Motivational Interviewing Overseas

The older members of our group (Jamie, Whit and me) have taken several days to adjust to the time difference and the altitude. The teens of course look like they don’t have any idea what we are talking about when we complain of feeling tired, light headed and short of breath at times. We are at a similar altitude as Denver, it being ‘the mile high city’.  We are all well on this fifth day.

I’m feeling the comfort of coming back to Guatemala having visited in April 2012. Familiar faces, expected changes in the pace, climate, walking conditions (rough cobblestones everywhere), etc. Of course it didn’t keep me from feeling anxious all over again about the talks I had planned for the social workers and psychologists of Common Hope. The first talk was on Resiliency and Positive Psychology. The second talk was on Motivational Interviewing. My major challenge was wondering how it was going to be to have me speaking English while my slides had been translated in to Spanish and then to have an interpreter playing go between. Thankfully, I had gotten excellent advise from Joji Suzuki, MD, from the addiction psychiatry department after practicing at our Motivational Interviewing practice group. He had suggested I try to speak more like a Ted Talk and less like a lecturer. Good advice for a talk in any country!

Suffice to say, both audiences were profoundly welcoming, grateful and fully engaged. Given budget cuts in training, they were most appreciative to have “some new strategies to try with our families.” They especially liked the concept that resiliency is not merely “bouncing back from adversity,” but THRIVING from adversity. This is especially necessary in this country where only a new generation is beginning to live a life free of a 36-year civil war,  having only ended in 1996.  One of the social workers in the group in fact has refused any promotion. As he explains, “I am the only person alive from my graduating class at university.” I learn that leadership for him means vulnerability which he wishes not to re-experience.

Motivational Interviewing was also a hit, although at one point I thought, “Maybe this is not culturally translatable?”  I had begun by discussing what Motivational Interviewing was NOT as a way to exemplify what it IS. They divided up into dyads and tried out “NOT MI” by giving the client advice, making a plan for them, telling them what they thought they should do to make their life better, etc. When I brought them back together, I asked, “What was it like to be the client?”. They explained that they had gotten”lots of good advise, and ideas on how to better themselves”, etc! Oh dear. Well, thankfully, I asked my interpreter who happened to have taken a course in college in Seattle on Motivational Interviewing (!) what she thought. She quietly explained that Guatemalans would never say publicly that their counterparts were not helpful. Ah! Of course, after introducing them to what MI is, having them practice this in dyads, they were easily able to say that they felt that it was much more helpful! Phew.

Common Hope has been able to weather much of the recession through having a strong sponsorship program. The families supported by Common Hope are matched with mostly Americans who send $30 (half sponsor) or $60 per month. A year and a half ago, we began to sponsor a then nine year old girl named Veronica. Buy in from our two children to contribute $15/month from their own earnings has made this one of their most valuable experiences in giving, sharing and being in relationship with someone from another culture. We visited Veronica last year at her home, and her picture welcomes visitors to our home in Boston. We were able to visit her again two days ago; I am still trying to peel Emma (14) off the ceiling! Veronica’s social worker, Alma, and an interpreter joined us on our visit. It is hard to put into words the power of our exchange. Veronica, a very shy, slender child of now 10 years, was delighted to see us. She showed us her artwork, her subject notebooks and talked to us about school, her best friend, Barbara, and her hobbies which include soccer and cleaning. Emma and she delighted in a spiragraph kit we brought for her and a map of the world where we found our respective cities.We At one point Veronica asked, “What are your favorite fruits?” After telling her she announced, “OK, so when you come next year, you must come for lunch and I will serve these fruits.” We didn’t know we would travel yearly! 🙂  Our visit ended with joyous pictures which we will send to them after returning to the states.

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More as our week proceeds!

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