Motivational Interviewing:  Helping People Change
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Motivational Interviewing: Helping People Change. Jerica Berge, Ph.D., MPH, LMFT Assistant Professor Department of Family Medicine and Community Health University of Minnesota mohl0009@umn.edu. Disclosure Statement.

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Motivational interviewing helping people change

Motivational Interviewing: Helping People Change

Jerica Berge, Ph.D., MPH, LMFT

Assistant Professor

Department of Family Medicine and Community Health

University of Minnesota

mohl0009@umn.edu


Disclosure statement
Disclosure Statement

I have no relevant financial relationships with the manufacturers(s) of any commercial products(s) and/or provider of commercial services discussed in this CME activity.


Motivational interviewing
Motivational Interviewing

PREPARING

PEOPLE

FOR

CHANGE


Ambivalence
Ambivalence

The Dilemma of Change


Ambivalence1
Ambivalence

  • State of having simultaneous, conflicting feelings:

    • Mixed Feelings

    • Uncertainty

    • Indecisiveness


Consequences of ambivalence
Consequences of Ambivalence

  • The result of being in a state of ambivalence can lead to avoidance or procrastination

  • OR…to deliberate attempts to resolve the ambivalence that may result in success or failure


Ambivalence2
Ambivalence

  • Ambivalence about proposed behavior change is NORMAL

  • Direct persuasion or advice giving is NOT an effective method for resolving ambivalence for most patients


The righting reflex
The Righting Reflex

Our desire to keep people from going down the wrong path, and to set things aright



Advice regarding health behavior change
Advice Regarding Health Behavior Change

  • We like to give it

  • We’ve been trained to give it

  • It’s not very effective

  • We do it anyway


Bad example mi
Bad Example MI

http://www.youtube.com/watch?v=80XyNE89eCs


Motivational interviewing helping people change

“Motivation to change is not a personality trait, but is affected by interpersonal interaction”

Miller & Rollnick, 1991


Four key principles
Four key principles affected by interpersonal interaction”

  • Express empathy

  • Develop discrepancy

  • Roll with resistance and avoid argumentation

  • Support self-efficacy


Good example of mi
Good Example of MI affected by interpersonal interaction”

http://www.youtube.com/watch?v=URiKA7CKtfc


What you can t do with mi
What You Can’t Do with MI affected by interpersonal interaction”

Ex. With a parent of a child who is overweight

  • In one given interaction you probably CANNOT:

    • Get the parent to totally change both the child’s eating AND exercise habits

    • Get the parent to change both the home food environment AND physical activity environment


What you can do with mi
What You Can Do with MI affected by interpersonal interaction”

You probably CAN:

  • Assess readiness for change

  • Engage with the parent so that she sees you as someone who would be willing to help if and when she wants help

  • Use reflective listening to encourage the parent to consider even a small step toward change

  • Plant the seed for behavior change by using the “confidence ruler” technique