Introduction To Motivational Interviewing Darryl Tonemah Ph.D.

Conceptual Beliefs of Motivational Interviewing Started with alcohol and other drug cessation, has expanded it’s applications to many other settings Addresses difficult discussions about behavior change in a safe way Deals with individual being actively involved in their own care The professional does not carry all the responsibility of change Creates a collaborative relationship, not adversarial It is not so much a series of techniques, but a way of being with people We are “Co-Healers” Address behavior change in an interpersonal context, how do two people respond to one another A combination of client centered and directive counseling Uses social psychological tenets that “The more I hear myself the more I believe myself” Client verbalizes reasons for change Promotes self-efficacy Ready, Willing, and Able to change, MI tries to pull all three together

Principles of Motivational Interviewing Express Empathy Avoid Argumentation Rolling with Resistance Support Self Efficacy Develop Discrepancy

Beginning- Setting the Tone Avoid the Traps Premature Focus Trap Confrontation Denial Trap Labeling Trap Blaming Trap Q and A Trap Expert Trap

Opening Strategies Ask open ended questions Listen reflectively Summarize-reflect what you heard Affirm Elicit self motivating statements

4 Types of Self-Motivational Statements Problem Recognition Expression of Concern Intention to Change Optimism for Change

How to Elicit Self-Motivating Statements Ask evocative questions Explore pro’s and con’s Ask for elaboration Imagining extremes Look forward Looking back

Listening & Summarizing Strategy #1 Listening & Summarizing Purpose: To build rapport with people and understand their points of view so we can be effective collaborators.

Resolving Ambivalence “The good things versus the not so good things” Strategy #2 Resolving Ambivalence “The good things versus the not so good things” Purpose: To explore the behavior in question in a non-threatening manner and to help people view their own ambivalence about changing or not changing, as the case may be.

Building Motivation & Strengthening Commitment Strategy #3 Building Motivation & Strengthening Commitment “Importance and Confidence Scales” Purpose: To quickly assess and support readiness for change.

Providing Information Strategy #4 Providing Information Ask/Provide/Ask Purpose: To offer relevant new information in a way that maintains the sense of collaboration and minimizes resistance.

Responding to Resistance

What is resistance? Describe.

Two Categories for responding to Resistance Reflective Response Strategic Response

Three Reflective Strategies Simple Reflection Amplified Reflection Double Sided Reflection

Strategic Responses Shifting focus Reframing Agreement with a twist Emphasize person’s choice and control Siding with the negative

Thank You Be Well