Motivational Interviewing

Size: px
Start display at page:

Download "Motivational Interviewing"

Transcription

1 Motivational Interviewing By: Tonia Stott, PhD What is Motivational Interviewing? A client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence (Miller and Rollnick, 2002) Motivational Interviewing (MI) is a framework for practice a way of thinking and believing about people and when and how people change (spirit of MI) the combination of practice approaches and micro skills that are consistent with the spirit of MI What is Motivational Interviewing? The founders of MI are William Miller and Stephen Rollnick. They have been teaching and researching MI for about 30 years. They were heavily influenced by Carl Rogers, though they differ from a Rogerian approach in that MI is a directed way of working with clients, rather than a non-directive approach that follows clients as they wander. 1

2 What is Motivational Interviewing MI explores with clients their willingness, ability, and readiness for change. Through reflections and evocations, the approach aims to assist clients in resolving ambivalence about change, in clarifying their thoughts about change, and in organizing their thoughts around change. Spirit of MI The philosophical foundations of MI: People explore change when they understand the discrepancy between their own values and their actions. Clients changes have to be consistent with their values. If clients values are different from the practitioner s or what the client is supposed to change, MI will not result in real or lasting change. People change when they feel ready, able, and willing to change. Practitioners or interventionists cannot instill or create for clients the feelings of ability, willingness, or readiness, though practitioners can assist clients in recognizing and believing in their ability, willingness, and readiness. People explore the possibility of change when they feel supported in doing so, and when they feel they would be in control of what is changed, how it is changed, and when it is changed. The warmth and empathy practitioners display when working with clients is as important and possibly more important than what they say. An empathic, authentic relationship between practitioner and client gives the client room to explore change without feeling pressured. The fear of loss of control is often more powerful than any other motivating force, so if clients feel there could be a loss of control, they are much less likely to explore change. If practitioners try to control what is changed, how it is changed, and when it is changed, it is more likely to result in the client becoming more resistant to change than exploring change. Spirit of MI MI is not: A script or series of questions and statements that should be used the same way with all clients. A method of manipulating or tricking clients into agreeing with making change, even though they do not fully value the change. An exclusive technique. Other approaches and techniques could be used in concert with MI, if they are used in a spirit consistent with MI. A way proving to clients that they are wrong or that they should change. MI will not result in making or getting the client to do something or change something. Only the client is in control of the change. The practitioner assists the client with understanding what changes they want and how they could go about achieving those changes by focusing on change talk and not focusing talk that does not elicit change. 2

3 The Foundations of MI Collaboration the practitioner does not try to assume the expert role or to advance his/her own agenda of the solution. Rather the client and practitioner work in harmony in discussing problems, changes, and solutions. Practitioners can collaborate with clients on agenda setting. In the opening of any meeting with a client, the practitioner can ask the client what they would like to discuss during that time. Evocation the practitioner elicits from the client their values, beliefs about change, and plans for change. The practitioner does not prescribe it. Autonomy the client can choose to change or not, can choose what to change and not to change, when to change, and how to change. The practitioner respects the client s autonomy even if the choices are contrary to what the practitioner or the practitioner s agency thinks is best. General Principles of MI 1. Express empathy 2. Develop discrepancy (difference between what client values and what client does) 3. Roll with resistance 4. Support self-efficacy How MI Works A practitioner using an MI approach tries to be in harmony with the client. The practitioner does not say or do things that would elicit defensiveness or argument from clients in support of the status quo. The reason is that often when people argue in defense of a position, they become more committed to that position, so argument is counterproductive. When clients and practitioners are not working in harmony, it is referred to as dissonance in the practitioner-client relationship. In MI, if a client is resistant, this is a function of the client-practitioner relationship, as clients cannot resist something that is posing no force or pressure. When there is consonance or harmony, the client may be willing to explore the possibility of change. Through the exploration, the practitioner listens for change talk (talk of potential change, thoughts about change, willingness to change, advantages of changing, problems with the status quo, hope of change, etc.). When change talk manifests, the practitioner focuses on the change talk through employing specific skills. The skills are designed to assist clients in organizing their thoughts about change and clarifying their willingness, ability, and readiness for change. 3

4 How MI Works The most important skill in MI is listening. The practitioner needs to listen for change talk The practitioner needs to listen for indications of willingness, ability, and readiness for change The practitioner needs to fully listen to the client s perspectives, values, beliefs, and experiences Listening requires a degree of vulnerability (I don t actually have the power to fix very much) and humility (I can t completely know what is best for someone else) on the part of the practitioner There are many roadblocks that can prevent practitioners from listening. These roadblocks keep the practitioner s mind busy with trying to gain control of the conversation, proving they are right, placing themselves in the expert role, or placing themselves in a more powerful position. 1. Ordering, directing, commanding 2. Warning, cautioning, or threatening 3. Giving advice, making suggestions, or providing solutions 4. Persuading with logic, arguing, or lecturing 5. Telling people what they should do, moralizing 6. Disagreeing, judging, criticizing, or blaming 7. Agreeing, approving, or praising 8. Shaming, ridiculing, or labeling 9. Interpreting or analyzing 10. Reassuring, sympathizing, or consoling 11. Questioning or probing 12. Withdrawing, distracting, humoring, or changing the subject (Gordon, 1970 as quoted in Miller & Rollnick, 2002) Thomas Gordon s Roadblocks to Listening Skills of MI: OARS Open-ended (non-judgmental) questions Affirmations Reflective listening Summaries 4

