Enhancing Motivation for Change CSD 5970

Motivation “Walk with your client through treatment, DON’T drag or push them!

Readiness Rulers At this moment, how important is it that you change your current _____________? 0 Not at all important 5 About as important as most other things 10 The most important thing in my life

Readiness Rulers At this moment, how confident are you that you will change your current _________? 0 Not at all important 5 About as important as most other things 10 The most important thing in my life

Readiness Rulers Both goal and confidence indicators have been associated with positive treatment outcomes.

Readiness Rulers Would you like to reduce or quit ________ if you could do so easily? How seriously would you like to quit ______ altogether? Do you intend to reduce or quit _______ in the next 2 weeks? What is the possibility that in the next 12 months you will not have a problem with ___?

Questions You are here because you are concerned about your drinking? How many children do you have? Do you think you might need to go to detox? Tell me, what brings you here today? Tell me about your family. What do you think of the possibility of going through detox?

Questions Do you think you smoke crack too often? When did you have your last drink? Do you like to smoke? In what ways are you concerned about your crack use? Tell me about the last time you drank? What are some of the things you like about smoking?

Questions Are you sure the probation officer told you she is only concerned about your cocaine use? When do you plan to quit drinking? Tell me about all of the conditions of your probation? What do you think you want to do about your drinking?

Coerced Clients Honor their anger Don’t assume Make clear that you are there to help with things they consider meaningful and helpful

Precontemplation to Contemplation Information about substance abuse and treatment options Discuss good aspects of use vs. less good aspects How are other life areas affected? Involve significant others in process. Comfortable – supportive - optimistic

Contemplation to Preparation Shift from extrinsic to intrinsic motivators Accentuate the client’s perception of a need to change, minimize the rewards of use. Identify barriers to change Examine his/her understanding of change and expectations for treatment. Understand grief Set goals – take small steps.

Preparation to Action Offer a menu of change options Contract for behavior Enlist social support system Identify sub-goals What changes do I want to make? What are my reasons to change? What are my goals for myself?

Preparation to Action The first step is …. Some things that might interfere. Help from others. My plan will have the following positive results. How will I know it worked?

Action to Maintenance Maintain rapport and engagement Examine and interpret incongruities between stated goals and behaviors. Identify triggers Develop a coping plan