Motivational Interviewing Basics of Motivational

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Motivational Interviewing
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Basics of Motivational Interviewing

• Motivation for change is a state, not a trait.
• People are at different levels of motivation or
  readiness to change for different changes.
• Understand the cxs readiness to change and
  support movement to the next stage.
• Stages of change are predictable

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Application to yourself

• Think of three different changes you would like
  to make in your life.
• How ready do you feel to make each of these
  changes?
• Use a rating ruler to rate your readiness to
  change
• NOT READY TO CHANGE UNSURE READY TO CHANGE
  TAKING ACTION
• 1 2 3 4 5 6
  7 8 9 10

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Stages of Change
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Stages of change

• Precontemplation-several types
• Reluctance
• Rebellion
• Resignation
• Rationalizing

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Four principles of Motivational Interviewing
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1. Express Empathy

• Validate cx feelings and perspective
• Recognize, name and explore ambivalence

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2. Develop Discrepancy

• Provide objective information
• Cost/benefit analysis of change or no change
• Heighten awareness of incongruities

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Challenges/Confrontation-3 Steps

• Recognize the incongruity
• Present it to the cx
• On the one hand
• Evaluate the effect how did the cx respond?
  (see box 9-3)
• Write down a challenge response for the following
  statements

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Some examples

• Cx I have good genesmy grandma ate whatever
  she wanted and she smokedshe lived to 98Im not
  worried about that kind of thing.
• Cx No friendship is perfect. Sometimes her
  criticism hurts my feelings, but thats just how
  she is. Im not going to take it personally.
• Cx I can always study more, but this teacher
  just doesnt like meits not really worth
  putting more time into because hes not fair and
  picks on me.

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The CCS

• Denial
• Partial examination
• Acceptance and recognition without change
• Generation of a new solution
• Transcendance development of new, larger, more
  inclusive patterns, beliefs, thoughts, behaviors

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3. Roll with Resistance it is a sign you are
moving too quickly

• Acknowledge cx response
• Amplified reflection
• Double-sided reflection-on the one hand
• Avoid arguing
• Avoid a power struggle
• Avoid trying to convince
• Acknowledge
• Explore reality of changing or not

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4. Support Self-Efficacy

• Identify successes
• Explore what cx can do
• Affirm cx thinking, action, decisions, etc.
• Change language re self
• Change the script

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Fish bowl Role Play

• Observe for
• 1. Expressing Empathy and Developing Discrepancy
• 2. Rolling with Resistance and Supporting Self
  Efficacy
• Stage of change? Readiness ruler?
• Incongruities and opportunity to confront

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Skills that may be useful

• Give advice
• Remove barriers
• Provide choices
• Decrease desirability
• Practice empathy
• Provide feedback
• Clarify goals