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Motivational Interviewing

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Shiuli M

on 6 November 2013

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Transcript of Motivational Interviewing

Motivational Interviewing

Motivational Interviewing is an
Motivational Interviewing
is an effective way of talking with people about change
(Kraybill and Morrison, 2007)
"empathic, person-centered counseling approach that prepares people for change by helping them resolve ambivalence, enhance intrinsic motivation, and build confidence to change."
Motivational interviewing is
Evidence based
Change in Behavior
People face many
Resistance to Change
lack
of
information
laziness
oppositional
personality
Denial
Ambivalence
leads to anxiety
PROCRASTINATION
MI can help resolve ambivalence and help elicit a person's own motivation to change
The Spirit of MI
Partnership
Acceptance &
Compassion
Evocation
The best ideas come from the client
Core Skills
O
pen Questions
A
ffirmations
R
eflections
S
ummaries
Did you have a good relationship with your parents?

What can you tell me about your relationship with your parents?
Affirmations

are statements and gestures that recognize client strengths and acknowledge behaviors
Understanding what the client is
thinking
and
feeling
, then saying it back to the client.
Summarizing
helps in recounting the major points of the clients conversation.


Begin with a statement indicating you are making a summary.



Like: Let me see if I understand so far…
Here is what I’ve heard. Tell me if I’ve missed
anything
Give special attention to
Change Statements
like :




Problem recognition
: “My use has gotten a little out of hand at times.”
Concern
: “If I don’t stop, something bad is going to happen.”
Intent to change
: “I’m going to do something, I’m just not sure what it is yet.”
Optimism
: “I know I can get a handle on this problem.”
The
4
PROCESSES
Engaging
Focusing
Evoking
Planning
The process of establishing a
trusting
and
mutually respectful
relationship.
An ongoing process of
seeking
and
maintaining
That is, eliciting,
CHANGE TALK
Developing a specific
change plan
that the client agrees to and is willing to implement.
Are you in pain?
How are you feeling?
How much alcohol do you drink in a day?
What role does alcohol play in your life?


Don't you want to move to a safer place?
What are the advantages that you see in moving?
DECISIONS
that require some sort of
CHANGE
at
EVERY
stage of their lives
LIKE
homework
career
housing
Marriage
Children
Retirement
living alone
accepting help
Exercise
Corrections
III

• Recognizing disadvantages of the status quo: “This is more serious than I thought.”
• Recognizing advantages of change: “I’d probably feel a lot better.”
• Expressing optimism about change: “I think I could do that if I decided to.”
• Expressing intention to change: “I’ve got to do something.”
Methods for Evoking Change Talk
• Asking evocative questions: “What worries you about your current situation?”
• Using the importance ruler (also use this regarding a client’s confidence to change): “How important would you say it is for you to ____? On a scale of zero to ten, where zero is not at all important and ten is extremely important, where would you say you are?”
0 1 2 3 4 5 6 7 8 9 10
Not at all Extremely
important important
• Exploring the decisional balance: “What do you like about your present pattern?” “What concerns you about it?”
• Elaborating: “What else?”
• Querying extremes: “What concerns you most about ___? “What are the best results you could imagine if you made a change?"
• Looking back: “What were things like before you ___? What has changed?”
• Looking forward: “How would you like things to be different a year from now?”
• Exploring goals and values: “What things are most important to you?”

• I appreciate that you are willing to meet with me today.
• You are clearly a very resourceful person.
• You handled yourself really well in that situation.
• That’s a good suggestion.

• So you feel…
• It sounds like you…
• You’re wondering if…

Eliciting change talk is the consciously directive strategy on the part of the counselor for resolving ambivalence.
Four Categories of Change Talk
• Recognizing disadvantages of the status quo: “This is more serious than I thought.”
• Recognizing advantages of change: “I’d probably feel a lot better.”
• Expressing optimism about change: “I think I could do that if I decided to.”
• Expressing intention to change: “I’ve got to do something.”

Dieting
Weight Loss
Dental Health
Practice
Medication
Adherence
Addictions
Study
Habits
Eliciting a client's own
motivation for change
Eliciting change talk is the consciously directive strategy on the part of the counselor for resolving ambivalence.

The idea is to have the counselor facilitate the client’s expression of change talk, that is, for the client to present the arguments for change.

that is, eliciting
Recognition and respect of clients strengths, autonomy, potential and perspective
Focus on client's interest
Counselor and client work collaboratively
SMART
ACHIEVABLE
MEASURABLE
SPECIFIC
RELEVANT
TIMED
wanting and not wanting the change or
wanting incompatible things at the same time
an Introduction
PLAN
We are engaging when the client feels:

welcome
comfortable
understood
hopeful
perceives mutual goals
clear direction
Setting an
agenda,
goals
,
priorities
Client speech that favors movement in the direction of change
I want...
I can...
I wish...
I will
Full transcript