5 Open-Ended Questions Using open-ended questions to honestly (not through trickery or manipulation) explore clients values and thoughts. If and What Questions I would like to know a little more about you and what your life is like, what is a typical day like for you? What would be the best thing about your life if you were not using meth? What worries you about your meth use? What do you think will happen if you keep using meth for the next five years? What would be the best thing about your life if you stopped using drugs? What would be the hardest thing about your life if you stopped using drugs? If you decided to stop using meth, how would you go about that? If you did decide that you wanted your change your discipline techniques, what would you do differently? Open-Ended Questions Readiness Scales Readiness Scales: Importance (willingness): On a scale of 1 to 10, with 1 being not important at all and 10 being very important, how important is it to you to stop using meth? Confidence (ability): If you did choose to stop using meth, on a scale of 1 to 10 with 1 being not confident at all, and 10 being very confident, how confident are you that you could stop? Readiness If you were to start following a plan to stop using meth, how soon would you want to start that plan, today, next week, next month, or next year? Trap to Avoid Question Answer Trap The question answer trap happens when a pattern develops of practitioner asking a question, client responding, practitioner asks question, client responds, etc. The reason this limits change talk is that the client may not become personally engaged in exploring change, rather the client waits for the expert to figure out the solution by simply asking enough questions. In question/answer patterns, the practitioner holds the power and responsibility for creating change. This is contrary to the spirit of MI. Generally, MI practitioners are encouraged to keep a 2 to 1 ratio of questions to reflections. 5

6 Affirmations Affirmations build clients sense of empowerment and self-efficacy. These are short statements specifically about the clients strengths that can be capitalized upon for change. Affirmations should be genuine and should be specific to behaviors. You have a lot of commitment to your family to have come here today despite your belief that there is nothing wrong. You are an independent person who is going to decide what is best for you. You don t let others make up your mind for you. You love your children and want to do what is best for them. You enjoy being with people and having a good time. reflect back to the client what you are hearing. aid you in ensuring you re understanding what the client is saying, but more importantly, they help the client clarify their thoughts. Though they said something and you reflected back what they said, after hearing it, they may change their mind slightly. This process of continuing to evaluate what specifically they think and feel assists clients in moving forward through ambivalence about change. should end in a period, not a question mark. Questions are useful to start a conversation or change a conversation, but questions interrupt the other person s thought processes., on the other hand, can keep the thought process going. can be simple, complex, amplified, understated, or double-sided. Different kinds of reflections can assist clients in clarifying their thoughts in different ways. Simple Reflection restates what the client said without much variation You feel that your use of drugs does not hurt anyone. It sounds like you have tried many times to leave your husband. You re wondering if you can get a job and support your children without prostituting. You don t know why your children were removed from your care. You believe that your Parent Aide doesn t understand how hard things are for you. 6

7 Complex test hypotheses or use words the client did not use to see if the statement rings true to client. Client: This is just too much, how am I supposed to do all this? This is like 3 pages long. I don t know even know what half this stuff means. SWer: You feel overwhelmed by the case plan tasks and are not sure where to start. Client: I can t work with that lady anymore. She s always saying this and that and how I do everything wrong. She doesn t understand what it s like and she thinks I have to be perfect and do everything just like her. Well I don t care about what she did with her kids and her perfect little life. SWer: The way the parent aid talks to you makes you feel like she doesn t respect you. Amplified reflections exaggerates or overstates what the client has said. This clarifies that things are not always a certain all or not all people respond to them that way, or there is no way they could ever do such a thing. It opens possibilities by allowing the client to explore exceptions. So, nothing bad has ever happened as a result of your substance use. You never get upset or angry with your children. You haven t learned anything at all from the parent aide classes. Understated reflections slightly lower the intensity of the client s statements in order to explore deeper meanings underlining the defensive emotion. Client: I love my kids and you all just ripped them away from me. How could you do this to them and call it protection? They hate that house and they look miserable. I didn t do anything wrong and this is all just bullshit. You re harming my kids because you believe some person at their school who barely knows them more than you believe us. They were fine with me. There was nothing wrong. SWer: You miss your children and you are confused about why they were removed from your care. Having a better understanding about why they were removed would be helpful to you. 7

8 Double-sided reflections mirror back to clients their ambivalence so it could be explored further. This is the one time to use the word but. Client: I love my husband and I don t want to leave him. I m tired of you people telling me how my marriage should be. So we fight, so what? He s not an abuser, I hit him as much as he hits me. Sure, sometimes he goes to far, but I should know better not to piss him off that much. SWer: You want to remain in the relationship with your husband but you understand that the violence in the relationship is not good for either of you. Summaries Summaries allows clients to hear how their thoughts have come together. Summaries come out of the narrative model. It assists clients with organizing their thoughts and reframing their experiences. You are angry about the removal of your children. You love them and you miss them. Taking care of them was hard, but you want them to come home as soon as possible. You do not think you have a substance abuse problem and you do not want to go to the evaluation. On the other hand you do understand that going to the evaluation is on your case plan and that whether or not you go will be reported to the court. You are willing to do anything for your kids, but you re just not sure you want to go to the evaluation, yet. Did I miss anything? Wrapping Up Concluding or wrapping up in an MI approach remains true to the spirit of MI in that the client is asked what she/he will do. Given what we have talked about, what will you do next? So, based on the choices available to you, what do you think you will do this week? How do you think you will decide what you are going to do about going to the evaluation or not? What will you do about this problem? 8

The Challenging Client: Using MI Tools to Engage & Treat

The Challenging Client: Using MI Tools to Engage & Treat The Challenging Client: Using MI Tools to Engage & Treat MCLEOD CENTER CHARLOTTE, NORTH CAROLINA NOVEMBER 16, 2018 L A U R I E C O N AT Y, L C S W, L C A S L A U R I E C O N AT Y. C O M M A K E I T W O

More information

BASIC VOLUME. Elements of Drug Dependence Treatment

BASIC VOLUME. Elements of Drug Dependence Treatment BASIC VOLUME Elements of Drug Dependence Treatment Module 2 Motivating clients for treatment and addressing resistance Basic counselling skills for drug dependence treatment Special considerations when

More information

Motivational Interviewing. Calvin Miller, CADC, MAATP

Motivational Interviewing. Calvin Miller, CADC, MAATP Motivational Interviewing Calvin Miller, CADC, MAATP Why use Motivational Interviewing? Respectful approach Considers the where the client is at in the Stages of Change. Considers the client s resources.

