advanced motivational interviewing practice
TRANSCRIPT
Advancing Motivational Interviewing Practice
Dr. Marilyn Herie PhD RSW
Learning Objectives 1. Assess your areas of MI proficiency and further
development
2. Practice OARS to evoke client change talk
3. Practice OARS to respond to clients’ change talk
4. Apply strategies to respond to clients’ sustain talk and enhance motivation for change.
how will I participate?
Pre-session
ice-breaker with a twist
Motivational
Interviewing
101
The “Righting Reflex” http://tinyurl.com/lyk4gqo
MI “Spirit”
4 Key Motivational Interviewing Skills
Miller and Rollnick, 2012
open questions
affirmations
reflections
summaries
d a r n c a t desire
ability
reasons
need
commitment
activation
taking Steps
Miller & Rollnick 2012
engaging
focusing
evoking
planning
four processes in MI
Miller and Rollnick, 2012, p. 26
Engaging
Focusing
Evoking
Planning
Motivational Interviewing: Practice Tips
MI Spirit: The Essential Foundation
Partnership: You and the client are equal experts
Acceptance: Absolute worth, accurate empathy, autonomy support, affirmation
Compassion: Beneficence, caring, focus on the other
Evocation: The client’s wisdom is most important
OARS: Key Skills
Open Questions: What are your reasons for change? How might you go about it in order to succeed?
Affirmation: You have worked hard to make this happen. I can see that you’ve given this a lot of thought.
Reflections: You wish that… You would like to…
Summary Statements: Let me make sure I understand how this all fits together…
Diagnosis Treatment
Plan
Symptoms
Benefits
Finances
Stress
Relationship
Agenda-Mapping Can we take a few minutes to talk about the different issues or concerns that you or others have? Just to get a “big picture” view of what you are coping with right now…
Given all of these possible areas for change, what are your priorities? Where would be the most helpful place for us to start?
0 1 2 3 4 5 6 7 8 9 10
People usually have multiple or competing priorities. On a scale of zero-to-ten, how important is it to change…? How confident are you that you could make this change?
Readiness Ruler
Why did you say [lower number] and not [higher number]?
What would it take to go from [lower number] to [higher number]?
Elicit: What do you already know about…?
Provide information: Be brief!
Elicit: How does that fit for you? What do you make of that?
Listen for Change Talk: DARN CAT
Desire, Ability, Reasons, Need
Commitment, Activation, Taking Steps
Reference: Miller, W. & Rollnick, S. (2012). Motivational Interviewing: Helping People Change (3rd Edition). New York: Guilford.
© 2013 Marilyn Herie, PhD RSW [email protected]
Four MI Processes
“what’s the skill?”
mining for affirmations
summarizing
find the change talk
CHANGE TALK
lunch
teach
back
evoking change talk
snatching change talk from the jaws of ambivalence
easy as…
recovering from mistakes
out of the woods
team consult
wrapping up
reflections and next steps
