Motivational Interviewing (MI): A Brief Overview - Part 2 Mark Evans, MSW, LCSW, CTTS Member, Motivational Interviewing Network of Trainers (MINT) Adapted from and based upon the work of William Miller, Ph.D. & Stephen Rollnick, Ph.D.

Where we left off…What is MI?

Where we left off…What is MI? Three definitions from the layperson to the technical. For our purposes we say that Motivational Interviewing is…

…A CONVERSATION ABOUT CHANGE!

The Spirit of Motivational Interviewing From: Advanced Motivational Training Two Day Seminar facilitated by Drs. Miller and Moyers. April 2012: Albuquerque, New Mexico

So how do we “do” MI? From: Advanced Motivational Training Two Day Seminar facilitated by Drs. Miller and Moyers. April 2012: Albuquerque, New Mexico

Dancing not Wrestling Direction. Example of wresting… From: Advanced Motivational Training Two Day Seminar facilitated by Drs. Miller and Moyers. April 2012: Albuquerque, New Mexico

Four Fundamental Processes in MI Relational Motivational Foundation Interviewing 4. Planning 3. Evoking 2. Focusing 1. Engaging Recursive…you go back and forth throughout. Motivational waxes and wanes…even in the same sentence…. Example: I really don’t want Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: Guilford Press. 2013 .

The Processes of MI - Defined Engage: the process by which both parties establish a helpful connection and a working relationship Focus: process by which you develop and maintain a specific direction in the conversation . Engaging: How comfortable is the person in talking with me? How supportive and helpful am I being? Do I understand this person’s perspective and concerns? How comfortable am I in this conversation? Does this feel like a collaborative relationship? Finding a Focus: From the client’s agenda Prescribed by the context of the setting What if you have your own goal(s) the client does not currently share? Clinical Expertise. What goals for change does this person really have? Do I have different goals/aspirations for change for this person? Are we working together with a common purpose? Does it feel like we are moving together, not in different directions? Do I have a clear sense of where we are going? Does this feel more like dancing or wrestling? Evoking What are this person’s own reasons for change? Is reluctance more about confidence or importance of change? What change talk am I hearing? Am I steering too far or too fast in a particular direction? Is the righting reflex pulling me to be arguing for change? Who should be arguing for change? The Michaelangelo belief. Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: The Guildford Press. 2013 Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: Guilford Press. 2013

The Processes of MI (continued) Evoke: having the person voice the arguments for change Planning: involves both developing commitment to change and formulating a concrete plan of action Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: Guilford Press. 2013 Engaging: How comfortable is the person in talking with me? How supportive and helpful am I being? Do I understand this person’s perspective and concerns? How comfortable am I in this conversation? Does this feel like a collaborative relationship? Finding a Focus: From the client’s agenda Prescribed by the context of the setting What if you have your own goal(s) the client does not currently share? Clinical Expertise. What goals for change does this person really have? Do I have different goals/aspirations for change for this person? Are we working together with a common purpose? Does it feel like we are moving together, not in different directions? Do I have a clear sense of where we are going? Does this feel more like dancing or wrestling? Evoking What are this person’s own reasons for change? HOW MIGHT YOU EVOKE REASONS FOR CHANGE FROM A PATIENT? WHAT BRINGS YOU IN TODAY? Is reluctance more about confidence or importance of change? What change talk am I hearing? Am I steering too far or too fast in a particular direction? Is the righting reflex pulling me to be arguing for change? Who should be arguing for change? The Michaelangelo belief. Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: The Guildford Press. 2013

Model: Facilitator is counselor; ask for volunteer Model: Facilitator is counselor; ask for volunteer. Ensure that the volunteer is open to discussing the change in front of the group. TOPIC: Something about yourself that you Want to change Need to change Should or ought to change Have been thinking about changing Ask these four questions: Why would you want to make this change? How might you go about it, in order to succeed? What are the THREE best reasons for you to do it? On a scale of 0/1-10, how important would you say it is to make this change? Follow-up: And why are you at a ____ and not a one/zero?

5 Questions for Beginners Why would you want to make this change? How might you go about it in order to succeed? What are the three best reasons for you to do it? How important is it for you to make this change and why? So what do you think you’ll do? Model: Facilitator is counselor; ask for volunteer. Ensure that the volunteer is open to discussing the change in front of the group. TOPIC: Something about yourself that you Want to change Need to change Should or ought to change Have been thinking about changing Ask these four questions: Why would you want to make this change? How might you go about it, in order to succeed? What are the THREE best reasons for you to do it? On a scale of 0/1-10, how important would you say it is to make this change? Follow-up: And why are you at a ____ and not a one/zero? Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: Guilford Press. 2013 .

How do we “do” MI? To be Continued…

A Sneak Preview…Where do we go from Here? The OARS Open-Ended Questions Affirmations Reflections Summaries Difference between these two scenarios…read script…volunteer/role play—OE questions/reflections

Eugen Hartung from the Mainzer Collection

Acknowledgements/References Unless otherwise noted, the materials in this presentation are from/adapted from the following publications/individuals/organizations: Miller, WR and Rollnick, S. Motivational Interviewing. Helping People Change. New York: The Guilford Press. 2013. Third Edition. The Motivational Interviewing Network of Trainers (MINT), and especially MINT members Patricia Figueroa, M.Ed., Lorraine Reitzel, Ph.D., Nanette Stephens, Ph.D., Theresa Moyers, Ph.D., Kenneth Resnicow, Ph.D., Stephen Rollnick, Ph.D. and William Miller, Ph.D. for training, mentoring, and sharing of materials. The Motivational Interviewing website: http://www.motivationalinterviewing.org/ Special thanks to Paul Cinciripini, Ph.D., Janice Blalock, Ph.D., Maher, Karam-Hage, MD, David Wetter, Ph.D. and Diane Beneventi, Ph.D., for training opportunities, encouragement and support for training.