1. M OTIVATIONAL I NTERVIEWING I MPLEMENTATION W ORKSHOP Jason Anderson EBP Program Administrator MN Department of Corrections August 26, 2011

2. Introductions

3. THREE LEVELS OR TYPES OF IMPLEMENTATION: ‘Paper’ (nothing really changes) ‘Process’ (procedures change; not outcomes) ‘Performance’ (procedures & outcomes change) Fixsen et al. (2005). Implementation Research: A Synthesis of the Literature.

4. 10 Things MI is NOT: Miller & Rollnick, 2009 1. Transtheroretical Model – Stages of Change 2.A technique. 3.A way to trick people. 4.A Decisional Balance. 5.It does not require assessment feedback.

5. 10 Things MI is Not (cont.): 6. A form of cognitive-behavioral therapy. 7. Just client-centered counseling. 8. Easy. 9. What you are already doing. 10. A panacea.

6. MI Defined: Motivational interviewing is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.

7. Stages of Learning Motivational Interviewing:

8. 1.Spirit 2.OARS 3.Recognizing Change Talk & Resistance 4.Elicit/Strengthen Change Talk 5.Roll w/Resistance 6.Develop Change Plan 7.Consolidate Commitment 8.Transition/Blending

9. 1. Overall Spirit: Collaboration Autonomy Evocation

11. 2. OARS: (Client-Centered Listening Skills) Open-ended ?s Affirmations Reflections Summarizations

12. 3. Recognizing Change Talk and Resistance Change Talk Sustain Talk Resistance

13. 4. Eliciting and Strengthening Change Talk Evoke and Reinforce change talk Apply OARS strategically Missed Opportunities

14. 5. Rolling with Resistance “Don’t wrestle with pigs…you’ll get muddy and the pigs love it.”

15. 6. Developing a Case Plan: Case Planning: Emphasis is on… - Written plan - SMART format - Criminogenic behavior targets - Aligning, plan w/client’ motivation is optimal - Developing a case plan is an event Change Planning: Priorities are… - Alignment w/client’s motivation - Criminogenic needs of client are considered - Written plan is optional - Change planning is a process (not an event)

16. 7. Consolidating Commitment Increasing strength of client’s commitment to change. Specify implementation intentions.

17. 8. Transition and Blending Blending MI style with other interventions Transition between MI and other approaches

18. Break Time!

19. Types of Training

20. 2 to 3 days “Level I” Training Clinical Training 1 hour to 1 day Application 2 hours to 1 day Intro

21. 3-4 days Equipped to facilitate Level I and II training. Training for Trainers 2-3 days Equipped to coach and facilitate practice sessions Supervisor Training 2-3 days May be broken into 2- hour sessions “Level II” Coaching Circles Advanced Clinical Training

23. An interview with Dr. Miller

24. Implementation Considerations: Training ≠ Implementation Internal Capacity Managerial Support Ongoing measurement with coaching feedback.

25. Resources http://motivationalinterviewing.org/ http://www.stephenrollnick.com/ Jason Anderson, EBP Programs Administrator Jason.Allen.Anderson@state.mn.us Jason.Allen.Anderson@state.mn.us