Motivational Interviewing

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Godfrey Boyd
7 years ago
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1 Building Motivational Interviewing Skills Ellen R. Glovsky, PhD, RD, LDN Training with Dr. Ellen Synergy Arizona April 25, Motivational Interviewing Definition: A directive, person-centered counseling style for increasing intrinsic motivation by helping clients explore and resolve ambivalence. (Miller & Rollnick, 2002) MI is a collaborativeapproach to helping people change their behavior regarding their health. Most applicable in consultations where there is a preferred outcome 2 Eight Stages in Learning MI 1. Getting the spirit of MI ** 2. Using client-centered skills (OARS) ** 3. Recognizing change talk ** 4. Eliciting and reinforcing change talk 5. Rolling with resistance 6. Developing a change plan ** 7. Consolidating client commitment** 8. Integrating MI with other intervention methods ** We will practice these Journal of Miller, W. R., & Moyers, T. B. (2006). Eight stages in learning motivational interviewing. Journal of Teaching in the Addictions reproduce without permission. 1

2 Eight Stages in Learning MI Not mutually exclusive Flow together and into each other These are the basic skills that clinicians need to learn to successfully implement the MI style 4 The Spirit of MI Collaboration You don t have to make change happen; you can t Evocation Calling forth that which the client already has Acceptance Not necessarily that you approve of the other s actions Express Accurate Empathy Let your client know that you understand how they feel and what their issues with this behavior change are. Affirmation Seek and acknowledge the other s strengths and efforts 5 The Spirit of MI Compassion Actively promote the other s welfare, give priority to the other s needs Affirm Autonomy Counselor is willing to let the patient decide if, when and how they will go about changing. 6 reproduce without permission. 2

Listening Skills Reinforce Change Talk Change Talk is any selfexpressed language that is an argument for change. It REALLY Matters Who Said What!

3 Listening Skills Reinforce Change Talk Change Talk is any selfexpressed language that is an argument for change. It REALLY Matters Who Said What! 7 Build A Foundation of Listening: Get Your OARS in the Water O: Open-ended questions How you ask questions is critical! Can not be answered with yes or no A: Affirm Rapport building R: Reflect Helps to let your listener know you heard and helps to clarify what you heard S: Summarize Like offering a bouquet Link material client has offered; ask if it s accurate Allows clinician a chance to build argument for change 8 Importance/Confidence 1. How importantis it for you right now to change? On a scale of 0 to 10, what number would you give yourself? not at all extremely important important A. Why are you there and not at 0? B. What would need to happen for you to raise your score a couple of points? 9 reproduce without permission. 3

4 Importance/Confidence 2. If you did decide to change, how confidentare you that you could do it? not at all extremely confident confident A. Why are you there and not at 0? B. What would need to happen for you to raise your score a couple of points? Effective/Ineffective 10 Work in groups of 3 One speaker and two counselors Counselor #1 will go first Counselor #2 listen carefully but don t speak yet 11 Speaker s Topic Something about yourself that you want to change need to change should change have been thinking about changing but you haven t changed yet i.e. something you re ambivalent about 12 reproduce without permission. 4

Counselor #1 Listen carefully with a goal of understanding the dilemma Give no advice Ask these four open questions: Why would you want to make this change?

5 Counselor #1 Listen carefully with a goal of understanding the dilemma Give no advice Ask these four open questions: Why would you want to make this change? How might you go about it, in order to succeed? What are the three best reasons to do it? On a scale from 0 to 10, how important would you say it is for you to make this change? Follow-up: And why are you at and not zero? 13 Counselor #2 Give a short summary/reflection of the speaker s motivations for change Desire for change Ability to change Reasons for change Need for change Use Behavior Counts handout Then ask: So what do you think you ll do? and just listen with interest 14 New: Training DVDs Available 15 reproduce without permission. 5

6 Ellen Glovsky: Resources for Motivational Interviewing 16 reproduce without permission. 6

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.