More information

Motivational Enhancement Therapy & Stages of Change

Motivational Enhancement Therapy & Stages of Change Motivational Enhancement Therapy & Stages of Change Learning Objectives Participants will be able to: 1) Identify the stages of change and how they can be implemented 2) Describe the principles of MET

More information

PM-SB Study MI Webinar Series Engaging Using Motivational Interviewing (MI): A Practical Approach. Franze de la Calle Antoinette Schoenthaler

PM-SB Study MI Webinar Series Engaging Using Motivational Interviewing (MI): A Practical Approach. Franze de la Calle Antoinette Schoenthaler PM-SB Study MI Webinar Series Engaging Using Motivational Interviewing (MI): A Practical Approach Franze de la Calle Antoinette Schoenthaler Webinar Housekeeping Please keep your phone on mute when not

More information

Motivational Interviewing for Family Planning Providers. Motivational Interviewing. Disclosure

Motivational Interviewing for Family Planning Providers. Motivational Interviewing. Disclosure for Family Planning Providers Developed By: Disclosure I I have no real or perceived vested interests that relate to this presentation nor do I have any relationships with pharmaceutical companies, biomedical

More information

MOTIVATIONAL INTERVIEWING

MOTIVATIONAL INTERVIEWING MOTIVATIONAL INTERVIEWING Facilitating Behaviour Change Dr Kate Hall MCCLP MAPS Senior Lecturer in Addiction and Mental Health School of Psychology, Faculty of Health, Deakin University. Lead, Treatment

More information

Understanding Your Coding Feedback

Understanding Your Coding Feedback Understanding Your Coding Feedback With specific feedback about your sessions, you can choose whether or how to change your performance to make your interviews more consistent with the spirit and methods

More information

Identify the benefits of using a Brief Negotiated Intervention (BNI) to screen for alcohol and drug disorders. Review a four step model of Screening,

Identify the benefits of using a Brief Negotiated Intervention (BNI) to screen for alcohol and drug disorders. Review a four step model of Screening, Kate Speck, PhD Identify the benefits of using a Brief Negotiated Intervention (BNI) to screen for alcohol and drug disorders. Review a four step model of Screening, Brief Intervention and Referral to

More information

VOLUME B. Elements of Psychological Treatment

VOLUME B. Elements of Psychological Treatment VOLUME B Elements of Psychological Treatment Module 2 Motivating clients for treatment and addressing resistance Approaches to change Principles of Motivational Interviewing How to use motivational skills

More information

Motivating Behavior Change What Really Works? Pre-Test

Motivating Behavior Change What Really Works? Pre-Test Motivating Behavior Change What Really Works? Practice of Medicine I Christine M. Peterson, M.D. Terry Saunders, Ph.D. Pre-Test Among deaths in the U.S. that occur prematurely, the per cent attributable

More information

VOLUME B. Elements of Psychological Treatment

VOLUME B. Elements of Psychological Treatment VOLUME B Elements of Psychological Treatment VOLUME B MODULE 1 Drug dependence and basic counselling skills Biology of drug dependence Principles of drug dependence treatment Basic counselling skills for

More information

The New York State Cessation Center Collaborative Statewide Conference Call. Jonathan Fader, PhD

The New York State Cessation Center Collaborative Statewide Conference Call. Jonathan Fader, PhD Motivational Interviewing & the Five R s: Helping Clients Who Aren t Ready to Quit The New York State Cessation Center Collaborative Statewide Conference Call Jonathan Fader, PhD September 2, 2009 Disclosure

More information

Motivational Interviewing Engaging clients in a conversation about change

Motivational Interviewing Engaging clients in a conversation about change Motivational Interviewing Engaging clients in a conversation about change 16 th Annual Social Work Conference University of Southern Indiana March 2nd, 2018 Chad Connor, MSSW, LCSW So what is Motivational

More information

Interviewing, or MI. Bear in mind that this is an introductory training. As

Interviewing, or MI. Bear in mind that this is an introductory training. As Motivational Interviewing Module 2 Slide Transcript Slide 1 In this module, you will be introduced to the basics of Motivational Interviewing, or MI. Bear in mind that this is an introductory training.

More information

A personal taste of MI. When practicing MI you don t need to be clever and complex, just interested and curious. An uncluttered mind helps.

A personal taste of MI. When practicing MI you don t need to be clever and complex, just interested and curious. An uncluttered mind helps. Building skills in MOTIVATIONAL INTERVIEWING helping people change MI is Your hopes? ken kraybill Your goals? A personal taste of MI Dilemma/concern? What s okay about status quo? What s not? If no change,

More information

Disclosure. What s this all about? From wrestling to dancing with patients: Motivational Interviewing in 10 minutes

Disclosure. What s this all about? From wrestling to dancing with patients: Motivational Interviewing in 10 minutes From wrestling to dancing with patients: Motivational Interviewing in 10 minutes Delwyn Catley, Ph.D. Professor Department of Psychology University of Missouri Kansas City Disclosure I have no relevant

More information

Motivational Interviewing

Motivational Interviewing Motivational Interviewing Joining and Engaging, Increasing Participation, Improving Behaviors, Mastering Resistance Mark M. Lowis, LMSW Core Skills What Is Motivational Interviewing? Motivational Interviewing

