Motivational Interviewing An Overview Presented by Lori Latimer, MSW, LSW
Learning Objectives Define Motivational Interviewing (MI) Introduce Key Practice Concepts Relevancy to Our Members Role Play Resources
MI: A Definition MI is a counseling approach that is, at once, a philosophy and a broad collection of techniques employed to help people explore and resolve ambivalence about behavioral change. Lundahl, Kunz, Brownell, Tollefson, and Burke (2010), 137.
MI: A Definition Evidence-based practice Effective in reducing risk behaviors and promoting adaptive changes related to: substance abuse smoking cessation weight loss domestic violence other health-related risk behaviors
MI: A Definition Lundahl, Kunz, Brownell, Tollefson, and Burke s (2010) meta-analysis indicate that MI consistently increases positive outcomes in comparison to TAU Promotes client buy-in for treatment Can be administered in fewer sessions than most other behavioral health modalities More likely to foster long-standing behavior changes posttreatment due to emphasis on self-efficacy Lundahl, Kunz, Brownell, Tollefson, and Burke (2010). A Meta-Analysis of Motivational Interviewing: Twenty-Five Years of Empirical Studies. Research on Social Work Practice, 20 (2), 137-160.
Key Practice Concepts The Stages of Change Derived from the Transtheoretical Model Stages help guide discussion on client s willingness to change Stages are non-linear
Stages of Change Pre-contemplation Contemplation Preparation Action Maintenance Relapse
Stages of Change Pre-contemplation Shows ambivalence Likely engaging in the risk behavior The problem may not feel harmful or important
Stages of Change Contemplation Recognizes the risk behavior Expresses confusion, reluctance about change Although the need for change is acknowledged, does not feel prepared to move forward
Stages of Change Preparation Demonstrates self-awareness about the problem Commitment to change Information gathering to make concrete plan for change May want to rush to Action, but needs encouragement to plan thoroughly
Stages of Change Action Implementation of change plan Behavior modification is evident to others Receptive to support Positive steps are taken, but change has not yet become routine
Stages of Change Maintenance Change has been integrated into lifestyle Support is critical for maintenance Peer support proves especially instrumental in sustaining change
Stages of Change Relapse Returns to risk behavior May have experienced relapse in previous change attempts Relapse in a natural part of the change process May return to any other stage (does not necessarily go back to Pre-Contemplation)
Key Practice Concepts AREDS Avoid arguing Roll with resistance Express empathy Develop discrepancy Support self-efficacy
Key Practice Tools OARS Open-ended questions Affirmations Reflective listening Summarizing
MI: What does it look like? What we re used to: https://www.youtube.com/watch?v=80xyne89 ecs The MI approach: https://www.youtube.com/watch?v=urika7c Ktfc
MI in PACE Treatment for older adults Cummings, Cooper, and McClure Cassie (2009) show that MI elicits positive outcomes for older adults regarding short-term weight loss, increased physical activity, nutrition, and general decreased health distress. Ideal for older adults since treatment is adaptable (phone sessions, home sessions). Cooper, Cummings, McClure Cassie (2009). Motivational Interviewing to Affect Behavioral Change in Older Adults. Research on Social Work Practice,19 (2),195-204
MI in PACE Research indicates that regardless of professional background and credentials, the ability to convey empathy is the key to MI success! How could you use MI in your discipline? What are some change behaviors that could benefit from an MI approach?
MI: Role Play! Now you try! Remember key practice concepts: AREDS Remember key practice tools: OARS
MI Resources Motivational Interviewing Network of Trainers (MINT) http://www.motivationalinterviewing.org/ Center for Evidence-Based Practice: http://www.centerforebp.case.edu/practices/mi