Cindy McGeary, Ph.D., ABPP Associate Professor Clinical Psychology Training Director Department of Psychiatry
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
Precontemplation Contemplation Preparation Action Maintenance Relapse Exercise
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)
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
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
The Spirit of Motivational Interviewing Partnership not Confrontation Acceptance not Judgment Compassion not Indifference Evocation not Education Partnership Acceptance Compassion Evocation
Express Empathy Develop Discrepancy Roll with Resistance Support Self-Efficacy
Acceptance helps to facilitate change Reflective Listening Ambivalence GOAL-Build Rapport
Patient should provide reasons for behavior change Discrepancy between patient s perceived goals and values versus current behavior GOAL-Decisional Balance (Pros/Cons)
Righting Reflex Discord GOAL-Respect Patient Autonomy Exercise
Key motivator is the patient s belief that change is possible Assert patient autonomy GOAL-Support patient in their ability to change
Importance Confidence Commitment Clip
Sustain Talk Change Talk
DARN CATS D-Desire A-Ability R-Reason N-Needs C-Commitment A-Activating TS-Taking Steps Clip
Engage Shall we walk together? Focus Where? Evoke Why? Plan How?
Open-ended questions Affirmations Reflections Summaries
Chunk-Check-Chunk Elicit-Provide-Elicit Clip
Recognition of a personal strength Approaching a problem Supporting changes already made Clip
Attempt to understand Clarify what you have heard Guideline of two reflections to every question Simple reflections, double-sided reflections, and complex reflections Clip
Longer than a rephrase Provide a summary of what has been covered or discussed Summaries can be simple or complex Clip
Contact Information: Cindy McGeary, Ph.D, ABPP mcgearyc@uthscsa.edu Check out Psychotherapy.net to review more information regarding MI URL: http://www.psychotherapy.net/stream/uthscsa-psy Username: uthscsa-psy Password: rgq6kb5l
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), 527-537. 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.