More information

29/05/2014. Motivational Approaches: Supporting Individuals With Complex Needs. Triangle Community Resources. Diverse and Complex Characteristics

29/05/2014. Motivational Approaches: Supporting Individuals With Complex Needs. Triangle Community Resources. Diverse and Complex Characteristics Motivational Approaches: Supporting Individuals With Complex Needs Triangle Community Resources Long history of delivering services specifically for Multi barriered individuals Extensive experience assisting

More information

COVER MONTANA MOTIVATIONAL INTERVIEWING- Gina Pate-Terry, LCSW, LAC,

COVER MONTANA MOTIVATIONAL INTERVIEWING- Gina Pate-Terry, LCSW, LAC, COVER MONTANA MOTIVATIONAL INTERVIEWING- Gina Pate-Terry, LCSW, LAC, gpateterry@mtpca.org MOTIVATIONAL INTERVIEWING It is an openness to a way of thinking and working that is collaborative rather than

More information

MOTIVATIONAL INTERVIEWING

MOTIVATIONAL INTERVIEWING MOTIVATIONAL INTERVIEWING Joining and Engaging, Increasing Participation, Improving Behaviors, Mastering Resistance Mark M. Lowis, LMSW CORE SKILLS What Is Motivational Interviewing? Motivational Interviewing

More information

DISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.

DISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics. DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this

More information

Motivational Strategies for Challenging Situations

Motivational Strategies for Challenging Situations Motivational Strategies for Challenging Situations Mandy Fauble, PhD, LCSW Executive Director, Safe Harbor Behavioral Health of UPMC Hamot James, Wyler, MA, CPRP Scenario When I talked to her about my

More information

Facilitating Change Using the Relational Elements of Motivational Interviewing

Facilitating Change Using the Relational Elements of Motivational Interviewing UNC-CH CLINICAL LECTURE INSTITUTE Facilitating Change Using the Relational Elements of Motivational Interviewing Marty Weems, LCSW, LCAS, MINT UNC School of Social Work 10-20-2016 Learning Objectives Understand

More information

Suggested topics to review with your students

Suggested topics to review with your students Working with Students: Building Blocks for Motivational Interviewing and Brief Intervention Strategies Jason R. Kilmer, Ph.D. University of Washington Associate Professor Psychiatry & Behavioral Sciences

More information

Motivational Interviewing in Healthcare. Presented by: Christy Dauner, OTR

Motivational Interviewing in Healthcare. Presented by: Christy Dauner, OTR Motivational Interviewing in Healthcare Presented by: Christy Dauner, OTR The Spirit of MI Create an atmosphere of acceptance, trust, compassion and respect Find something you like or respect about every

More information

The Utilization of Motivational Interviewing Techniques with Consumers of Color

The Utilization of Motivational Interviewing Techniques with Consumers of Color The Utilization of Motivational Interviewing Techniques with Consumers of Color By Dr. Allen E. Lipscomb, PsyD, LCSW What is MI? a collaborative, person-centered form of guiding to elicit and strengthen

More information

In helping people change, your biggest challenge is. A Little About Shawn & MI. An Overview 9/12/2013

In helping people change, your biggest challenge is. A Little About Shawn & MI. An Overview 9/12/2013 A Little About Shawn & MI An Overview If you treat a person as he is, he will stay as he is; But if you treat him as if he were what he ought to be and could be, he will become what he ought to be and

More information

Objectives. David Hodgins, University of Calgary. The Fundamentals of Motivational Interviewing: Engaging Clients and Avoiding Dropout

Objectives. David Hodgins, University of Calgary. The Fundamentals of Motivational Interviewing: Engaging Clients and Avoiding Dropout David Hodgins, University of Calgary 2015-05-20 The Fundamentals of Motivational Interviewing: Engaging Clients and Avoiding Dropout David Hodgins www.addiction.ucalgary.ca Midwest Conference on Problem

More information

ADDITIONAL CASEWORK STRATEGIES

ADDITIONAL CASEWORK STRATEGIES ADDITIONAL CASEWORK STRATEGIES A. STRATEGIES TO EXPLORE MOTIVATION THE MIRACLE QUESTION The Miracle Question can be used to elicit clients goals and needs for his/her family. Asking this question begins

More information

Introduction to Stages of Change and Change Talk in Motivational Interviewing Lisa Kugler, PsyD. March 29, 2018

Introduction to Stages of Change and Change Talk in Motivational Interviewing Lisa Kugler, PsyD. March 29, 2018 Introduction to Stages of Change and Change Talk in Motivational Interviewing Lisa Kugler, PsyD. March 29, 2018 Workshop Objectives Participants will be able to identify 3 key elements of motivational

More information

MOTIVATIONAL INTERVIEWING OVERVIEW & TIPS

MOTIVATIONAL INTERVIEWING OVERVIEW & TIPS Sobell & Sobell 2003 MOTIVATIONAL INTERVIEWING OVERVIEW & TIPS GOAL To get people to resolve their ambivalence (i.e., conflict) about changing their behavior, while not evoking resistance (e.g., get confrontational,

More information

Introduction. Jim Tillman, D.Min. Certified Integrative Health Coach Presently working with HTN patients in Lenoir Co.

Introduction. Jim Tillman, D.Min. Certified Integrative Health Coach Presently working with HTN patients in Lenoir Co. Introduction Jim Tillman, D.Min. Certified Integrative Health Coach Presently working with HTN patients in Lenoir Co. Acknowledgement Material contained within this training was largely based on the work

More information

What is Motivational Interviewing?

