1. Motivational Interviewing (MI): A Brief Overview - Part 2
Mark Evans, MSW, LCSW, CTTS
Member, Motivational Interviewing Network of Trainers (MINT)
Adapted from and based upon the work of William Miller, Ph.D. & Stephen Rollnick, Ph.D.

2. Where we left off…What is MI?

3. Where we left off…What is MI?
Three definitions from the layperson to the technical. For our purposes we say that Motivational Interviewing is…

4. …A CONVERSATION ABOUT CHANGE!

5. The Spirit of Motivational Interviewing
From: Advanced Motivational Training Two Day Seminar facilitated by Drs. Miller and Moyers. April 2012: Albuquerque, New Mexico

6. So how do we “do” MI?
From: Advanced Motivational Training Two Day Seminar facilitated by Drs. Miller and Moyers. April 2012: Albuquerque, New Mexico

7. Dancing not Wrestling Direction. Example of wresting…
From: Advanced Motivational Training Two Day Seminar facilitated by Drs. Miller and Moyers. April 2012: Albuquerque, New Mexico

8. Four Fundamental Processes in MI
Relational Motivational
Foundation Interviewing
4. Planning
3. Evoking
2. Focusing
1. Engaging
Recursive…you go back and forth throughout. Motivational waxes and wanes…even in the same sentence….
Example: I really don’t want
Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: Guilford Press

9. The Processes of MI - Defined
Engage: the process by which both parties establish a helpful connection and a working relationship
Focus: process by which you develop and maintain a specific direction in the conversation .
Engaging:
How comfortable is the person in talking with me?
How supportive and helpful am I being?
Do I understand this person’s perspective and concerns?
How comfortable am I in this conversation?
Does this feel like a collaborative relationship?
Finding a Focus:
From the client’s agenda
Prescribed by the context of the setting
What if you have your own goal(s) the client does not currently share? Clinical Expertise.
What goals for change does this person really have?
Do I have different goals/aspirations for change for this person?
Are we working together with a common purpose?
Does it feel like we are moving together, not in different directions?
Do I have a clear sense of where we are going?
Does this feel more like dancing or wrestling?
Evoking
What are this person’s own reasons for change?
Is reluctance more about confidence or importance of change?
What change talk am I hearing?
Am I steering too far or too fast in a particular direction?
Is the righting reflex pulling me to be arguing for change? Who should be arguing for change?
The Michaelangelo belief.
Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: The Guildford Press
Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: Guilford Press. 2013

10. The Processes of MI
(continued)
Evoke: having the person voice the arguments for change
Planning: involves both developing commitment to change and formulating a concrete plan of action
Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: Guilford Press. 2013
Engaging:
How comfortable is the person in talking with me?
How supportive and helpful am I being?
Do I understand this person’s perspective and concerns?
How comfortable am I in this conversation?
Does this feel like a collaborative relationship?
Finding a Focus:
From the client’s agenda
Prescribed by the context of the setting
What if you have your own goal(s) the client does not currently share? Clinical Expertise.
What goals for change does this person really have?
Do I have different goals/aspirations for change for this person?
Are we working together with a common purpose?
Does it feel like we are moving together, not in different directions?
Do I have a clear sense of where we are going?
Does this feel more like dancing or wrestling?
Evoking
What are this person’s own reasons for change? HOW MIGHT YOU EVOKE REASONS FOR CHANGE FROM A PATIENT? WHAT BRINGS YOU IN TODAY?
Is reluctance more about confidence or importance of change?
What change talk am I hearing?
Am I steering too far or too fast in a particular direction?
Is the righting reflex pulling me to be arguing for change? Who should be arguing for change?
The Michaelangelo belief.
Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: The Guildford Press

11. Model: Facilitator is counselor; ask for volunteer
Model: Facilitator is counselor; ask for volunteer. Ensure that the volunteer is open to discussing the change in front of the group.
TOPIC: Something about yourself that you
Want to change
Need to change
Should or ought to change
Have been thinking about changing
Ask these four questions:
Why would you want to make this change?
How might you go about it, in order to succeed?
What are the THREE best reasons for you to do it?
On a scale of 0/1-10, how important would you say it is to make this change?
Follow-up: And why are you at a ____ and not a one/zero?

12. 5 Questions for Beginners
Why would you want to make this change?
How might you go about it in order to succeed?
What are the three best reasons for you to do it?
How important is it for you to make this change and why?
So what do you think you’ll do?
Model: Facilitator is counselor; ask for volunteer. Ensure that the volunteer is open to discussing the change in front of the group.
TOPIC: Something about yourself that you
Want to change
Need to change
Should or ought to change
Have been thinking about changing
Ask these four questions:
Why would you want to make this change?
How might you go about it, in order to succeed?
What are the THREE best reasons for you to do it?
On a scale of 0/1-10, how important would you say it is to make this change?
Follow-up: And why are you at a ____ and not a one/zero?
Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: Guilford Press

13. How do we “do” MI? To be Continued…

14. A Sneak Preview…Where do we go from Here?
The OARS
Open-Ended Questions
Affirmations
Reflections
Summaries
Difference between these two scenarios…read script…volunteer/role play—OE questions/reflections

15. Eugen Hartung from the Mainzer Collection

16. Acknowledgements/References
Unless otherwise noted, the materials in this presentation are from/adapted from the following publications/individuals/organizations:
Miller, WR and Rollnick, S. Motivational Interviewing. Helping People Change. New York: The Guilford Press Third Edition.
The Motivational Interviewing Network of Trainers (MINT), and especially MINT members Patricia Figueroa, M.Ed., Lorraine Reitzel, Ph.D., Nanette Stephens, Ph.D., Theresa Moyers, Ph.D., Kenneth Resnicow, Ph.D., Stephen Rollnick, Ph.D. and William Miller, Ph.D. for training, mentoring, and sharing of materials.
The Motivational Interviewing website:
Special thanks to
Paul Cinciripini, Ph.D., Janice Blalock, Ph.D., Maher, Karam-Hage, MD, David Wetter, Ph.D. and Diane Beneventi, Ph.D., for training opportunities, encouragement and support for training.