motivational interviewing (mi) club - the 4 mi processes

December 2016 with John Russell

www.miinlondon.org / [email protected]

Follow us on Twitter @miinlondon / Tweet #miinlondon

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Topic: The 4 MI Processes Welcome to MI Club

Four MI Processes

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AimsandObjec0ves

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Aims of today 1. To recognise the 4 processes in MI.

2. To learn how to flow through each process

and recognise they are not always linear.

3. To practise open questions in each process.

4. To watch a trainer demonstration.

5. Have a laugh! This is a safe place to practise.

Objectives

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18:00 4 Processes (Ps): Your experience

18:10 4 Ps: What are they / Why use them?

18:20 Practise (yay!)

18:40 Trainer Demonstration

18:50 Debrief

Four MI Processes

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Whatdoesgoodlook

like?

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Think about a time when someone tries to make a plan or set a goal with you, but youre not ready to.

1. How do you react? 2. Have you ever tried to make a plan with someone who

you thought was ready but wasnt. How did this go? 3. Talk to the person/people next to you to discuss (5 mins) 4. Then well all have the chance to feedback as a group

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Four MI Processes

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WhatdoesMIliteraturesay?

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The 4 MI Processes


Engaging

Focusing

Evoking

Planning

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The 4 MI Processes


Following the 4 MI Processes sets an informal structure of where to guide your client.

We may use different uses of OARS throughout.

Today well focus on open questions, and how these may differ through each of the processes.

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Process 1: Engaging Engaging is the process by which both parties establish a helpful connection and a working relationship Miller and Rollnick, 2012


TIP

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Remove the Chat Trap

In one treatment study, higher levels of in-session informal chat predicted lower levels of client

motivation for change (Bamatter et al., 2010)

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Process 1: Engaging WHAT MIGHT YOU BE ASKING IN THIS PROCESS What is is thats brought you here today? Whats been your experience of XYZ condition? Im wondering how things have gone for you since we spoke?

NEXT: FOCUSING


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Process 2: Focusing Focusing is the process by which you develop and maintain a specific direction in the conversation about change Miller and Rollnick, 2012


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Process 2: Focusing WHAT MIGHT YOU BE ASKING IN THIS PROCESS Would you be willing to go thorugh an agenda map? I have some things Id like to chat about today [such as XYZ], what are some of the things you might like to discuss?

NEXT: EVOKING


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Process 3: Evoking Evoking is having the person voice the arguments for change Miller and Rollnick, 2012


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Step 3: Evoking


Evoke:Toelicitordrawforth

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Step 3: Evoking WHAT MIGHT YOU BE ASKING IN THIS PROCESS Would would some advantages be of XYZ change? What might get worse if things stayed the same? How might life be different for you if you did change?

NEXT: PLANNING

NEXT: PROVIDE (GIVE YOUR INFO / ADVICE)


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Process 4: Planning Planning is a process of negotiation and collaboration drawing on the client's expertise (as well as your own). Miller and Rollnick, 2012


TIP

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Dont plan too soon!

If you try to develop a change plan before the client is sufficiently ready

you may undo whatever progress you have made through engaging, focusing

and evoking.

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Process 4: Planning WHAT MIGHT YOU BE ASKING IN THIS PROCESS What do you think would be some ways to take this forward?

NEXT: LETS PRACTISE


Four MI Processes

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MISkillsPrac0se

MI Snakes and Ladders

(MI is 10% theory, 90% practise)


10 minutes group practise. Using open questions

Please get into groups of 3!

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4 Processes Snakes & Ladders:

1. Receive a game board & one set of colours 2. Choose a counter per person 3. Choose who goes first, this is the person

whose birthday is nearest to Christmas! 4. This person is player 1, to the left of you is

player 2, to the next left is player 3.

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4 Processes Snakes & Ladders:

1. I will draw two cards in place of dice, these added together will be the number of squares moved by whomevers go is next.

2. We will then go to player 2 and repeat, etc. 3. This will continue until we have a winner

from each team!

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Debrief in your groups

Discuss:

1. Did you find any one process more difficult the others?

2. How might you work on that in the future?

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Debrief as a full team

What comments, questions or observations do you have?

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Four MI Processes

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TrainerDemonstra0on

Live Trainer DemoCan I have a volunteer?

4 Processes on next slide


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The 4 MI Processes


Engaging

Focusing

Evoking

Planning

Four MI Processes

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Summaryoftoday+

Ques0ons

Ques1ons

Q: How do you know when the right 1me is go towards the planning stage?A: Whilst there are always opportune moments to veer towards the collabora1ve joy that is the planning there are plenty of piDalls to avoid. As we discussed during the mul1ple op1ons during the trainer demonstra1on today, trying to planning too soon, and on the interviewers agenda can set the conversa1on back and cause the other person to withdraw. Moving towards planning can be achieved through the process of recapitula1on, the art of giving a skilled transi1onal summary that is awash with change talk. This allows you to test the water and offer a key ques1on (one that is open, searching but noncommiMal in nature). Such as where does this leave you or What do you think of all this, I wonder what you might decide to do?, What might someone in your situa1on do next?, Whats in your mind at the moment?, What are you thinking about at this point?. Let the person decide what is next for them, let them tell you.


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Merry Christmas! Have a one.

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See you on Tuesday 7th February 2017

Thanks for coming!

Send us an email: [email protected]

motivational interviewing (mi) club - the 4 mi processes

Healthcare