CHRIS WAGNER, PH.D. LICENSED CLINICAL PSYCHOLOGIST VIRGINIA COMMONWEALTH UNIVERSITY Motivational Interviewing and Positive Psychology

Motivational Interviewing Empathic, goal-oriented approach that promotes change by resolving ambivalence Draws from wide range of sources Essentially pragmatic rather than theoretical Both relational and technical components are integral Relational components have emphasized positive elements; technical components mixed emphasis No well-defined model of motivation

Motivation as Inspiration (Relational) Rogerian basis: people are motivated toward growth/wellness Rogerian conditions of empathy and unconditional acceptance facilitate positive growth/change Supporting client autonomy facilitates positive change Enhancing confidence promotes positive change

Status Quo or Negative Change Positive Change Ambivalence

Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganized Other Priorities Interest in Changing Positive emotions Vision/Confidence/H ope about Changing Focused Readiness to Change Ambivalence

Motivation as Discontent (Technical) Cognitive Dissonance (Festinger) – Dissonant cognitions produce tension.  People are motivated to reduce dissonance between contradictory beliefs. Values Clarification (Rokeach) – Discrepancy between values and behavior produces tension of lowered self-regard.  People are motivated to reduce tension from discrepancies between how they think they should act/be and how they actually do act. Decisional Balance (Janis and Mann) – Ambivalence produces decisional conflict; apprehension, desires to escape, self-blame  People are motivated to resolve conflict by escaping, impulsive decision-making or careful consideration of pros and cons of options

Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganization Other Priorities Interest in Changing Positive emotions Vision Confidence/Hope about Changing Readiness to Change Ambivalence Developing Discrepancy How do problem behaviors fit with your values? Identity?

Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganization Other Priorities Interest in Changing Positive emotions Vision Confidence/Hope about Changing Readiness to Change Ambivalence Developing Discrepancy How do problem behaviors fit with your values? Goals? Negative Reinforcement Motivating person by increasing tension that person wants to escape or avoid by reducing discrepancy

Classic Emotions Theory Negative emotions (anger, fear, sadness, disgust)  Increase tension  Narrow cognitive focus  Serve to protect people from present or near danger  Prime for action (action tendencies, “fight or flight”)  Anger – Attack  Fear – Escape  Sadness – Wall off  Disgust - Expel

Frederickson’s Positive Emotions Theory (Broaden and Build model) Positive emotions (joy, curiosity, contentment)  Reduce tension  Broaden cognitive focus  Help people build resources for future threats  Prime for development (thought-action tendencies)  Joy – play – builds physical, socioemotional, intellectual skills  Curiosity – explore – increases knowledge and pscyhological complexity  Contentment – relax – builds resilience, appreciation, interpersonal bonds  Elevation – seek – increases inspiration, creativity, development

Frederickson’s Positive Emotions Theory (Broaden and Build model) Finding positive meaning in adversity predicts greater well-being, better health Upward spirals  Positive perspective/meaning fosters positive emotions  Positive emotions increase finding positive meaning through broadening perception  Upward spiral produces greater resilience and positivity

Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganization Other Priorities Interest in Changing Positive emotions Vision Confidence/Hope about Changing Readiness to Change Ambivalence Negative Discrepancy How do problem behaviors fit with your values? Identity? Negative Reinforcement Motivating person by increasing tension that person wants to escape or avoid by reducing discrepancy Positive Discrepancy What is your vision of how you’d like your life to be?

Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganization Other Priorities Interest in Changing Positive emotions Vision Confidence/Hope about Changing Readiness to Change Ambivalence Negative Discrepancy How do problem behaviors fit with your values? Identity? Negative Reinforcement Motivating person by increasing tension that person wants to escape or avoid by reducing discrepancy Positive Discrepancy What is your vision of how you’d like your life to be? Positive Reinforcement Motivating person by increasing desire to move toward more fulfilling future

Negative vs. Positive Motivation Need to change (Motivation as Discontent) Want to change (Motivation as Inspiration) Negative reinforcement (seek to escape tension, negative state) Positive reinforcement (seek to gain reward, positive state) Shame, guilt, fear, anger toward self, frustration Interest, curiosity, hope, joy, excitement, peacefulness

Negative vs. Positive Focus in MI Looking forward Where are your current actions leading you? How will things be in five years if you keep doing this? Envisioning How would you like things to be in five years? How can you get there? Values – Negative In what ways are you not living in line with your values? Values – Positive How can you live even more in line with your values? Decisional balance What are some of the downsides of how things are? Decisional balance What could be better if you made some changes’?

Positive Emotions and MI Positive focus in MI  Soothes client defensiveness  Makes conversation a rewarding event  Broadens cognitive focus to consider previously overlooked or rejected perspectives, options, attitudes, identities  Cognitive flexibility helps resolve ambivalence and increases openness to engage in actions leading to health change  Can increase confidence, sense of accomplishment, self-esteem and mood  These serve as increased resources to draw upon in service of change

MI Groups (Wagner & Ingersoll, in press) Four Phases  Engaging the Group  Exploring Members’ Perspectives  Broadening Members’ Perspectives  Moving Into Action Focus on the Positives  Negative focus (dissatisfactions) riskier in group than individual – breeds conflict, harder to turn ship around  Positive focus increases sharing, support, altruism, creativity, confidence, connects members to wisdom and resources of the larger group and enhances group energy for change  Protecting factor for times of group stress or crisis

(8) Broadening Perspectives – Looking Forward/ Envisioning  Share a vision for how things might be different in the future. How they may desire things to be if they could choose.  Link together on content, motivation to change, specific visions.  Identify a few personal strengths; explore and link  How might those strengths help moving forward?