1. SBIRT TRAINING: FIELD SUPERVISORS APPRECIATION R. Lyle Cooper, Ph.D.

2. SBI T RAINING Outline Motivational Interviewing Skills (Miller, Benefield, & Tonigan; r=.65) Responding to Change Talk Role Play

3. R ESISTANCE AND A MBIVALENCE Ambivalence STATUS QUO Problems with Status quo Hopes for change CHANGE Desired effects of status quo Fear of Change Counselor Behavior Ambivalence Maintains the Balance Counselor Behavior Assists in Resolving Ambivalence, OR Assists in Maintaining It!!!!!

4. O PENING S TRATEGIES Micro Skills OARS PENQUESTIONSFFIRMINGEFLECTIVEUMMARIZING

5. SBI T RAINING Change Talk Desire: wish, want, like Ability: can, could, able Reasons: ct gives reasons for change Need: need, should, got to, must Commitment Language Commitment: will, promise, intend Taking steps: ct expresses things they have done to change

6. SBI T RAINING Drumming for Change Talk I am going to read a series of statements You all listen, and if you hear change talk drum on your table or legs or something If you year commitment language, I want you to rub the pearl as it is precious in terms of change

7. SBI T RAINING SBIRT Badge Card Use the badge card to guide the conversation with the client in the following exercise.

8. SBI T RAINING Try it Out In groups of 3 you will be given a case study. One person will be the patient, one the social worker, and the third the observer. SW and observer, study the case study together and identify areas of interest for the interview. Patient, study your description. Use the AUDIT and/or DAST responses you have to start a motivational conversation about behavior change. Observer, use the BIOS to critique the work of the doc in your group.

9. References Miller, W.R., Benefield, G.S., & Tonigan, J.S. (1993). Enhancing motivation for change in problem drinking: A controlled comparison of two therapist styles. Journal of Consulting and Clinical Psychology, 61, 455-461. Burke, B.L., Arkowitz, H., & Menchola, M. (2003). The efficacy of motivational interviewing: A meta-analysis of controlled drinking trials. Journal of Consulting and Clinical Psychology, 71, 843-861. Bertholet, N., Daeppen, J.B., Weitsbach, V., Fleming, M., & Burnand, B. (2005). Reduction of alcohol consumption by brief alcohol intervention in primary care: Systematic review and meta-analysis. Archives of Internal Medicine, 165(9), 986-985.