Motivational Interviewing 06.15.2012

7/31/2019 Motivational Interviewing 06.15.2012

1/14

Click to edit Master subtitle style

6/26/12

MotivationalInterviewing

A Brief Overview and Practice SessionByRose George,MD

Information for this Presentation is from the bookMotivational Interviewingby William Miller and Stephen Rollnick


2/14

6/26/12

What is motivational

interviewing?Motivational interviewing s a person-centered, directive intervention designed toresolve ambivalence about change. (Miller

and Rollnick, 1991)

If motivational interviewing is a way of being

with people, then its underlying spirit lies inunderstanding and experiencing the humannature that gives rise to that way of being.How one thinks about and understands theinterviewing process is vitally important inshaping the interview.(Miller and Rollnick,


3/14

6/26/12

Components of MICollaboration communicate in apartner-like relationship.

Evocation the interviewers role isone of eliciting, of finding thesethings within and drawing them from

the personAutonomy responsibility for

change is left with the client


4/14

6/26/12

Underlying AssumptionsAcceptance

Autonomy/Choice

Less is Better

Elicit versus impart

Michelangelo Belief

Ambivalence is normal

Care-frontation

All judgment is violence Be Non-judgmental

Chan e Talk


5/14

6/26/12

Exercise 1Pair up with someone you dont know as well

One person talks the other person does active

reflective listeningReflect it as if you are with them. You are

going through.

Topics: Dream, Education, Financial Health,Diet, Family and Children, Nicotine use, Job,spiritual practice, physical health, vacationyou havent taken, habit you want to change

3 minutes then exchange roles and repeat


6/14

6/26/12

Four General PrinciplesExpress Empathy acceptance facilitates

change, skillful reflective listening isfundamental, ambivalence is normal

Develop Discrepency clients job topresent arguments perceived discrepancyb/w present behavior and important personal

goals or valuesRoll with Resistance least desirable

situation is for the counselor to advocate forchange while the client argues against it

avoid arguing for change resistance is a


7/14

6/26/12

Accurate Empathic

ReflectionEmpathic Reflection is the keyto this work. The best

motivational advice we can giveyou is to listen carefully to yourclients. They will tell you what

has worked and what hasnt.What moved them forward andshifted them backward.

Whenever you are in doubt about


8/14

6/26/12

Dancing or Wrestling?If wrestling, you may be engendering the

resistance you are trying to overcome. Themore you apply force the more the client

resists. However if dancing, you must attendto your partner carefully. When leading inballroom dancing, you apply subtle pressuresthat move your partner forward in a manner

that uses his or her energy and momentum.You guide rather than force. When dancing isdone well, the appearance is of almosteffortless but directed movement. So if you

find yourself grappling with a client, you might


9/14

6/26/12

Strategies - OARSO open ended

questionsA Affirmations

R Reflective ListeningS - Summaries


10/14

6/26/12

Exercise 2Switch roles with your partner

Interviewer use OARS to elicitissue and help interviewee to

come to plan for change

4-5 minutes

Then we will reverse roles

and do exercise again.


11/14

6/26/12

Guiding the MI Effort and

Match Clients Stage ofChangeGood and less good things clients canexplore what might be less good about abehavior interviewer can explore what

positives may be sustaining a behavior.

Looking Forward/ Looking Back Sothings have really changed. Tell me a little bit

about what life was like back then.Personalized Feedback Report the

interviewer is merely a conduit for information the client ascribes meaning

Importance and Confidence explores


12/14

6/26/12


13/14

6/26/12


14/14

6/26/12

Thank You

If you have any questions orcomments about this presentationplease feel free to email me:

[email protected]

Documents

Motivational Interviewing 06.15.2012