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MOTIVAT I ONAL I NTERVIEWING

TALKING TO PARENTS ABOUT

TOUGH TOPICS

Holli Seabury, CEO

McMillen Center for Health Education

Learning Outcomes

By the end of the session participants will be able to:

• Describe the different components of the OARS approach used in

Motivational Interviewing.• Demonstrate how to use the circle

chart approach in Motivational

Interviewing.• Describe how to use the different

components of OARS in practice.

Housekeeping

• Ask questions when you have them

• Feel free to get up and leave, we will take a break at 75 minutes

• The pronoun I will use is “mom”

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MOTIVATIONAL INTERVIEWING

The most recent definition of

Motivational Interviewing (2009) is:

A collaborative, person centered

form of guiding to elicit and

strengthen motivation for change.

Motivational Interviewing is about

CHANGE

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Why we resist change

Ambivalence

Uncomfortable

Not a priority

Stress

Bad example

https://www.youtube.com/watch?v=_VlvanBFkvI

What did you see? Who is driving the change?

Good example

https://www.youtube.com/watch?v=67I6g1I7Zao

What did you see? Who is driving the change?

GROUP ACTIVITY

Examples of specific difficulties we are facing with

parents/caregivers.

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Children subjected to such stress may lack crucial coping skills and

experience significant behavioral and academic problems in school.

Teaching with Poverty in Mind by Eric Jensen

PARENTS IN STRESS

Communicating with parents

in stress:

• we need to help reduce their

stress before we can introduce

what we want to discuss.

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Brain Areas of Known Difference Between Low and Middle-Income Children

Source: Adapted from "Neurocognitive Correlates of Socioeconomic Status in Kindergarten Children,” by K. G. Noble, M. F. Norman, and M. J. Farah, 2005, Developmental Science, 8,

pp. 74–87.

EFFECTS OF STRESS ON SCHOOL

BEHAVIOR AND PERFORMANCE

Chronic stress:

• Is linked to over 50 percent of all absences (Johnston-Brooks, Lewis, Evans, &

Whalen, 1998).

• Impairs attention and concentration (Erickson, Drevets, & Schulkin, 2003).

• Reduces cognition, creativity, and memory (Lupien, King, Meaney, & McEwen,

2001).

• Diminishes social skills and social judgment (Wommack & Delville, 2004).

• Reduces motivation, determination, and effort (Johnson, 1981).

• Increases the likelihood of depression (Hammack, Robinson, Crawford, & Li, 2004).

• Reduces neurogenesis (growth of new brain cells) (De Bellis et al., 2001).

COGNITIVE LAGS

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BRAIN DIFFERENCES

How we tend to communicate:

• You have a problem

• Here’s how you should fix it

How Motivational Interviewing works:

• What do you think the problem is?

• How do you think you can solve it?

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OARS

• Open-Ended Questions

• Affirming

• Reflective Listening

• Summarizing

OARS

• Understand that when you start using these techniques, what you want to talk about may not be what your client wants to talk about. If you don’t help them take care of the problems they are focusing on, you won’t be able to focus on what you want to talk about.

OARS

Open-Ended Questions

Begin the question with “What, Who or How”

• “What are your ideas…”

• “What steps can you take…”

• “Who has helped you…”

Probe for more information:

• “Tell me more about…”

• “How do you feel about that?”

But, avoid asking “why” (candy bar example)

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OARS

Affirming• "I'm really glad you brought that up."

• "I think what you are doing is really difficult. I'm really proud to be working with you on this."

• “I appreciate that you are willing to talk about this.”• “That’s a good idea.”

• “I’ve enjoyed talking with you today.”

Emphasizing past successes• “You are clearly a very resourceful person.”• “You handled yourself well in that situation.”

• “If I were in your shoes, I don’t know if I could have managed nearly so well.”

Reframe: “You’ve had a setback, but you are really trying. Look at the progress you are making.”

I've learned that people will

forget what you said, people

will forget what you did, but

people will never forget how

you made them feel.

Maya Angelou

OARS

Affirming

•Always thank clients for coming in

•What is the most important

compliment you can give a parent?

•When they leave always thank them

for coming, say you enjoyed talking

to them or it was good to see them.

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OARS

Reflective Listening

• So you feel…

• It sounds like you…

• You’re wondering if…

• What I hear you saying is…

OARS

Reflective Listening

•Mom: “I know I should brush his teeth,

but I don’t like upsetting him.”

• Your Response: “You are aware of all the reasons you should be brushing

his teeth, but it’s hard for you when he gets upset.”

OARS

Reflective Listening

• Mom: “I know I should be reading to my children every day, but my life is just to hectic”

• Your Response:

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OARS

Summarizing

• How do you start the summary?

• “If look at everything we talked about,

what I am seeing is…”

• “What I heard today is…..”

• “The picture that I see is…”

Circle Chart

Finding a Finding a Finding a Finding a dental dental dental dental home.home.home.home.

Develop a plan Develop a plan Develop a plan Develop a plan to make to make to make to make

bedtimebedtimebedtimebedtime easiereasiereasiereasier....

Circle Chart – Group Activity

Last week you discussed updating immunizations, but ran out of time

before you could make a plan to get immunizations updated. When you arrive at the home visit, Mom says, “I have been having a lot of

problems with getting him potty trained. Plus, all of a sudden now he refuses to brush his teeth.”

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GROUP ACTIVITY

•What does it say in the circle that

would be completed before you arrive

at the home visit?

•What would you put in the circles at

the home visit?

HEALTH BEHAVIOR CHANGE MODEL F0R

PARENTS

Will I have a positive outcome or avoid a negative outcome if I do this behavior?

Is everyone else doing it?

Do I understand how to do it?

Is it something I feel I can feasibly get done, given my daily life?

Can I afford it?

Does it fit my core values for my child?

Health Behavior Decision

SCALING

•On a scale of 1 to 10 where one is not

important at all and 10 is critically

important, where does this fall?

•On a scale of 1 to 10 where one is not confident at all and 10 is very

confident, how confident are you that

you can make this change?

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SCALING

Why did you pick 9 and not a lower number?

What would it take to move to a higher number?

Learning Outcomes

By the end of the session participants will be able to:

• Describe the different components of the OARS approach used in

Motivational Interviewing.• Demonstrate how to use the circle

chart approach in Motivational

Interviewing.• Describe how to use the different

components of OARS in practice.

CONTACT

Holli SeaburyMcMillen Center for Health Education

260.456.4511

hseabury@mcmillencenter.org

Desk resource for motivational interviewing:

http://www.sedgwickcounty.org/corrections/Motivational%20Interviewing/Motivational%20Interviewing%20Desk%20REFERENCE%20Guide.pdf

Or Google: desk reference motivational interviewing