1. IPL Symposia: Working with resistive behaviour
Chidi Onwuasoanya

2. Problems Solutions

3. Helping patients change behaviour
What strategies have you observed/used in practice to influence behaviour change? What are your observations in the following video clip?

4. MOTIVATIONAL INTERVIEWING (MI)
What is MI?

5. Talking with patients about change in an effective way.
Definition of MI
Talking with patients about change in an effective way.
I wish I can stop smoking, it’s really affecting my health
Can I give you information about services that can support you?

6. MI supports and enables behaviour change

7. Definition of MI
MI is a person centered, semi-directive approach that was originally developed within medical settings to help people with addiction problems (Miller & Rollnick, 2008)
Acknowledges that people are not always ready or willing to change their behaviour to improve their health, and it takes a non-judgmental approach.
MI is a collaborative conversation style that strengthens a person’s own commitment to change.
Persuasive and supportive rather than confrontational

8. We can make changes about..
Smoking
Social Health
Medication Adherence
Relationships
Keeping Appointments
Drugs
Physical Health
Alcohol
Mental Health
Addictions
Exercise

9. Observe the professional’s approach and the patient’s response in the following video clip:

10. Observe the different approach, compared to the previous video clip

11. MI MAY HELP WITH…
AMBIVALENCE
PROCRASTINATION
RESISTANCE

12. Observe how MI is used to work on resistance to change in the video clip:

13. Using MI to support behaviour change
Successful in influencing attitudes & behaviour
Acknowledges that people are at different stages of readiness to change, which may fluctuate at times. This may also cause a feeling of ambivalence.
Attempts to move the individual away from ambivalence and support them to achieve the next stage of behaviour.

14. Cycle of change

15. MI Strategies
Open question
Affirmation
Reflection
Summarise
OARS

16. Processes of MI Engaging Focusing Evoking Planning
By applying the OARS MI strategies at each stage.

17. Observe the OARS strategies of MI, engagement and communication skills used in this video clip:

18. Approaches used in MI
MI offers information and advice only when it is allowed and desired by the patient.
It is a patient-centered approach that values patient’s feelings and shows empathy
It avoids argument
It supports self-efficacy, giving positive affirmation for any change to increase and encourage patient’s belief that they are able to make the required changes
It encourages patient’s consideration of alternative views whilst allowing the need to ‘roll with resistance’ and avoids challenging directly.

19. Encourages patients to appreciate change by considering the difference between how clients are at present and how they want their lives to be.
MI strategies encourage ‘change talk’ and opens up discussions on any barriers to their achieving their goals, and what support they need to achieve them.

20. Thank you

21. Reading List
Miller, W.R., and Rollnick, S. (2012) Motivational Interviewing – what it is, how it works, how to learn it. Course Materials. Cardiff.
Rollnick, S., Miller, W.R., and Butler, C. (2008) Motivational Interviewing in Health Care – helping patients change behaviour. New York Guilford Press
Rollnick, S., and Miller, W. R. (1995). What is motivational interviewing? Behavioural and Cognitive Psychotherapy, 23,
Rubak, S., Sandback, A., Lauritzen, T., and Christensen, B. (2005). Motivational Interviewing: a systematic review and meta-analysis. British Journal of General Practice, 22,
Prochaska, J.O., and DiClemente, C.C. (1984). The transtheoretical approach: Crossing the traditional boundaries of therapy. Melbourne, Florida: Krieger Publishing Company.
Tober, G., and Raistrick, D. (eds) (2007) Motivational Dialogue; preparing addiction professionals for motivational interviewing practice. Routledge. London.

22. Reminder
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