1. Motivational Interviewing Presented by Nick Alenkin,MSSW PHLAG Conference Call October 23, 2007

2. Presentation Overview Define Motivational Interviewing (M.I.) Key Components of M.I. Creating “Change” In Consumers Case Example Discussion

3. Motivational Interviewing “Client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence” (Miller & Rollnick, p. 25). We look to the individual to recognize their own current situation and align ourselves with them to create change.

4. Key Components of M.I. Person-Centered- it focuses on the individual and their agenda, not ours. Directive- it focuses on the dynamics of ambivalence(“maybe”) and incorporates change talk. Non-technical- it focuses on communication with our consumers not on a technique (e.g.,CBT).

5. Key Components of M.I.(cont.) Elicits motivation- it focuses on intrinsic motivators through recognition of current life situations. Value-driven- it focuses on the values and concerns for change.

6. Stages of Change Veteran’s RoleWorkers Role Pre-contemplation (Pros and Cons) “What problem?” “Some benefits are…” Contemplation(Reason for Change) “Tell me more” “I can help you with this” Preparation (Educate on Change) “I have gathered my resources” “Here are some options”

7. Stages of Change Veteran’s RoleWorkers Role Action (Supporting Change) “I’ve met with my therapist” “What else can I do?” Maintenance(Connecting to Change) “I can see a difference”“Keep up the good work” Relapse(Reflecting on Change) “Did I fail?”“Change can be hard”

8. Eliciting Change Talk Creating a “motivation” for change Current Goal Situation We move the veteran to their goal through: Collaboration with them Eliciting their values, perceptions, and goals Affirming their right to make choices and accept outcomes

9. Creating a Success Plan Success Map My current situation is: I would like to be ___________ in ____________(days, weeks, etc…). Two goals I have are: 1) 2) I plan to incorporate the following to reach my goals: (Action)(By this date) Other people that can help me with the goal are: Some of the areas which may impact my goal(s) are: I know when I have been progressing in my goal or am successful when I:

10. Case Study David has been coming to group for the last 3 weeks, he has non-service connected benefits at this time. He reports a homeless history of the last 3 years. His last living situation was with a roommate 3 years ago for which he left, “When we couldn’t get along”. He reports applying for housing but is not able to secure anything. He reports, “What gives, I think I’m doing the right thing here?” What other information would be pertinent for you to secure from David? What in what “stage” is he in? How can you elicit “change talk” with David?

11. Discussion/References References http://www.motivationalinterview.org/ DiClemente, C. C. and J. O. Prochaska (1985). Processes and stages of self- change: Coping and competence in smoking behavior change. Coping and Substance Use. S. Shiffman and T. A. Wills. New York, Academic Press. Miller, W. & Rollnick, S. (2002). Motivational Interviewing (2n Ed.) Preparing People for Change. NY:Guilford Press.