In this month’s post we hear from one of our Macro Stack Collaborators, Jess Sneed.
And…please SAVE THE DATE for our first virtual Macro MI Summit: January 29, 2027, more details to be announced soon.
Now, here’s Jess:
What I would like readers to know about me:
First and foremost, I’m just a regular person who stumbled into Motivational Interviewing (MI) and completely fell in love with it. I am a HUGE MI nerd. I love exploring and discussing how it can be applied across different fields and professions—from healthcare and social work to leadership and coaching.
How I began learning MI and how MI has influenced my work:
I began learning MI almost 10 years ago. I was looking to change careers when a good friend invited me to apply for a coaching position with a mental wellness startup that primarily used MI in client/member conversations. I remember feeling worried because I didn’t have a therapy background. My good friend said, “You’re a naturally compassionate person. I think MI will really resonate with you.” And it did! The Spirit of MI resonated so deeply with me as a way I wanted to show up in all of my relationships.
How I discovered Macro MI and how it has influenced my work:
It really was a ‘lightning in a bottle’ moment. The spark came at the 2022 International Motivational Interviewing Network of Trainers (MINT) Forum during a presentation by Dr. David Avruch about his research with Dr. Wendy Shaia on Macro MI. It felt like they lit a path forward by giving words to ideas many of us had been carrying around. Because traditional MI centers on individual choice, we didn’t have a clear framework for the systemic realities we were seeing, and that presentation brought those threads together.
Since then, Macro MI has transformed how I listen—I’m constantly zooming in and out. For instance, when working with clients with diabetes who express frustration over the cost of fresh produce and how fast it spoils when trying to feed a family, I’m listening to their immediate individual struggle. But simultaneously, I’m holding the larger structural context that shapes their actual opportunities, choices, and access.
For me, the primary differences between a conventional motivational conversation and one with a macro approach:
To me, the primary difference is perspective and context. In a conventional MI conversation, the focus is largely on the individual’s internal motivations and personal choices. With Macro MI, we’re constantly holding the client within the context of larger social systems—like structural barriers, systemic inequities, or institutional dynamics. We intentionally invite that reality into the conversation with genuine curiosity, exploring how living within those systems impacts their direct, lived experience.
For example, when my stepfather tried to quit smoking cigars, his struggle wasn’t just about personal health—it was about connection, tradition, and how smoking with his brothers reinforced his sense of masculinity. Taking a macro lens meant recognizing how targeted tobacco and alcohol marketing in communities of color influenced older generations in his family, turning smoking into an entrenched social bond. Macro MI brings those systemic influences into the room with curiosity, helping us explore how a person’s choices are shaped by the systems they live in.
What obstacles, if any, have I found for approaching conversations from a macro perspective:
There are a few obstacles that I’ve run into - navigating timing, avoiding increased client hopelessness, and controlling my own righting reflex as a helper.
As guides in MI, our reflections carry power. A major obstacle when introducing a macro perspective is knowing when not to bring it up. If a client isn’t already thinking about broader systems, forcing that lens can feel invasive or distract from their immediate personal priorities.
Even when macro factors are relevant, naming oppressive structures like poverty or institutional racism can risk overwhelming the client. The challenge becomes walking a fine line: validating systemic barriers without inadvertently leaving the client feeling powerless—balancing ‘the system is stacked against you’ with ‘given this reality, where do you still hold power?’
Finally, there’s the challenge of managing our own ‘righting reflex.’ It’s easy for a practitioner to get passionate about systemic injustice and start steering the conversation toward their own political or social agenda rather than following client cues. For instance, if a client mentions feeling exhausted by their work schedule, jumping straight to a reflection about systemic labor exploitation under capitalism might be my agenda, whereas the client might simply want to explore personal boundaries or self-care.
If a practitioner new to macro could try just one thing...
I would encourage them to bring curiosity about structural pressures into their open questions.
Adding an open question to their toolbox that invites the client to speak about their interactions with larger systems like healthcare, policies, or cultural norms that can gently open the door without forcing an agenda. It moves the conversation beyond individual choice to explore how those broader forces shape their choices.
For example, we might ask: ‘How have past experiences with healthcare systems or institutions made it harder—or easier—to manage this?’
A few options to try:
‘What role do you think societal expectations play in...?’
‘What outside constraints are making it hard for you to move the way you want to?’
‘When you think about the bigger environment around you, what makes this decision feel more complicated?’“
Ways a practitioner can learn more about macro and incorporate into their practice:
I think the Macro Stack is a fantastic place to stay connected!
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More Material—
Music:
Art: Mildred Howard, Black Has Always Been A Color (2024). Glass bottles, wood glue, high heels
Quote: “Long live the rose that grew from concrete when no one else even cared.” Tupac Shakur
Books: End Times Fascism (2026, Klein and Taylor; TL;DR: https://www.eliseloehnen.com/p/what-almost-all-of-us-agree-on-naomi-klein-astra-taylor); Don’t Buy What I’m Selling (2026, Chekowsky)