thing as well a couple of weeks isn't it yeah.

10th of may alex's fantastic yeah so doing a little bit of that so we'll do we'll do a group fast then to just intro to people to that and just get people to go in groups and sort of collaborate between and assess each other's communication and notch off a few mi skills do some mitty coding but other than that yeah so great just just to not gloss over that for because because alice and gary were both crucify me which is a good time of year to get crucified but now

that was wrong we'll edit that out but yeah great for people who are in the south yeah two weeks time you've got sta southern conference going on in pool yeah yeah pool which is accessible for a lot of people in the south and it's too cheap i have to talk to gary about that later on but it's waiting i think it's 45 quid or something it's crazy considering they've got like people like yourself there and who else have they got down there alex is doing some pilates stuff down there

there's i've looked at the line up the other day so again gary's going he's going as well there's business um injections injected ideas there as well so it'd be great and also what we're talking about before off air was it's a great way just to meet up and collaborate with therapists not too far away from you and kind of discuss and reflect and all those wonderful things and like i say dan is going to be there as well so that'd be great first

of all if you're in the south two weeks time tickets still available as far as i saw on the last social media post if you're looking for more details on that just go to the sta.

Page or the sta member page or the open group there's all sorts of posts all over there and then scotland as well which is great so if you're the other end of the country nothing so much in the middle at the moment we'll work on that but if you're at the other end of the country, scotland then that'd be great that's a face-to-face one which would be a lovely opportunity to meet up with people as well so good for stevie bar and and wonderful people like that and leslie up that those end of

the woods fantastic and if people are interested in this so let's just bring up the websites people can see that as a visual you've got a beautiful colored website mate very nice thank you very much you know so is it new yeah yeah i mean in september so work in progress still but yeah doing the job is lovely so yeah go along to the mvmnt which really costs me to say oh it obviously it's movement shortened down my life now is trying to.

I've got to stick with it yeah but it's fine it's movement abbreviated to mvmnt so the movement therapist but that's fine because it means you've got those characters to fit into i think it's the same thing isn't it on instagram as well yeah yeah go along to the website and there's great information there is a beautiful website even for people looking to how to develop their website make it look modern and go along there i'd love a good website i might

talk to you later on see um yeah who you got to do that but yeah and all the information about there is on there and people can contact you and and be updated about when other things come around so great opportunity people and to learn from somebody who, like I say, has been with the co-founders and is a great educator anyway. So that's very exciting.

Oh, Tris Attenborough has decided to come through the door at the last minute. Talking of great educators, I'll be there hanging out. Let's hope not, Tris, that you don't have the same problem you had at Therapy Expo with those trousers with the zipper broken, but we won't go down that road.

But Tris, I'm glad, this is a good segue, by the way, because Tristan Attenborough, full name, actually Sir Tristan Attenborough is going to be with us next week, because did you know he's with us next week, Daniel? No, I don't know. There you go. That's me. Yeah, it's news to you. Next week in our reflection series, I'm really looking forward to this, we're going to have, this is Tuesday the 8th.

No, sorry, Tuesday 8pm on April 29th, my guest clinicians are going to be Stevie Bar and Tris Attenborough, who are both going to be reflecting on episode 74. So we're still going back some, which was an episode with Anna Maria Matsieri and Matt Skarsberg, which was called Massage 2021, Year of Change? Isn't that great? Reflecting on that, was 2021 a year of change for massage?

There was a lot of movement going on and there was the Massage Collective with Matt Skarsberg and I'm at Cieri and Becky involved in there. How much of that made a difference? Are we at a different stage today? So what better than Triss Attenborough to talk about that and Stevie Barr as well? So that's going to be next week. I wasn't going to say that before thanking you, but as Triss came through the door, I thought we better look after that ego.

Yeah, when the bus comes on, you've got to thank him. When the bus comes on, you've got to thank him. But anyway, that's next week. But so do join us for that if you're around. If you listen to the podcast, then I mean, it'd be great. If you're a massage therapist in particular, but not only that, if you just, If any time in your life you put hands on people and get paid for it, then, yeah, it'd be worth listening to that.

How far have we come since 2021 with regards to how we explain the mechanisms and all that sort of stuff? Are we better if we know how something works? Are we actually making it better? But I jumped the gun there because first of all, I wanted to say thank you very much to Daniel Williams for joining us. You've managed the first of the reflection episodes to go way over the half hour I allotted, but it's such a great topic.

I appreciate your insight and skills i mentioned the website if people want to follow you instagram you're active as well is that worth following you there yeah i'm inconsistent but yeah whenever i can be bothered to post i'll post i'll do it for a bit i'll get hyper focused and i'll leave it for a couple of weeks again again your girlfriend's so lucky and she you really are it's such a catch yeah yeah you're testing number three on blind date yeah definitely

but yeah daniel.williams.mvmnt on instagram i follow him i think it's worth following it i think it's good being consistent but it's good and also like i say yeah the south coast uh, conference, which is going on in Paul, that'd be a good place to catch you as well. Right. And have I missed people in the audience who joined us live? Cecily. Yes, fixing is the better word. Thanks, gents, for your perspectives. Thank you, Cecily, for asking.

Fine. Yeah. Thank you, people who joined us live. Really appreciate it. And thank you for listening to the podcast. If you have listened to the podcast and you've enjoyed it, you found any bit of it useful, then do please leave a review or ratings. Very quick.

Just chuck your five stars in there, and maybe say great so thank you very much if you're in a hurry which you probably are um but do put something because it just helps this information appear higher in google podcast no one makes any money out of that it's purely about getting the information out there um on a wider scale to kind of fight the mainstream rubbish which is out there hey daniel absolutely it's what we're here for we've got a counterbalance counterbalance so

do please do that you can play your part in helping healthcare across the board just by leaving a decent rating and reviews for the podcast so i appreciate that right on that note thanks again daniel really appreciate your time no worries thank you very much but we will be around next tuesday again at eight o'clock on the sports therapy social youtube channel if you want to join us until that take care of each other and listen to each other a little bit more bye-bye. Music.