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MOTIVATIONAL INTERVIEWING

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INTERVIEWING. Carol Rankin, Rh.D., CRC. California State University - Fresno ... Persons with alcohol and substance abuse. Confrontation = resistance ... – PowerPoint PPT presentation

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Title: MOTIVATIONAL INTERVIEWING


1
MOTIVATIONAL INTERVIEWING
  • Carol Rankin, Rh.D., CRC
  • California State University - Fresno
  • crankin_at_csufresno.edu

2
William Miller Stephen Rollnick
  • Persons with alcohol and substance abuse
  • Confrontation resistance
  • Client resistance and change
  • Change as a natural process
  • www.motivationalinterviewing.org

3
  • Instead of asking why dont people change we
    need to ask
  • Why is it that people do change?

4
Approach - Avoidance
  • Natural process
  • I want to change and I dont want to change!

5
  • Reasons to change
  • Ambivalence
  • Reasons not to change

6
(No Transcript)
7
AMBIVALENCE
  • 1.
  • 2.
  • 3.
  • 4.
  • 5.

8
FACES OF RESISTANCE
  • Clients resistance
  • Argue interrupt negate ignore
  • Our resistance
  • Reasons for change lecture shame, blame label

9
  • CARL ROGERS
  • Counselor Effects and Therapeutic Relationship
  • Accurate empathy
  • warmth
  • Genuineness
  • Reflective Listening

10
  • INCREASE MOTIVATION
  • DECREASE RESISTANCE

11
Four Spokes of a Wheel for increasing change
talk and decreasing resistance
  • 1. Communicate Empathy (OARS)
  • 2. Identify Discrepancy
  • 3. Go with Resistance (a sign to respond
    differently)
  • 4. Identify Self-Efficacy

12
MI Defined
  • a client-centered, directive method for
    enhancing intrinsic motivation to change by
    exploring and resolving ambivalence.
  • Directive increase change talk decrease
    resistance
  • Nondirective when exploring

13
Change Talk
  • 1. Disadvantages of the Status Quo (explore what
    isnt working)
  • 2. Advantages of Change (explore the advantages
    of change)
  • 3. Optimism for Change
  • 4. Intention to Change

14
disadvantages of the status quo(what isnt
working)
15
advantages of change
16
intention to change
17
optimism for change
18
Motivation
  • Importance
  • Confidence

19
  • Why are you at a _____and not zero?
  • What would it take for you to go from ____
  • to a (higher number)?
  • Why are you at a _____and not a 10?

20
DECREASE RESISTANCE
  • Identify ambivalence
  • Reflect resistance
  • Use decisional balance sheet

21
Balance Sheet
Reasons to continue the good things you get Reasons not to continue what isnt so good
22
  • Can be used with other techniques and has
    incorporated Stages of Change

23
Using Stages of Change
  • Prochaska, DiClemente, Norcross, 1992
  • Precontemplation does not see the need to
    change
  • Contemplation - ambivalence
  • Preparation - plans
  • Action -does
  • Maintenance -continues

24
  • Summary
    ..

25
  • Moving toward change talk
  • Or away from change talk (resistance)

26
  • MI is nondirective when exploring or examining
  • MI is directive when there is an identified goal

27
Strengths of Motivational Interviewing
  • It is both a counseling style and a communication
    style that can be used throughout treatment and
    with other approaches
  • Gets people engaged
  • Gets people engaged sooner rather than later

28
  • Ambivalence vs Blaming
  • Dancing vs. Wrestling
  • Nonjudgemental

29
  • Way of doing and way of being
  • that enhances and improves change that the
    client wants.

30
What is your ambivalence?
  • I want to change and I dont want to change
  • My stage of change precontemplation,
    contemplation, preparation, action, maintenance

31
The Gift of Time
  • if you act like you only have a few minutes it
    can take all dayif you act like you have all
    dayit can happen now.
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