1. Motivational Interviewing

2. Basics of Motivational Interviewing
Motivation for change is a state, not a trait.
People are at different levels of motivation or readiness to change for different changes.
Understand the cx’s readiness to change and support movement to the next stage.
Stages of change are predictable

3. Application to yourself
Think of three different changes you would like to make in your life.
How ready do you feel to make each of these changes?
Use a rating ruler to rate your readiness to change:
NOT READY TO CHANGE UNSURE READY TO CHANGE TAKING ACTION

4. Stages of Change

5. Stages of change Precontemplation-several types Reluctance Rebellion
Resignation
Rationalizing

6. Four principles of Motivational Interviewing

7. 1. Express Empathy Validate cx feelings and perspective
Recognize, name and explore ambivalence

8. 2. Develop Discrepancy Provide objective information
Cost/benefit analysis of “change” or “no change”
Heighten awareness of incongruities

9. Challenges/Confrontation-3 Steps
Recognize the incongruity
Present it to the cx
On the one hand…
Evaluate the effect: how did the cx respond? (see box 9-3)
Write down a challenge response for the following statements:

10. Some examples
Cx: I have good genes…my grandma ate whatever she wanted and she smoked…she lived to 98…I’m not worried about that kind of thing.
Cx: No friendship is perfect. Sometimes her criticism hurts my feelings, but that’s just how she is. I’m not going to take it personally.
Cx: I can always study more, but this teacher just doesn’t like me…it’s not really worth putting more time into because he’s not fair and picks on me.

11. The CCS Denial Partial examination
Acceptance and recognition without change
Generation of a new solution
Transcendance; development of new, larger, more inclusive patterns, beliefs, thoughts, behaviors

12. 3. Roll with Resistance: it is a sign you are moving too quickly
Acknowledge cx response
Amplified reflection
Double-sided reflection-on the one hand…
Avoid arguing
Avoid a power struggle
Avoid trying to convince
Acknowledge
Explore reality of changing or not

13. 4. Support Self-Efficacy
Identify successes
Explore what cx can do
Affirm cx thinking, action, decisions, etc.
Change language re: self
Change the script

14. Fish bowl Role Play Observe for:
1. Expressing Empathy and Developing Discrepancy
2. Rolling with Resistance and Supporting Self Efficacy
Stage of change? Readiness ruler?
Incongruities and opportunity to confront

15. Skills that may be useful
Give advice
Remove barriers
Provide choices
Decrease desirability
Practice empathy
Provide feedback
Clarify goals