What is Motivational Interviewing? What is Motivational Interviewing? Motivational Interviewing (MI) is a guiding style of communication that provides patients with the opportunity to create change in behaviors by providing a nonjudgmental

More information

Introduction to Motivational Interviewing in NAS Interventions

Introduction to Motivational Interviewing in NAS Interventions Introduction to Motivational Interviewing in NAS Interventions Daniel Raymond Tanagra M. Melgarejo Workshop Overview 1 Training Objectives By the end of this session you will be able to: Describe the fundamental

More information

Taste of MI: The Listener. Taste of MI: The Speaker 10/30/2015. What is Motivational Interviewing? (A Beginning Definition) What s it for?

Taste of MI: The Listener. Taste of MI: The Speaker 10/30/2015. What is Motivational Interviewing? (A Beginning Definition) What s it for? What is Motivational Interviewing? (A Beginning Definition) Implementing Motivational Interviewing Kelly Wurdelman, MSN, RN Behavioral Health Clinic CentraCare St. Cloud Hospital What s it for? Motivational

More information

Motivational Interactions

Motivational Interactions Motivational Interactions James Carter, Ph.D. Specialty Behavioral Health UCSD Dept. of Psychiatry Presented for TRICOR Nashville, TN June 9, 2011 What motivates people to change? Rewards Punishments /

More information

Motivational Interviewing

Motivational Interviewing An introduction to Motivational Interviewing Dr Tim Anstiss M.B., M.Ed., D.Occ.Med.,M.F.S.E.M. Visiting Research Fellow Human Development and Health Academic Department University of Southampton Medical

More information

How to Increase Motivation

How to Increase Motivation How to Increase Motivation Richard Saitz, MD, MPH Professor of Medicine & Epidemiology Boston University Schools of Medicine and Public Health Boston Medical Center What Is Motivation? (Or Lack of Motivation?)

More information

What is Motivational Interviewing?

What is Motivational Interviewing? What is Motivational Interviewing? Motivational Interviewing (MI) is a guiding style of communication that provides patients with the opportunity to create change in behaviors by providing a nonjudgmental

More information

Objectives. Changing Landscape of Healthcare

Objectives. Changing Landscape of Healthcare The Well Woman Visit Pre/Interconceptional Care, One Year Later Motivational Interviewing Peg Dublin, RN, MPH Richard Rutschman, EdD. IDHS Bureau of Maternal & Infant Health Satellite Conference June 17,

More information

1. Evolution in MI-3 2. Three Puzzles Emerging from MI Research MINT Forum, Sheffield

1. Evolution in MI-3 2. Three Puzzles Emerging from MI Research MINT Forum, Sheffield 1. Evolution in MI-3 2. Three Puzzles Emerging from MI Research 2011 MINT Forum, Sheffield 1983 1991 MI-1 2002 MI-2 2008 2012 MI-3 2022 MI-4 X Generalized Principles of MI 1. Express Empathy 2. Develop

More information

Motivating Behavior Change What Really Works?

Motivating Behavior Change What Really Works? Motivating Behavior Change What Really Works? Practice of Medicine Christine M. Peterson, M.D. Pre-Test Do You Know? Half of all deaths in the US are attributable to personal behavior, including: Tobacco

More information

MOTIVATIONAL INTERVIEWING IN MIHP Application challenges and strategies. Steven J. Ondersma, PhD School of Medicine & MPSI Wayne State University

MOTIVATIONAL INTERVIEWING IN MIHP Application challenges and strategies. Steven J. Ondersma, PhD School of Medicine & MPSI Wayne State University MOTIVATIONAL INTERVIEWING IN MIHP Application challenges and strategies Steven J. Ondersma, PhD School of Medicine & MPSI Wayne State University Challenge Relevant core skills Specific strategies THE CURIOUS

More information

Welcome to Motivational Interviewing Enhancing Motivation to Change Strategies. This is the third module that you ll be taking about motivational

Welcome to Motivational Interviewing Enhancing Motivation to Change Strategies. This is the third module that you ll be taking about motivational Welcome to Motivational Interviewing Enhancing Motivation to Change Strategies. This is the third module that you ll be taking about motivational interviewing. 1 The goals for this session are listed on

More information

How to increase motivation

How to increase motivation How to increase motivation Richard Saitz MD, MPH, FACP, FASAM Professor of Medicine & Epidemiology Boston University Schools of Medicine & Public Health Director, Clinical Addiction, Research and Education

More information

Brief Intervention: Motivational Interviewing

Brief Intervention: Motivational Interviewing Brief Intervention: Motivational Interviewing Introduction, Spirit, Principles Tim Guimond, MD, MSc, FRCPC, PhD (cand) Clinician-Researcher, St. Michael s Hospital Consulting Psychiatrist, Casey House

More information

8/6/2015. Managing Resistance To Improve Diabetes Self-Management. Internal Influences. External Influences. Cognitive Ability Motivation

8/6/2015. Managing Resistance To Improve Diabetes Self-Management. Internal Influences. External Influences. Cognitive Ability Motivation Eliot LeBow MSW, LCSW, CDE Diabetes-Focused Psychotherapist DiabeticTalks New York, NY Disclosure to Participants Notice of Requirements For Successful Completion Please refer to learning goals and objectives

More information

Overview. What about your clients? MOSBIRT Annual Training Nikole J Cronk, PhD. o Review of MI basics

Overview. What about your clients? MOSBIRT Annual Training Nikole J Cronk, PhD. o Review of MI basics Nikole J Cronk, PhD Overview o Review of MI basics o Moving Forward with MI o Interactive, tailored problem solving and skill enhancement What about your clients? o Myth of the unmotivated patient/client

More information

Amy Shanahan, MS, CADC Director of Clinical Care Services Western Psychiatric Institute & Clinic of UPMC

