The Righting Reflex: why the plan keeps dying between sessions

Somewhere between the last session and this one, the plan died. It was agreed to. The client nodded in the right places, or the parent did, and took the sheet. A fortnight later almost none of it has happened, and you respond the way training and instinct both suggest: you go through it again. Slower. With better reasons.

It is worth being plain about the stakes, because this is not a side irritation of community work. Most therapy happens between sessions or it does not happen at all. The practice a parent runs at the kitchen table, the routine a support worker holds, the strategy that only helps if it is used daily. When the plan dies in the gap, the outcome usually dies with it.

Which makes the next finding uncomfortable. Explaining it again, the most natural response available, tends to make things worse.

The urge to explain has a name. William Miller and Stephen Rollnick, the psychologists behind motivational interviewing, call it the righting reflex: the itch to fix, to correct, to supply the argument the other person seems to be missing. And that matters, because of one of the steadier findings in behaviour change research: people are persuaded by the arguments they hear themselves make. Not the ones made at them, the ones in their own voice.

The righting reflex is generous in origin, we correct because we care. But it is also structural, and this is the part worth sitting with. We are attached to outcomes because we are judged by them. Progress reports, plan reviews, funding that continues or does not, all of it rests on change we can point to, so responsibility for the change settles quietly onto the clinician. The reflex is what carrying that responsibility sounds like out loud. But it is also what is getting in the way of actual change.

Motivational Interviewing is the forty-year-old answer to this situation, and plenty of us were taught it. A lecture block, a workshop, a slide with OARS on it. But there is a wide gap between having met a method and the method surviving a stalled session, and the righting reflex lives in that gap.

The method itself has accumulated one of the largest evidence bases of any approach to clinical conversation: adherence, health behaviour change, chronic condition self-management, the territory where community outcomes are actually won and lost. And its working parts are ordinary. Open questions, affirmations, reflections, summaries. What is not ordinary is what it asks the clinician to put down.

MI hands responsibility for change back to the client, because that is the only place change was ever going to come from, and keeps for the clinician the thing actually within their control: the conversation. Letting go of the outcome feels like negligence. It is the method.

(I am aware of the irony here. Several hundred words, explaining that explaining does not work. The reflex survives being named.)

The first place to start doesn't have to be a course. It is a tally. In your next few sessions, quietly track one thing: who is making the argument for change, you or them. If it is mostly you, the reflex is running. That is not a verdict on your practice; it is a reflex doing what reflexes do. But the most persuasive voice in the room was never yours. It is already sitting across from you, waiting to be asked.

If you are interested in exploring this further there are some quality Motivational Interviewing Trainers in Victoria running courses both in person and online. If you'd like some recommendations, email me and I'll happily point you in their direction.