The most rewarding things?

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1 Motivational Interviewing: A Brief Introduction Presented by Ali Hall, member of the Motivational Interviewing Network of Trainers (MINT) 2011

2 Objectives Increase our ability to enhance client importance, confidence and readiness for change Increase our ability to ask effective, change-generating generating open questions Identify options for increasing collaboration, evocation and autonomy support with clients

3 Introductions Exercise Please find a partner and have a conversation about the following: 1. Name and job role 2. The most rewarding thing about their work 3. The most challenging thing about their work Debrief as a large group

4 The most rewarding things?

5 And the challenges are?

6 Motivational Interviewing What works to increase another s motivation? What doesn t work to increase another s motivation?

7 Motivational Interviewing: A Working Definition Motivational Interviewing is a collaborative, person centered form of guiding to elicit and strengthen motivation for change (Miller and Rollnick, 2010)

8 Reasons for Practicing MI It works! It s all in the welcoming, and welcoming is easy It doesn t cost much Small intervention, big effect! The opposite approach, confrontational counseling, has poor results It fits well with other treatment interventions It makes our jobs easier and more enjoyable

9 It Works! (continued) Robust and enduring effects when MI is added at the beginning of treatment MI increases treatment retention, adherence and perceived motivation The effects of MI emerge quickly The effects of MI tend to diminish over 12 months, except in additive studies

10 It Works! (continued) Mean Combined Effect Size by problem area: 3 months: 12 months/follow up: HIV risk: Drug abuse: Gambling: Tx adherence: Alcohol: Diet/exercise: Smoking:.04.14

11 Ready to Change? Willing= Importance In order to be ready to change Able= Confidence The person must be both willing and able

12 Practice Exercise Scaling importance, confidence and readiness

14 MI Style Collaboration Evocation Autonomy Support

15 Contrasting Styles Collaboration Confrontation Evocation Education Autonomy Support Authority

16 CONTRASTING COUNSELING STYLES Motivational Interviewing Confrontational Aggressive

17 Practice Exercise: Does MI Style work? Contrasting Persuasion and the Motivational Conversation

18 Structure of an MI Conversation Open questions Affirmations Reflections Summaries

19 Practice Exercises Change your questions, change the conversation Affirm it, get more of it

20 MI Flow Chart OARS Does change-talk occur naturally without explicit elicitation? yes Respond with Elaboration Qs Affirmation Reflection Summarization Develop a plan no Apply Techniques For Eliciting Change-Talk

21 DARN-CAT Desire: I want to Ability: I think I can Reason: The most important reasons/benefits are Need: I should Commitment: I will Activation: I am ready to Taking Steps: The first steps I ll take are

22 Change Talk, Commitment Language and Behavior Change Change Talk Commitment Language Behavior Change

23 For what are you motivated? What change do you want most? What are your most important reasons for changing? On a scale of 1 to 10, how importantis it to you to change? In what ways are you already able to make the changes you want to make? What steps are you willing to take? How will you do it?

24 Practice Exercise Listening for the DARN-CAT

25 And the opportunities are???

26 Debrief Something I liked Something I learned The first thing I ll try

27 Excellent texts for further reading Also: Arkowitz, H., Westra, H. A., Miller, W. R., & Rollnick, S. (Eds.). (2008). Motivational interviewing in treating psychological problems. New York: Guilford Press.

28 For further information and assistance Ali Hall

These core elements are included in three increasingly detailed levels of definition:

These core elements are included in three increasingly detailed levels of definition: A Definition of Motivational Interviewing The definition of Motivational Interviewing (MI) has evolved and been refined since the original publications on its utility as an approach to behavior change.