Amy Shanahan, MS, CADC Director of Clinical Care Services Western Psychiatric Institute & Clinic of UPMC Motivational Interviewing Introduction Amy Shanahan, MS, CADC Director of Clinical Care Services Western Psychiatric Institute & Clinic of UPMC shanahana@upmc.edu Jeff Geibel, PhD Senior Program Director

More information

OPIOID SUMMIT Partners Behavioral Health Management

OPIOID SUMMIT Partners Behavioral Health Management OPIOID SUMMIT Partners Behavioral Health Management March 11, 2016 Presented By: David R. Swann, MA, LCAS, CCS, LPC, NCC Senior Integrated Healthcare Consultant MTM Services The National Council for Behavioral

More information

Screening, Brief Intervention, Referral to Treatment

Screening, Brief Intervention, Referral to Treatment Screening, Brief Intervention, Referral to Treatment Kalea Benner, PhD, MSW, LCSW Cassie Brown, MSW, LCSW Funded by SAMHSA, Grant #TI - 025976 Rationale SBIRT research and implementation has primarily

More information

Motivating Behavior Change What Really Works?

Motivating Behavior Change What Really Works? Motivating Behavior Change What Really Works? Pre-Test Practice of Medicine 1 Christine M. Peterson, M.D. David Waters, Ph.D. Do You Know? Half of all deaths in the US are attributable to personal behavior,

More information

ASDAH December MEANT FOR EACH OTHER: MOTIVATIONAL INTERVIEWING AND THE HEALTH AT EVERY SIZE PRINCIPLES

ASDAH December MEANT FOR EACH OTHER: MOTIVATIONAL INTERVIEWING AND THE HEALTH AT EVERY SIZE PRINCIPLES ASDAH December 2014 1 MEANT FOR EACH OTHER: MOTIVATIONAL INTERVIEWING AND THE HEALTH AT EVERY SIZE PRINCIPLES Ellen R. Glovsky, PhD, RD, LDN www.trainingwithdrellen.com Ellen@TrainingWithDrEllen.com ASDAH

More information

Using Motivational Interviewing

Using Motivational Interviewing Using Motivational Interviewing to Support Providers & Consumers Jon Diggs, LPC Psychotherapist T2SEnterprises, LLC jon@t2senterprises.com @jdiggslpc About the Presenter Worked in HIV Prevention for 10

More information

Motivational Interviewing (Brief)

Motivational Interviewing (Brief) Motivational Interviewing (Brief) Stephen R. Andrew LCSW LADC CCS CGP Health Education & Training Institute 25 Middle Street Portland, Maine 04101 www.hetimaine.org 207-773-3275 Biography Stephen R. Andrew,

More information

Approaches to Treatment - Motivational Interviewing

Approaches to Treatment - Motivational Interviewing Approaches to Treatment - Motivational Interviewing Presenter: Date: Kevin Fisher, R. Psych November 25, 2009 The FASD Learning Series is part of the Alberta government s commitment to programs and services

More information

Slide

Slide Slide 2 13.7.2010 Slide 6 13.7.2010 Slide 7 13.7.2010 Slide 14 13.7.2010 Conflict within an individual is the simultaneous arousal of two or more incompatible motives. To understand the dynamics

More information

Reflections on Motivational Interviewing

Reflections on Motivational Interviewing Reflections on Motivational Interviewing Cardiff September 27, 2011 1983 1991 MI-1 2002 MI-2 2008 2012 MI-3 2022 MI-4 X Generalized Principles of MI 1. Express Empathy 2. Develop Discrepancy 3. Avoid

More information

Conflict of Interest. Motivational Interviewing (MI) What is Motivational Interviewing. Empathy & MI spirit Consistent use of MI

Conflict of Interest. Motivational Interviewing (MI) What is Motivational Interviewing. Empathy & MI spirit Consistent use of MI Conflict of Interest Motivational Interviewing (MI) The speaker has no conflict of interest t to disclose Edna Hamera PhD APRN Upon completion you will be able to: Identify philosophy and mechanisms of

More information

Principles of MI. Afternoon at the Improv. MI Begins with Lending an Ear. Contemplation. 1. Express Empathy. 2. Develop Discrepancy

Principles of MI. Afternoon at the Improv. MI Begins with Lending an Ear. Contemplation. 1. Express Empathy. 2. Develop Discrepancy Motivational Interviewing Presented by: Beth A. Cassel Mary M. LeVasseur Mary Lee Steffy Theresa Whitesel Motivational Interviewing (MI) http://www.ctri.wisc.edu/hc.providers/healthcare_o ndemand_tug.htm

More information

Helping People Change

Helping People Change Helping People Change Richard Saitz MD, MPH, FACP, FASAM Chair, Department of Community Health Sciences Professor of Community Health Sciences and Medicine Boston University Schools of Medicine & Public

More information

Risk Assessment and Motivational Interviewing. Tracy Salameh MSN, APRN, FNP-BC

Risk Assessment and Motivational Interviewing. Tracy Salameh MSN, APRN, FNP-BC Risk Assessment and Motivational Interviewing Tracy Salameh MSN, APRN, FNP-BC Today's Presentation Performing a risk assessment Principals of motivational interviewing Unique prevention measures Treatment

More information

Prevention for Positives with Motivational Interviewing

Prevention for Positives with Motivational Interviewing Prevention for Positives with Motivational Interviewing S H A R L E N E J A R R E T T C L I N I C A L P S Y C H O L O G I S T ( M & E O F F I C E R N A T I O N A L H I V / S T I P R O G R A M M E, J A

More information

Motivational Interviewing

Motivational Interviewing Taste of MI Motivational Interviewing I have had prior training in MI. I feel competent in using MI. TRUE FALSE ENTER Transtheoretical Change Process HOW PEOPLE CHANGE Maintenance Precontemplation Action

