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MotivationalInterviewing
A Brief Overview and Practice SessionByRose George,MD
Information for this Presentation is from the bookMotivational Interviewingby William Miller and Stephen Rollnick
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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,
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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
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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
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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
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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
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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
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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
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Strategies - OARSO open ended
questionsA Affirmations
R Reflective ListeningS - Summaries
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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.
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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
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Thank You
If you have any questions orcomments about this presentationplease feel free to email me: