Good day

This morning, I crawled out of bed as slowly as I could, careful not to wake the sleeping hubby next to me. As I opened the door to let Lola outside, I shivered.  Although it was officially morning, the darkness was hanging around and the air crisp and still. I knew what I had to do. I crept back to our room and found a pair of slipper socks and then quietly logged on to the computer to search for a pumpkin pancake recipe. After a few minutes, I found one on allrecipes.com that had 1,164 reviews and 4.5 stars, good enough for me! I read through the reviews and decided to add an extra egg and used pastry flour for extra fluffiness. Also, I added extra spices for a bolder flavor. Try adding chopped pecans and pure maple syrup as toppings. Mmm, I can’t think of a better way to start a cool fall day.

Pumpkin Pancakes:

Ingredients

• 1 1/2 cups milk (I use Coconut Milk)
• 1 cup pumpkin puree
• 1 egg (Many reviewers used 2 eggs)
• 2 tablespoons vegetable oil
• 2 tablespoons vinegar
• 2 cups all-purpose flour (Try whole wheat pastry flour)
• 3 tablespoons brown sugar
• 2 teaspoons baking powder
• 1 teaspoon baking soda
• 1 teaspoon ground allspice
• 1 teaspoon ground cinnamon
• 1/2 teaspoon ground ginger
• 1/2 teaspoon salt

Directions

1. In a bowl, mix together the milk, pumpkin, egg, oil and vinegar. Combine the flour, brown sugar, baking powder, baking soda, allspice, cinnamon, ginger and salt in a separate bowl. Stir into the pumpkin mixture just enough to combine.
2. Heat a lightly oiled griddle or frying pan over medium high heat. Pour or scoop the batter onto the griddle, using approximately 1/4 cup for each pancake. Brown on both sides and serve hot.               

After pancakes, I slipped into my jeans, a cozy sweater and my beloved scarf. My hair went up into a quick pony tail and I scrambled to put my face together before I rushed out the door to Eastlake Community Church (ECC). I have been attending the morning service for a while and absolutely love it! On my way in, I stopped by the tea station and grabbed a peppermint herbal tea with a few shakes of raw sugar. I found a seat and swayed to the soulful music.  The lead singer has the most beautiful voice. You can't help but feel lifted no matter what you're going through. ECC has recently opened two new locations, but still uses the same pastors to deliver the service. How do they do this you might ask?? By using hologram technology, of course! They have a modern message and do great things for the community. Plus, it's just around the corner from us, for now anyways. Come November we'll be in moving to a house in Edmonds. This weekend we've been painting a few of the rooms and working on packing all of our stuff. We sure accumulate a lot of stuff! But speaking of painting and packing, I better get back to work!!

“Everything that is done in the world is done by hope.” Martin Luther

Motivational Interviewing

This past Saturday I spent the day with colleagues at a workshop learning motivational interviewing (MI) and counseling skills. Drs. John S. Baer and Kevin King introduced the basics and coached us through group activities. In the medical field, motivational interviewing has been gaining popularity. The newest definition describes MI on three levels. I like the technical therapeutic definition which describes MI as a 'collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person's own reasons for change within an atmosphere of acceptance and compassion.' It's a mouthful but paints a thorough picture of what this patient-centered counseling style entails.

The essence of motivational interviewing is best described by the acronym A.C.E. The 'A' is for honoring autonomy and recognizing the patient will make his or her own choices. The 'C' stands for collaboration. In MI it is important to not always act as the 'expert' but to instead build a non-authoritarian and non-judgemental partnership with the patient. Lastly, during the session you will evoke change by eliciting the client's ideas, desires, reasons and needs. In short, it is our job to support and assist the clients while they resolve their own issues.

We do this by incorporating the four fundamental processes.


1. Engaging:  This is a very important step and may have to be circled back to if the client shows signs of discord. OARS is a set of skills developed to help build relationships and fully understand the client's issue. 

Open-ended questions: Questions formed in a way that push the client to elaborate instead of answering yes or no. Helps the provider gain perspective.

Affirmations: Honoring and recognizing efforts, successes and intentions. Encourage clients by finding things they value about themselves. Remember, affirmations must be genuine to work.

Reflective listening: Using simple or complex reflections to help communicate understanding or empathy. This was a huge focus at the training because MI is basically built on these skills. It felt awkward at first, I was more worried about formulating a response than actually listening. Try using the suggested stems below.

"So you are saying..." "It sounds like..." "You are wondering if..."

 Summaries: Type of reflective listening used to change directions or ask a key question. Start by indicating you are about to summarize, be concise, note both sides of  ambivalence (if any) and end with an open question.

2. Focusing: Strategically using information and advice to set an agenda.

3. Evoking: Using questions, responses and summaries to elicit change talk.

4. Planning: Requires some commitment from the client, then work with them to develop a plan for change.

 
With all of its parts, it may seem a bit daunting. However, one of the benefits to learning such a comprehensive style, is that no matter the situation, you always have relevant material to apply. At first during the activities it felt a little uncomfortable and somewhat forced. I stumbled through reflections and fought my natural "righting" reflex, but in the end I found this workshop to be extremely helpful. Like any other skill, it doesn't always come natural. Yet as you begin to master the different elements of MI, it certainly becomes a huge asset. Not only is it useful in nutritional counseling but I believe it will be beneficial in most relationships (even marriages). :)

To learn more about motivational interviewing, please check out these additional resources:
Website:           www.motivationalinterview.net
Books:

Rollnick S, Miller, W.R., & Butler C. (2008). Motivational Interviewing in Health Care. New York: Guilford Press.
Rosengren, D.R. (2009). Building Motivational Interviewing Skills: A Practicioner Workbook. New York: Guilford Press.
Naar-King, S. & Suarez, M. (2011) Motivational Interviewing with Adolescents and Young Adults. New York: Guilford Press.