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Motivational Interviewing

Motivational Interviewing

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Motivational Interviewing

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  1. Motivational Interviewing

  2. Basics of Motivational Interviewing • Motivation for change is a state, not a trait. • People are at different levels of motivation or readiness to change for different changes. • Understand the cx’s readiness to change and support movement to the next stage. • Stages of change are predictable

  3. Application to yourself • Think of three different changes you would like to make in your life. • How ready do you feel to make each of these changes? • Use a rating ruler to rate your readiness to change: NOT READY TO CHANGE UNSURE READY TO CHANGE TAKING ACTION 1 2 3 4 5 6 7 8 9 10

  4. Stages of Change

  5. Stages of change • Precontemplation-several types • Reluctance • Rebellion • Resignation • Rationalizing

  6. Four principles of Motivational Interviewing

  7. 1. Express Empathy • Validate cx feelings and perspective • Recognize, name and explore ambivalence

  8. 2. Develop Discrepancy • Provide objective information • Cost/benefit analysis of “change” or “no change” • Heighten awareness of incongruities

  9. Challenges/Confrontation-3 Steps • Recognize the incongruity • Present it to the cx • On the one hand… • Evaluate the effect: how did the cx respond? (see box 9-3) Write down a challenge response for the following statements:

  10. Some examples Cx: I have good genes…my grandma ate whatever she wanted and she smoked…she lived to 98…I’m not worried about that kind of thing. Cx: No friendship is perfect. Sometimes her criticism hurts my feelings, but that’s just how she is. I’m not going to take it personally. Cx: I can always study more, but this teacher just doesn’t like me…it’s not really worth putting more time into because he’s not fair and picks on me.

  11. The CCS • Denial • Partial examination • Acceptance and recognition without change • Generation of a new solution • Transcendance; development of new, larger, more inclusive patterns, beliefs, thoughts, behaviors

  12. 3. Roll with Resistance: it is a sign you are moving too quickly • Acknowledge cx response • Amplified reflection • Double-sided reflection-on the one hand… • Avoid arguing • Avoid a power struggle • Avoid trying to convince • Acknowledge • Explore reality of changing or not

  13. 4. Support Self-Efficacy • Identify successes • Explore what cx can do • Affirm cx thinking, action, decisions, etc. • Change language re: self • Change the script

  14. Fish bowl Role Play Observe for: 1. Expressing Empathy and Developing Discrepancy 2. Rolling with Resistance and Supporting Self Efficacy • Stage of change? Readiness ruler? • Incongruities and opportunity to confront

  15. Skills that may be useful • Give advice • Remove barriers • Provide choices • Decrease desirability • Practice empathy • Provide feedback • Clarify goals