TCPI Motivational Interviewing Series Part 1 of 3 May 1, 2018 Hosted by: Margaret M. Menna, MBA Senior Training & Education Specialist Rhode Island Quality Institute Trainer: Beth Bennett, NCTTP, CTTS-M, NBC-HWC Clinical Director Tobacco Cessation Services of RI CODAC Behavioral Healthcare
Motivational Interviewing in the Clinical Environment: Tobacco and Depression Screening Beth Bennett, NCTTP, CTTS-M, NBC-HWC Clinical Director Tobacco Cessation Services of RI CODAC Behavioral Healthcare 2018
Today s Objectives Review MI spirit and skills Put MI into practice for depression screening Put MI into practice for tobacco screening and referral to cessation resources
Definition of Motivational Interviewing Motivational Interviewing is a collaborative, goaloriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person s own reasons for change within an atmosphere of acceptance and compassion. Stephen Rollnick and William R. Miller, Sheffield, UK Oct 2011
Motivational Interviewing: Spirit Collaboration come alongside, honor client s wisdom, they are the expert on their life. Evocation elicit vs impart Autonomy ability to chose, empowerment Compassion empathy, understanding their competent world view
RULE of MI Resist the righting reflex Understand Motivation Listen Empower the client
Structure: What the Heck are We Doing Here? ENGAGE: EXPRESS EMPATHY (radical acceptance, rapport, compassion) FOCUS: HEIGHTEN AMBIVALENCE (allows them to be heard and believed) (clarifies the two sides of an identified change) DEVELOP DISCREPANCY (increases importance, creates subtle discomfort) EVOKE:.CHANGE TALK PLANNING: EMPOWERMENT (Supports self-efficacy and confidence, autonomy)
Skills and Strategies: OARS O: open-ended questions have more than a yes/no, or one word answer A: affirmations notice their strength/courage listen for values/dreams... R: reflections are empathic and help build safety use more reflections than questions... S: summaries use during transitions & end of the conversation selectively highlight content
Change Talk: DARN-CAT Desire I do want to quit someday. Ability I can do things that I put my mind to. Reason I don t want my daughter to smoke when she is an adult. Need Smoking is getting pretty expensive. Commitment I guess I can smoke outside. Activation Today, I am going to talk to my partner after work about my addiction. Taking Steps I made an appointment to see my doc.
Responding to Change Talk E: Elaborating - Ask for more detail Ask what s next? Ask, How are you going to do that? A: Affirming Comment positively on the person s change talk R: Complex Reflecting Continue the paragraph, etc. S: Summarizing Collect bouquets of the person s change talk
Planning What would be a reasonable next step? Am I evoking rather than prescribing a plan? Am I asking permission to give information or advice? Does this feel like a collaborative partnership? Am I maintaining a sense of quiet curiosity about what kind of support will work best for this person?
Elicit Provide - Elicit 1. ELICIT client s ideas, needs 2. Ask PERMISSION to share information 3. PROVIDE relevant advice, information or a menu 4. ELICIT client s reactions & commitment to taking the next step.
Demonstrations: Conversation with and without MI skills
Leaving in Action Contact your RIQI- TCPI Practice Facilitator for further assistance in understand Preventative Care and Screening quality measures, including Screening for Depression and Follow-Up and Tobacco Use: Screening and Cessation Intervention. Tobacco Cessation Services of RI A CODAC Behavioral Healthcare Resource offers Tobacco Treatment Specialist training as well as individual and group cessation services. CODAC Behavioral Healthcare offers individualized Motivational Interviewing trainings at your practice. If you or someone you know is in need of support and treatment because of substance use please call 401-461-5056. WWW. CODACINC.ORG
Questions Please enter your questions in the chat box.
Resources for Learning MI Motivational Interviewing Network of Trainers http://www.motivationalinterviewing.org/ Motivational Interviewing (hosted by the Mid-Atlantic Addiction Technology Transfer Center) http://www.motivationalinterview.org/ UMass Center for Integrated Primary Care: Certificate of Intensive Training in MI http://www.umassmed.edu/cipc/ Health Education & Training Institute (HETI) http://www.hetimaine.org/ Motivational Interviewing in Health Care (Rollnick, Miller, Butler) https://www.guilford.com/books/motivational-interviewing-in-health-care/rollnick- Miller-Butler/9781593856120/reviews
Contacts Beth Bennett, NCTTP, CTTS-M, NBC-HWC Clinical Director Tobacco Cessation Services of RI CODAC Behavioral Healthcare bbennett@codacinc.org Margaret Mottola Menna, MBA Training & Education Specialist Rhode Island Quality Institute mmenna@riqi.org You can register for the next two webinars in this MI series here: Tuesday, May 22, 2018 12:00 1:00 PM Med Reconciliation and Med Documentation Presenters: Kate Prendergast, MS, LMHC and Farrell Carley, LCDP, LMHC REGISTER Thursday, June 7, 2018 12:00 1:00 PM A1c Control and Lowering BMI Presenters: Kate Prendergast, MS, LMHC and Farrell Carley, LCDP, LMHC REGISTER
Thank you!