In 2020, Deb Solomon was working as a social worker in Adult Care when she got a surprise ADHD diagnosis. She went on to chair the first UK group for neurodivergent social workers through the British Association of Social Workers, and she now presents workshops on neurodiversity and executive functioning.
In a 2023 episode of the Talking to Change podcast, Solomon talked through what motivational interviewing practitioners need to know when they sit with a neurodivergent client. The method is not about telling someone what to do. It is built on acceptance, partnership and empowerment.
Motivational interviewing began as a way to help people who felt pulled in two directions about change. Christine Alter, writing in Autism Spectrum News in 2012, explained that it was first developed to assess and build readiness for treatment among people with substance-use problems. Alter, a licensed clinical social worker with the New York Institute of Technology Vocational Independence Program, wrote that its usefulness extends to autistic students deciding whether to commit to post-secondary education.
Autistic people often prefer routine and can feel sharper anxiety when change comes, Alter noted. That makes the early phases of change easy to overlook. Prochaska, Norcross, and DiClemente identified five stages: pre-contemplation, contemplation, preparation, action and maintenance. Families tend to jump to planning, Alter said, but a young person may still be in pre-contemplation, barely aware of a problem, or in contemplation, aware but not ready to move.
Listening before planning
That is where listening matters.
Miller and Rollnick, the pioneers of the approach, believed that when in doubt about what to do, listening was the answer. Reflective listening can mean repeating back what someone said or paraphrasing and offering feedback. The hard part is holding back from warning, judging or directing.
Open-ended questions are another tool. Alter offered examples from the work: “Would you tell me about…”, “How would you like things to be different…”, “How can I help you…”, “What do you want to do next…”, or “What have you tried before…”.
Summarizing helps the helper reflect what they have learned and can highlight “change talk.” A phrase such as “Let me see if I understand thus far” keeps the conversation open and collaborative. Affirmations that are genuine and that name a person’s strengths build confidence and a sense of being on the same team.
Readiness has to come from the individual, not from the counselor or the family. Alter cited research showing that when someone argues for change, resistance increases, and higher resistance is usually connected to poorer outcomes. The core skill is to “roll with the resistance.”
In the podcast episode, one segment is titled “I have to get it (a thought) out.” For practitioners, that kind of detail is a reminder to create conversations where neurodivergent people feel safe to be themselves, and to look past labels toward what a person actually needs.
Motivational interviewing can help an autistic young person and their family decide whether they are ready to commit the time, resources and effort required for a post-secondary or vocationally based transition program, Alter wrote.
Sources
- Neurodiversity & MI–Talking To Change – A Motivational Interviewing Podcast – Apple Podcasts
- Motivational Interviewing – A Useful Approach for Families and Counselors Planning for Post-Secondary Transition – Autism Spectrum News
