MI Exercise Examples Mindy and Paul will demo a “favorite exercise”. It will either be a good example of facilitating participatory learning … or it will be a bad example! (Or both). Either way, we’ll learn something from it!

MI Exercise Examples This demo is NOT about the exercise – it is about the facilitation of the exercise. Ask yourself “what am I noticing about how this is being done?”

Things to notice… -What seemed to work well? -What did you notice about the facilitator’s approach? -Instructions to participants? -What might have worked better? -What might you try differently?

Putting It All Together! -The purpose of this exercise is to give trainees a sense of how an MI interview might flow, using beginning OARS skills. -Divide into groups of at least 7. Colleen

Putting It All Together! -Elicit from the trainees what OARS are (from slide). -Leave slide posted. Paul

Putting It All Together! -Hand 6 members index cards that go in this order: O-R-R-R-A-S. -The 7th person is the “client” who will speak on “Something I feel two ways about” or “Something I am thinking about changing”. Open-Ended Questions Affirmations Reflective Listening Summaries Paul

Putting It All Together! -The “client” should be sitting next to the person with the O. -O begins by asking the client about his or her concern. -R goes next, another R, and third R. (No need to worry whether simple or complex R.) Paul

Putting It All Together! -“A” provides an affirmation. -“S”- provides a summary. -Then, repeat one more round Paul

Putting It All Together! -Have everyone hand their cards to the left, and begin again. (The O becomes the new client. The Rs in the middle get a lot of R practice!) -Debrief. Paul

USING YOUR OARS! OPEN QUESTIONS AFFIRMATIONS REFLECTIONS SUMMARIES Paul

Paul will demo some “Change Talk” Orientation Exercises Recognizing Change Talk Responding to Change Talk Eliciting Change Talk

“What is the purpose of MI?” Often, the concept of change talk is introduced after OARS skills have been practiced at some length. Introducing change talk early in training helps people understand the purpose of OARS skills.

MI is “directional” Many new learners flounder with OARS skills when they are not clear as to the target around which the OARS skills should be focused.

Know your target! In order to do MI, you need to know what you are aiming for. “Equipoise” is not “pure” MI in that it involves no directionality. MI is not only about ambivalence resolution!

The OARS involve steering! Knowing what to reflect and what content to affirm and what to include in a summary is just as important as knowing how to use the skills. Understanding change talk helps inform the decisions that need to be made.

Recognizing & Responding to Change Talk When change talk surfaces in client conversation, it’s a pretty good indicator that change is just down the road! Paul

It is important to smell it … …so we know where to dig! I Paul

Does MI Create Change? Good Morning Paul

Probably Not! Good Morning Paul

Oh – DARN! MI DESIRE ABILITY DARN! REASON NEED

Good (“Will”) Hunting! MI DESIRE ABILITY REASON NEED COMMITMENT (I will …) Paul

MI Oh – DARN! TAKING STEPS COMMITMENT (I will …) DESIRE ABILITY REASON NEED COMMITMENT (I will …) Paul

CHANGE MI Oh – DARN! TAKING STEPS COMMITMENT (I will …) DESIRE ABILITY REASON NEED COMMITMENT (I will …) Paul

Recognizing & Responding To Change Talk Sometimes, when we’re lucky, change talk announces itself with great gusto – making it hard to miss …

But- we can’t afford to be caught sleeping! Change talk often whispers in almost unrecognizable tones. Learning to “listen up” for the change talk that emerges against the giant voices that compete is an important competency. Paul

3 Magic Skills in Dancing With Change Talk Recognize it Respond Evoke + Invite Paul

Exercises in Recognition Search carefully for the DARN-CATS in the following examples? Is there any evidence of Desire, Ability, Reason, Need, Commitment, or Taking Steps that lurks within Paul’s statements.

WATCH OUT for that DARN CAT! -Desire -Ability -Reason -Need -Commitment -Taking Steps Paul Joyce, 2005

Exercises in Responding Once you get good at hearing change talk, it’s important to know how to respond! Change Talk is too valuable to recognize it and not try to get it in the spotlight a little! Joyce, 2005

-Elaboration -Affirmation -Reflection -Summary So – we use our EARS Paul

Q= What if Change Talk isn’t coming to the surface? A= We dig for it! Mining for change talk involves finding ways to elicit client statements about their desires, abilities, reasons and needs (related to the target)

Eliciting Change Talk with OARS Try using various OARS skills to “pull” talk about desire for change, or the down side of the status quo. Try affirming previous attempts at change. Try reflecting elements connected to the need for change.