More information

Motivational interviewing; another tool at our disposal (is more than just good listening)

Motivational interviewing; another tool at our disposal (is more than just good listening) Motivational interviewing; another tool at our disposal (is more than just good listening) Deb Hemgesberg, LMSW Project Manager, NEMCMH Aug 10 11, 2017, Culture of gentleness Conf. Motivational Interviewing

More information

Client Care Counseling Critique Assignment Osteoporosis

Client Care Counseling Critique Assignment Osteoporosis Client Care Counseling Critique Assignment Osteoporosis 1. Describe the counselling approach or aspects of different approaches used by the counsellor. Would a different approach have been more appropriate

More information

Difficult Conversations

Difficult Conversations Difficult Conversations Corban Sanchez Academic Advisor NACADA Conference 2011 Douglas Stone, Bruce Patton, and Sheila Heen of the Harvard Negotiation Project Moving Toward a Learning Conversation Normal

More information

AFSP SURVIVOR OUTREACH PROGRAM VOLUNTEER TRAINING HANDOUT

AFSP SURVIVOR OUTREACH PROGRAM VOLUNTEER TRAINING HANDOUT AFSP SURVIVOR OUTREACH PROGRAM VOLUNTEER TRAINING HANDOUT Goals of the AFSP Survivor Outreach Program Suggested Answers To Frequently Asked Questions on Visits Roadblocks to Communication During Visits

More information

An Introduction to Motivational Interviewing Helping People Change

An Introduction to Motivational Interviewing Helping People Change An Introduction to Motivational Interviewing Helping People Change Todd Gibbs, M.A., LPC a person-centered counseling style for addressing the common problem of ambivalence about change Motivational Interviewing:

More information

Motivational Interviewing: Walking Through the Four Processes

Motivational Interviewing: Walking Through the Four Processes Motivational Interviewing: Walking Through the Four Processes William R. Miller, Ph.D. University of New Mexico Hong Kong December 17, 2018 1 2 1. Engaging 2. Focusing 3. Evoking 4. Planning Can we walk

More information

Erica R. Thomas MS DDA Health Initiative

Erica R. Thomas MS DDA Health Initiative Erica R. Thomas MS DDA Health Initiative Learning Objectives Nurses will be able to identify, practice and apply the basic strategies of motivational interviewing Nurses will be able to define the importance

More information

Why Is It That Men Can t Say What They Mean, Or Do What They Say? - An In Depth Explanation

Why Is It That Men Can t Say What They Mean, Or Do What They Say? - An In Depth Explanation Why Is It That Men Can t Say What They Mean, Or Do What They Say? - An In Depth Explanation It s that moment where you feel as though a man sounds downright hypocritical, dishonest, inconsiderate, deceptive,

More information

National Inspection of services that support looked after children and care leavers

National Inspection of services that support looked after children and care leavers National Inspection of services that support looked after children and care leavers Introduction Children and young people that are looked after and those leaving care need the best support possible. Support

More information

Motivational Interviewing

Motivational Interviewing Motivational Interviewing The behavior of human beings is influenced not only by the past and current environment, but also by our images of the future. AI Lisa Stockwell, M.Ed. There are three levels

More information

Motivational Interviewing

Motivational Interviewing MI Motivational Interviewing Jassin M. Jouria, MD INTRODUCTION Motivational interviewing (MI) is a method that promotes behavior change, and can be used in a multitude of environments and situations to

More information

SHIP Conference Motivational Interviewing. Shannon Garrett, LGSW Mountain Manor Treatment Center

SHIP Conference Motivational Interviewing. Shannon Garrett, LGSW Mountain Manor Treatment Center SHIP Conference Motivational Interviewing Shannon Garrett, LGSW Mountain Manor Treatment Center Substance Abuse Counseling and Motivational Interviewing Discuss risky behaviors that students participate

More information

Traditional Health Teaching is. Evidence-based Health Coaching is IN!

Traditional Health Teaching is. Evidence-based Health Coaching is IN! Traditional Health Teaching is Out Evidence-based Health Coaching is IN! Melinda Huffman, BSN, MSN,CCNS,CHC National Society of Health Coaches Copyright 2015 Miller & Huffman Outcome Architects, LLC All

More information

Utilizing Strength-Based Communication Strategies with Older Adults

Utilizing Strength-Based Communication Strategies with Older Adults Utilizing Strength-Based Communication Strategies with Older Adults Linda J. Keilman, DNP, GNP-BC Objectives: 1. Identify interactive communication skills helpful to use with older adults to learn their

More information

Academic advising from the lens of a psychologist. Mehvash Ali, Ph.D. NACADA 2014

Academic advising from the lens of a psychologist. Mehvash Ali, Ph.D. NACADA 2014 Academic advising from the lens of a psychologist Mehvash Ali, Ph.D. NACADA 2014 Introduction Clinical Psychologist 10+ years of experience in college mental health Currently working as Director of Academic

More information

How to Work with the Patterns That Sustain Depression

How to Work with the Patterns That Sustain Depression How to Work with the Patterns That Sustain Depression Module 5.2 - Transcript - pg. 1 How to Work with the Patterns That Sustain Depression How the Grieving Mind Fights Depression with Marsha Linehan,

More information

Motivational Interviewing Training

Motivational Interviewing Training Motivational Interviewing Training National Stroke Nurse Forum Kelly Davis Martin 16 th May 2014 Agenda Introductions What is Motivational Interviewing How is it being used Theories that inform Motivational

More information

Relationship Questionnaire

Relationship Questionnaire Relationship Questionnaire The 7 Dimensions of Exceptional Relationships Developed by Gal Szekely, MFT The Couples Center.org Copyright Gal Szekely, 2015. All rights reserved. Permission is granted to

