Community Support Services Training Direct Care Series Session 3 Rutgers, The State University of New Jersey School of Health Professions Department of Psychiatric Rehabilitation and Counseling Professions Rutgers, The State University of New Jersey
Olmstead Permanent Supportive Housing Communication Skills Learning Application
Demonstrate an understanding of Motivational Interviewing principles Verbalize an understanding of the stages of change concept Practice using a motivational interviewing strategy Demonstrate understanding of the 8 dimensions of wellness Identify the relationship between the 8 dimensions of wellness and setting meaningful goals
You would think That having had a heart attack would be enough to persuade a man to quit smoking, change his diet, exercise more, and take his medications. That hangovers, damaged relationships, an auto crash, and memory blackouts would be enough to convince a woman to stop drinking. That time spent in the dehumanizing privations of prison would dissuade people from reoffending.
What is motivation? Low resistance Openness and collaboration Expressing emotion Adhering to a change plan Changing
Motivational Interviewing (MI) An evidence-based treatment that addresses ambivalence to change A conversational approach designed to help people with the following: examine ambivalence expressing the desire to change (in their own words) enhance confidence in taking action elicit and strengthen change talk strengthen commitment to change plan for and begin the conversation for change (Miller & Rollnick, 2013)
Motivational Interviewing Clip MI Video Clip (Fader, 2012)
Stages of Change Maintenance Precontemplation Action Contemplation Preparation
Stages of Change Pre-Contemplation-Not seeing a problem behavior or not considering change. Contemplation-Acknowledging that there is a problem but struggling with ambivalence. Weighing pros and cons and the benefits and barriers to change. Preparation-Taking steps and getting ready to change. Action-Making the change and living the new behaviors, which is an all-consuming activity. Maintenance-Maintaining the behavior change that is now integrated into the person's life. (Rosengren, 2009)
Stages of Change Activity
How does this translate to interventions Pre-Contemplation Contemplation/Preparation Action Maintenance Outreach Trusting Relationship Practical Support Assessment Motivational Interventions Education Skill building Social Support Cognitive Behavioral Interventions Planning Recovery Lifestyle Social Support
Principles of Motivational Interviewing Express empathy Develop discrepancy Avoiding argumentation Roll with resistance Support self efficacy (Miller & Rollnick, 2013)
Change Talk DARN CAT Desire: I want to Ability: I can Reason: It s important Need: I should Commitment: I will Activation: I am ready Taking steps: I am doing it tomorrow
Activity-ICR Scale
Motivational Interviewing (MI) Resource http://www.motivationalinterviewing.org/
Wellness involves being aware of ourselves as whole people, including a sense of balance and comfort with our bodies, our lives, and our jobs. It is a sense that things are going well for us today, and can continue to go well for us tomorrow. It is a sense that we have meaningful relationships, love, and a sense of meaning and purpose. Although we have setbacks, or we experience stress and trauma, we are resilient, have emotional strength, material resources, and the support of others to survive and thrive. ---Peggy Swarbrick
On each post it, write a different area of your life that you want to improve or change.
Dimensions of Wellness Activity Each participant places each post-it on the appropriate Wellness Dimension Group discussion
Health disparities that exist between those who are diagnosed with mental illness and those who are not Life situations that contribute to poor health Mind/Body Connection (Druss & Reisinger, 2011; Schroeder, 2007)
(Druss & Walker, 2011) (Druss & Reisinger, 2011)
Critical Component of Wellness Assessment
Group Activity Wellness Assessment Choose a partner Each person completes the assessment with their partner (30 min) Identify 2 or 3 areas that they would like to work on for change (5min) Provide each other with feedback on conducting the assessment: How did work for you? (10min) Facilitators will role play first
Learning Application Complete a Wellness Assessment with one consumer Be prepared to discuss successes or challenges that you have encountered
Q&A and Evaluations Demonstrate an understand of Motivational Interviewing principles Verbalize an understanding of the stages of change concept Practice using a motivational interviewing exercise Demonstrate understanding of the 8 dimensions of wellness Identify the relationship between the 8 dimensions of wellness and goal setting by using a Wellness tool
Zakia Clay, MSW, LCSW, CPRP Zakia.Clay@shp.rutgers.edu Ann Reilly MA, LSW, CPRP Reillya2@shp.rutgers.edu Anthony Zazzarino MA, LPC, ACS, CPRP ASZ28@shp.rutgers.edu
Druss, B.G & Reisinger W, E. (2011) Mental disorders and medical comorbidity. Biological Psychiatry, 54(3), 215-225. Fader, J. (2012, June 13). Dr. jonathan fader demonstrates motivational interviewing skills [Video file]. Retrieved from https://www.youtube.com/watch?v=zxkzakfzgf8. Miller, W., Rollnick, S. (2013). Motivational interviewing: helping people change. [3 rd edition]. New York: Guilford Press.
Rosengren, D. B. (2009). Building motivational interviewing skills: a practitioner workbook. New York: Guilford Press. Swarbrick, M. (2012). Introduction to Wellness Coaching. Freehold, NJ: Collaborative Support Programs of New Jersey Inc., Institute of Wellness and Recovery. Schroeder, S. (2007). We Can do Better Improving the Health of the American People. New England Journal of Medicine, 357, 1221-1228.