2. MOTIVATIONAL INTERVIEWING Key Concepts

3. Lack of Information Laziness Oppositional Personality Denial Resistance MISCONCEPTIONS

4. AMBIVALENCE IS OFTEN MISTAKEN FOR RESISTANCE MOTIVATIONAL INTERVIEWING CAN ELICIT A A PERSON’S MOTIVATION TO CHANGE

5. CORE SKILLS FOR MOTIVATIONAL INTERVIEWING Open Questions Affirmations Reflections Summaries

6. CLOSED VS. OPEN QUESTIONS CLOSED OPEN How much alcohol do you drink a day? What role does alcohol play in your life? Don’t you want to move to a safer place? What are the advantages that you see in moving? Are you in pain? How do you feel?

7. AFFIRMATIONS “You really care a lot about your family” “This is hard work your doing”

8. REFLECTIONS Patient - “I have been this way for so long, I think it’s just my personality” Provider Response - “So all of this seems normal to You”

9. SUMMARIES “If I understood you correctly, you’ve been Thinking about moving. There is a downside In that you have to find a new doctor”

10. SPIRIT OF MOTIVATIONAL INTERVIEWING CORE PRINCIPALS ACCEPTANCE COMPASSION EVOCATION

11. THE FOUR PROCESS OF MOTIVATIONAL INTERVIEWING Engaging Focusing EvokingPlanning

12. ENGAGING  Helps to establish a trusting and mutually respectful relationship  Avoid bombarding patient with questions in the initial encounter  Avoid telling patients how to fix their problem  Avoid labeling patients ie. stubborn, resistant

13. FOCUSING An ongoing process of seeking and maintaining direction Agree on an agenda based on client’s and counselor’s goals & priorities Practice listening skills

14. EVOKING Elicit a client’s own motivation to change “change talk” Asking questions that favors a movement in the direction of change “I want”, “I can”, “I wish”

15. PLANNING Developing a specific change plan Plan should be -Specific -Measurable -Achievable -Relevant -Timed

17. REFERENCES Miller, W. & Rollnick, S. (2002). Motivational Interviewing: Preparing people for change (2 nd ed.). New York, NY: Guilford Press Rochon, D., Ross, M.W. Looney, C., Nepal, V.P., Price, A.J. & Giordano, T.P. (2011). Communications strategies to improve HIV treatment adherence. Health Communication, 26, 461-467