Meaningful Goal Setting Session 2

1. Meaningful Goal SettingSession 2 November 4, 2011 Maggie Brett, L.C.S.W. mmibrett@gmail.com

2. Agenda • Check In • Motivational Interviewing • SMART Goals • Activities • Wrap-up

3. Check-In • Thoughts/Questions stewing from last session (problems with Wikispaces?) • Did anything we talked about in terms of readiness reverberate in your work these past weeks? • Were you able to take advantage of reflective time?

4. Initial Interviews: What are we trying to accomplish? • Elicit information • Provide information • Begin to build a relationship • Establish a working contract

5. Activity We’re going to do a quick role-play. Reflect on what the client is feeling, what the interviewer is feeling, and what’s happening in the relationship.

6. http://www.youtube.com/watch?v=80XyNE89eCs&feature=related

7. What words describe what you’re feeling? Interviewer Ineffective Repetitive Unrelenting Frustrated Condescending Angry Unempathic Hopeless Client Resentful Doubtful of self Coerced Bullied Low self-esteem Defensive Misunderstood Need to be dishonest Criticized Judged Evasive Stuck Angry Anxious Depressed Hopeless

8. What’s happening in the relationship? • Coercion • Confrontation • Pressure • Power imbalance • Tug-of-war • Distance

9. Motivational Interviewing—Theory • Grew out of the addictions field, in response to aversion to argument and labels • Key Concept: Client ambivalence: every person has both arguments for change within them • Key Concept: Professional empathy: MI is a relationship-based intervention (collaborative) • Strength-based vs. deficit-based • Supports autonomy and self-determination • Resistance can be a self-fulfilling prophesy • Insidious nature of coercion/conversion and rebound effect • Link need to change to client’s own reasons --Miller and Rollnick

10. Motivational Interviewing--Practice • OARS Open-ended questions Affirmations Reflective Listening Summaries • Change talk vs. Sustain talk --Miller and Rollnick

11. Change Talk • Anything a client says that “favors movement in the direction of change,” having to do with a specific behavior change • Change talk: DARN-CAT: desire, ability, reasons, need commitment, activation, taking steps • Strength of change talk is significant • EARS (elaboration, affirmation, reflect, and summarize) change talk • Listen to resistance

12. Let’s try the same interview again… In groups of 3 (client, interviewer, and observer), interview the client using the theories and techniques we talked about. Again reflect on what the client is feeling, what the interviewer is feeling, and what is observed in the relationship.

13. http://www.youtube.com/watch?v=URiKA7CKtfc&feature=related

14. Now, how do you feel? Interviewer Effective Helpful Energized Sense of progress Hopeful Client Heard Supported Energized Helped Enhanced self-esteem Sense of autonomy Sense of responsibility Empowered

15. How does the relationship feel? • Collaborative • Supportive • Equal • Affirming • Hopeful

16. SMART Goals • Specific • Measurable • Attainable • Relevant • Time-Bound

17. Capture your Thoughts (York-Barr, et al, 2001)