More information

Most applicable in consultations where there is a preferred outcome

Most applicable in consultations where there is a preferred outcome Motivational Interviewing for Health Behavior Change Ellen R. Glovsky, PhD, RD, LDN The Institute for Motivation and Change And Northeastern University 2010 Missouri WIC Conference October 26, 2010 Motivational

More information

Ch2- Cont d Motivational Interviewing

Ch2- Cont d Motivational Interviewing 1 Ch2- Cont d Motivational Interviewing FNU 425-FAR SPRING 1435-1436 10/ 5/ 1436 outline 2 Motivational Interviewing Definition Intrinsic vs. Coerced motivation Motivational factors MI elements MI spirit

More information

Helping Patients Make Healthy Fistula Choices Craig R. Fisher, Ph.D., L.C.S.W. Slide 1. Slide 2. Slide 3. 1 of 19

Helping Patients Make Healthy Fistula Choices Craig R. Fisher, Ph.D., L.C.S.W. Slide 1. Slide 2. Slide 3. 1 of 19 1 Helping Patients Make Healthy Choices When the patient does not have a clue about the reasons they should or any desire to do so.. A training Module developed by the Patient Leadership Committee of Renal

More information

Tobacco Cessation Best Practices: Motivational Interviewing

Tobacco Cessation Best Practices: Motivational Interviewing Tobacco Cessation Best Practices: Motivational Interviewing Please do the following Housekeeping Turn off or mute your computer speakers.* If you close out of the webinar, reconnect through the webinar

More information

MOTIVATING BEHAVIOUR CHANGE IN PATIENTS USING OPIOIDS

MOTIVATING BEHAVIOUR CHANGE IN PATIENTS USING OPIOIDS MOTIVATING BEHAVIOUR CHANGE IN PATIENTS USING OPIOIDS Opioid Webinar Series Laura Murphy, PharmD Disclosures No conflict of interest Acknowledgements Andrea Fernandes Anne Kalvik Pearl Isaac Karen Ng Beth

More information

Assertive Communication

Assertive Communication Assertive Communication Listed below are some of the key features of the three main communication styles: Passive Aggressive Assertive Apologetic You statements I statements Overly soft or tentative voice

More information

Coaching Patients If I could choose just one thing

Coaching Patients If I could choose just one thing Coaching Patients If I could choose just one thing Patty Fredericks, MS Essentia Health Heart and Vascular Wellness Program Coaching Patients If I could choose just one thing Patty Fredericks, MS Essentia

More information

Helping Your Asperger s Adult-Child to Eliminate Thinking Errors

Helping Your Asperger s Adult-Child to Eliminate Thinking Errors Helping Your Asperger s Adult-Child to Eliminate Thinking Errors Many people with Asperger s (AS) and High-Functioning Autism (HFA) experience thinking errors, largely due to a phenomenon called mind-blindness.

More information

Working with Clients with Personality Disorders. Core Issues of All Personality Disorders. High Conflict Personality Disorders

Working with Clients with Personality Disorders. Core Issues of All Personality Disorders. High Conflict Personality Disorders Working with Clients with Personality Disorders AFCC Webinar July 18, 2018 Bill Eddy, LCSW, Esq. Copyright 2018 High Conflict Institute www.highconflictinstitute.com Core Issues of All Personality Disorders

More information

COPING WITH A CANCER DIAGNOSIS. Tips for Dealing with What Comes Next

COPING WITH A CANCER DIAGNOSIS. Tips for Dealing with What Comes Next COPING WITH A CANCER DIAGNOSIS Tips for Dealing with What Comes Next Copyright 2012 Alliance Health Networks www.alliancehealth.com About half of all men and a third of all women in the United States will

More information

Pacific Problem Gambling A Motivational Approach. ABACUS Counselling, Training and Supervision Ltd

Pacific Problem Gambling A Motivational Approach. ABACUS Counselling, Training and Supervision Ltd Pacific Problem Gambling A Motivational Approach ABACUS Counselling, Training and Supervision Ltd 1 Pacific People Affected by PG Consider each of the following statements extracted from an AOD paper (Robinson

More information

Motivational Interviewing

Motivational Interviewing Motivational Interviewing Barbara M. Miller, RN, CEC Robin Seabury, MS WVU School of Nursing And Finally What Do You Want To Leave With Today? Change Remember, change is much larger than behavior.

More information

Improve Patient Adherence with Motivational Interviewing

Improve Patient Adherence with Motivational Interviewing Improve Patient Adherence with Motivational Interviewing Bruce A. Berger, PhD President, Berger Consulting, LLC and Professor Emeritus, Auburn University Harrison School of Pharmacy bbergerconsulting@gmail.com

More information

MOTIVATIONAL INTERVIEWING: MOVING PARENTS TOWARDS CHANGE Presented by Dr. Dianne Maing May 5 & 6, 2015 Sault. Ste. Marie

MOTIVATIONAL INTERVIEWING: MOVING PARENTS TOWARDS CHANGE Presented by Dr. Dianne Maing May 5 & 6, 2015 Sault. Ste. Marie MOTIVATIONAL INTERVIEWING: MOVING PARENTS TOWARDS CHANGE Presented by Dr. Dianne Maing May 5 & 6, 2015 Sault. Ste. Marie Objectives Engage in a conversation about Motivational Interviewing (MI) Become

More information

Motivational Interviewing: Clinical Updates within Substance Abuse Treatment TARA DEWITT, PHD

Motivational Interviewing: Clinical Updates within Substance Abuse Treatment TARA DEWITT, PHD Motivational Interviewing: Clinical Updates within Substance Abuse Treatment TARA DEWITT, PHD Learning Objectives Updates within MI-3 Appreciate the Spirit of Motivational Interviewing: including awareness

More information