Cindy McGeary, Ph.D., ABPP Associate Professor Clinical Psychology Training Director Department of Psychiatry

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1 Cindy McGeary, Ph.D., ABPP Associate Professor Clinical Psychology Training Director Department of Psychiatry

2 Stages of Change What is Motivational Interviewing? Research Support Spirit of Motivational Interviewing Four Principles of Motivational Interviewing Challenge of Change Language of Change Ingredients of Change Motivational Interviewing Processes Core Motivational Interviewing Techniques Questions Resources

3 Precontemplation Contemplation Preparation Action Maintenance Relapse Exercise

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5 Motivational Interviewing approach grew out of William R. Miller s work with problem drinkers In 1991, William R. Miller and Stephen Rollnick wrote, Motivational Interviewing: Preparing People to Change Addictive Behavior A second edition was published in 2002 outlining the research behind MI and expanded to areas outside of substance use The third edition was published in 2013 and added the idea of the four processes of MI conversations (engaging, focusing, evoking, and planning)

6 Directive, client-centered counseling style to help elicit behavior change while addressing ambivalence to change Present focused Non-judgmental, non-confrontational, and non-adversarial Requires warmth, genuine empathy, and acceptance Ambivalence is resolved by weighing the pros and cons of change vs. not changing

7 Significantly more effective than no treatment Useful in the treatment of: Substance Use (Alcohol, Marijuana, Tobacco, and other Drugs) Reducing Risky Behaviors Increasing Client Engagement Single Disease States and Behavior Change (Diabetes, Obesity, Cardiovascular, Hypertension, Chronic Pain) Medication Adherence Oral Hygiene Student Outcomes in Academic Settings

8 The Spirit of Motivational Interviewing Partnership not Confrontation Acceptance not Judgment Compassion not Indifference Evocation not Education Partnership Acceptance Compassion Evocation

9 Express Empathy Develop Discrepancy Roll with Resistance Support Self-Efficacy

10 Acceptance helps to facilitate change Reflective Listening Ambivalence GOAL-Build Rapport

11 Patient should provide reasons for behavior change Discrepancy between patient s perceived goals and values versus current behavior GOAL-Decisional Balance (Pros/Cons)

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13 Righting Reflex Discord GOAL-Respect Patient Autonomy Exercise

14 Key motivator is the patient s belief that change is possible Assert patient autonomy GOAL-Support patient in their ability to change

15 Importance Confidence Commitment Clip

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17 Sustain Talk Change Talk

18 DARN CATS D-Desire A-Ability R-Reason N-Needs C-Commitment A-Activating TS-Taking Steps Clip

19 Engage Shall we walk together? Focus Where? Evoke Why? Plan How?

20 Open-ended questions Affirmations Reflections Summaries

21 Chunk-Check-Chunk Elicit-Provide-Elicit Clip

22 Recognition of a personal strength Approaching a problem Supporting changes already made Clip

23 Attempt to understand Clarify what you have heard Guideline of two reflections to every question Simple reflections, double-sided reflections, and complex reflections Clip

24 Longer than a rephrase Provide a summary of what has been covered or discussed Summaries can be simple or complex Clip

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26 Contact Information: Cindy McGeary, Ph.D, ABPP Check out Psychotherapy.net to review more information regarding MI URL: Username: uthscsa-psy Password: rgq6kb5l

27 Arkowitz, H., Westra, H.A., Miller, W.R., & Rollnick, S. (Eds.). (2015). Motivational Interviewing in the Treatment of Psychological Problems (2 nd edition). New York, NY: Guilford Press. Miller, W.R., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change (3 rd Edition). New York, NY Guilford Press. Miller, W.R., & Rose, G. (2009). Toward a theory of motivational interviewing. American Psychologist, 64(6), Naar-King, S., & Suarez, M. (2011). Motivational Interviewing with Adolescents and Young Adults. New York, NY: Guilford Press. Rollnick, S., Miller, W.R., & Butler, C. (2008). Motivational Interviewing in Health Care. New York, NY: Guilford Press. Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner s Workbook. New York, NY: Guilford Press.