MOTIVATIONAL INTERVIEWING

Presented by:

Dale House

Dale.House@dallascounty.org

Julie Williams

Julie.Williams@dallascounty.org

Connie Kent

Constance.Kent@dallascounty.org

ASSUMPTIONS ABOUT BEHAVIOR CHANGEWHAT ARE YOUR ASSUMPTIONS?

ACTIVITY 5-10 MINUTES

MI Non-Adherent

Assumptions

MI Adherent

Assumptions

Behavior Change Assumptions

Is each assumption MI adherent or Non-Adherent??

Assumption MI Adherent MI Non-Adherent

When faced with change we feel ambivalent about it    

Resolving this discrepancy builds internal motivation to change    

Threatening people with consequences forces them to change    

When people do not change, it is because they have not suffered enough    

Answers about behavior change come from the client    

Agents are responsible for making clients change    

What we say out loud about change influences whether or not we change    

Motivation is a client trait—some are motivated and some are not, and there is nothing anyone can do about it

   

People do not change    

DEFINITION OF MOTIVATIONAL INTERVIEWING

Motivational interviewing is a collaborative conversation style for strengthening a person’s own motivation and commitment to change.

CONTINUUM OF STYLES

Guiding

Directing Following

TellOrderSteerAdministerRuleLeadGovern

AssistCollaborateInspireMotivateSupportElicitPointAccompany

AllowPermitShadowStay withGo along withObserve

LESS DR. PHIL, MORE OPRAH

Less blaming, shaming, sarcasm, and lecturing

More evoking, active listening, empathy and compassion

TWO PRIMARY SUCCESS FACTORS

The level of the client’s motivation

The style and approach of the helping professional

The quality of your professional relationship with clients IS important!!

  “PUTTING IT ALL INTO PERSPECTIVE, THE

AMOUNT OF CHANGE ATTRIBUTABLE TO THE RELATIONSHIP IS ABOUT SEVEN TIMES THAT

OF THE AMOUNT ATTRIBUTABLE TO A SPECIFIC MODEL OR TECHNIQUE”

-Hubble, Duncan, and Miller 1999

FOCUS ON INTRINSIC MOTIVATION

*Find long term and short term goals-this will help identify their intrinsic motivators

(i.e. family, friends, perceived work ethic, respect of others, feeling of control..etc.)

Remember: For most people, change is an INSIDE job!!

MI GLOBAL CONCEPTS-THE HEART OF MI Evocation

Helping professional works proactively to evoke client’s own reasons for change and ideas about how change should happen.

Collaboration

Helping professional actively fosters and encourages power sharing in the interaction in such a way that client’s ideas substantially influence the nature of the interview.

Autonomy

Helping professional adds significantly to the feeling and meaning of client’s expression of autonomy, in such a way as to markedly expand client’s experience of own control and choice.

Direction

Helping professional exerts influence on the session and generally does not miss opportunities to direct client toward the target behavior or referral questions.

Empathy

Helping professional shows evidence of deep understanding of client’s point of view, not just for what has been explicitly stated but what the client means but has not yet said.

S.O.A.R.THE BASIC SKILLS OF MI

S = Summaries

O = Open Ended Questions

A= Affirmations

R= Reflections

FIVE CHAIRS EXERCISE

Defensive/ Resistant

Motivated

Ambivalent

CLIENT LANGUAGE

Sustain Talk Change Talk

“”You don’t know how annoying my wife can

be..she makes me do it”

I want to change to make a better home for my kids”

EVOKING CHANGE TALK-WHERE THE MAGIC BEGINS

EVOKING CHANGE TALK

• Asking evocative questions

• Importance/confidence rulers

• Querying extremes

• Looking back/Looking forward

• Exploring goals/values

MOTIVATIONAL INTERVIEWING RESOURCES

MI IN GROUPS

SOME HELPFUL WEBSITES

http://motivationalinterviewing.org

casaa.unm.edu/download/miti3_1.pdf

http://www.texasmicoop.com/coding.html

http://nicic.gov/library/topic/792-motivational-interviewing