Introducing 

Prezi AI.

Your new presentation assistant.

Refine, enhance, and tailor your content, source relevant images, and edit visuals quicker than ever before.

Loading…
Transcript

Building Confidence

  • Belief in your client - supporting self-efficacy
  • Encouraging - instill hope and confidence
  • Change talk, reframing, affirmation.
  • Empathy - fostering a collaborative relationship (non-judgemental)

Developing Discrepancies

  • Summarising - OARS (reflecting intentions for change)
  • Open-ended questions
  • Rolling with resistance - avoiding a power struggle
  • Decisional balance

Envisioning

  • Setting long-term goals
  • Change planning discussion

Coaching Skills for Positive Behaviour Change

References

Transtheoretical Model of Change

Burke BL, Arkowitz H and Menchola M (2002) The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials. Journal of Consulting and Clinical Psychology 71, 843-861.

Boston University School of Public Health (2013) Behavioral Change Models [online]. Available at: http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/SB721-Models/SB721-Models6.html [Accessed on 24th April 2014]

Csikszentmihalyi M (1988) The flow experience in human psychology. In Csikszentmihalyi M and Csikszentmihalyi IS (eds) Optimal Experience: Psychological Studies of Flow in Consciousness. Cambridge: Cambridge University Press.

Department of Health (England) and the devolved administrations (2007). Drug Misuse and Dependence: UK Guidelines on Clinical Management. London: Department of Health (England), the Scottish Government, Welsh Assembly Government and Northern Ireland Executive.

Department of Health (DoH) (2010) Personalisation through Person-Centred Planning. London: Crown.

Diclemente CC and Prochaska JO (1998) Toward a Comprehensive, Transtheoretical Model of Change: Stages of Change and Addictive Behaviors. In Miller, WR and Heather, N (eds) Treating Addictive Behaviors (2nd edition). New York: Plenum Press.

Emmelkamp PMG and Ellen V (2006) Evidence-Based Treatment for Alcohol and Drug Abuse. New York: Taylor and Francis Group.

Floyd MR and McCord RS (2002) Substance use disorders and the patient-clinician relationship. In Floyd, MR and Seale, JP (eds) Substance Abuse: A Patient-centered Approach. Abingdon, Oxfordshire: Radcliffe Medical Press.

Helbig K and McKay EA (2003) An Exploration of Addictive Behaviours from an Occupational Perspective. Journal of Occupational Science 10(3), 140-145.

Hettema J, Steele J and Miller WR (2005) Motivational interviewing. Annual Review of Clinical Psychology 1, 91-111.

Miller WR (1999) Enhancing Motivation for Change in Substance Abuse Treatment. Rockville, MD: Diane Publishing.

Miller WR and Rollnick S (2002) Motivational interviewing: Preparing people for change (2nd edition). New York: Guilford.

National Institute for Health and Clinical Excellence (NICE) (2007) Drug misuse: Psychosocial Interventions. London: National Institute for Health and Clinical Excellence.

Smedslund G, Berg RC, Hammerstrøm KT, Steiro A, Leiknes KA, Dahl HM and Karlsen K (2011) Motivational interviewing for substance abuse (Review). The Cochrane Collaboration Issue 5.

Study Blue (2011) Occupational Therapy 530 [Online]. Available at: http://www.studyblue.com/notes/note/n/midterm/deck/981981 [Accessed 25th April 2014]

Taylor RR (2007) The Intentional Relationship: Occupational Therapy and the Use of Self. Philadelphia: F A Davis Company.

Conclusion

  • Explore the clients arguments for change.
  • Elicit self-Verbalisations.
  • Reflect intentions to change.
  • Offer summaries of change talk uttered.

(Boston University School of Public Health, 2013)

(Miller and Rollnick, 2002)

Motivational Interviewing (MI)

'MI can reduce the extent of substance abuse compared to no intervention, no significant difference between MI and TAU' (Smedslund et al, 2011).

Effects on substance abuse and health behaviour equivalent to other active treatments (Burke et al, 2002; Hettema et al, 2005).

'Explore ambivalence about drugs, possible treatment, motivation and provide non-judgemental feedback (NICE, 2007).

MI part of guidelines that distinguishes it as collaborative partnership with client (DoH, 2007), congruent with person-centered planning (DoH, 2010)

Raj Yufus

'The active process of living, incorporating how people occupy themselves within various contexts and noting that occupation overcome barriers and impact on health' (Townsend, 1997).

Therapeutic strategies and skills for Supporting Raj

'Relapses within a week'

'family who are supportive...angry at the moment... bringing family shame'

  • Dysfunctional occupational performance.
  • Occupational risk factors.
  • Impacts on health and well being.
  • Flow

Example one

'Been trying to quit meth for the last month or so'

'I don't have much motivation as I don't really find anything interesting anymore'

'my dad has recently kicked me out'

'my work has really suffered'

'It takes full command over me'

'I have bugs under my skin', 'paranoid', 'aggressive'

Raj: I can't control my use

Therapist: Are there times that you haven't used?

Raj: (recalls an event)

Therapist: So there are circumstances when you are not as powerless as you think and are able to control your use, does this make sense?

Example two

Raj: I want to quit meth and alcohol as I don't want to shame my family. I don't want to quit marijuana or tobacco as they're not causing me any problems.

Therapist: So your family are ashamed that you use meth and drink alcohol and you therefore want to quit. How does your family feel about your use of marijuana?

(Study Blue, 2011; Csikszentmihalyi, 1988; Helbig and McKay, 2003; Kielhofner, 2008)

(Emmelkamp and Vedel, 2006; Floyd and McCord, 2002; Diclemente and Prochaska, 1998; Taylor, 2008)

Learning Objectives

  • Knowledge and understanding of substance misuse in relation to occupational risk factors.
  • Know the evidence for Motivational Interviewing.
  • Know policies informing practice.
  • Understand how the Transtheoretical Model of Change informs therapist approach in Motivational Interviewing.
  • Learn how skills and therapeutic media are applied for engaging clients with treatment.
Learn more about creating dynamic, engaging presentations with Prezi