motivational interviewing: spirit and practice€¦ · dedicated to quality, accessible prevention...

Peer Assistance Services, Inc. 2015

Motivational Interviewing:

Spirit and Practice

Colorado Rural Health Center

THE FORUM 2015

Presenter:

Carolyn Swenson, MSPH, MSN

Peer Assistance Services, Inc.


Peer Assistance Services, Inc.

Dedicated to quality, accessible prevention and

intervention services in workplaces and

communities, focusing on substance use and

related issues.

Incorporated in 1984


Acknowledgements

SBIRT Colorado is an initiative of the Governor, funded

by the Substance Abuse and Mental Health Services

Administration, administered by the Colorado

Department of Human Services, Office of Behavioral

Health and managed by Peer Assistance Services, Inc.


The plan

1. Explore the spirit of motivational interviewing.

2. Describe specific techniques to enhance motivation.

3. Practice short conversations about change.


Ineffective brief intervention on tobacco:

http://www.youtube.com/watch?v=80XyNE89eCs

Effective brief intervention on tobacco:

http://www.youtube.com/watch?v=URiKA7CKtfc

SBIRT Primary Care videos: Especially “Jill”

http://www.sbirtoregon.org/

Ineffective SBIRT in ED :

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

Effective SBIRT in ED:

https://www.youtube.com/watch?v=uL8QyJF2wVw

Marijuana Brief Intervention:

http://www.youtube.com/watch?v=sRUHv6_cRpE



http://www.youtube.com/watch?v=URiKA7CKtfc











Motivational Interviewing Basics

Spirit and principles:

– Empathetic listening

– Collaborative

– Respects autonomy

– Elicits intrinsic motivation to change

– Explores and resolves ambivalence

– “Rolls” with resistance

– Reinforces commitment and confidence


Empathy acceptance ≠ approval


Activity: Listen and Summarize

Speaker: Pick a real-life change issue.

Listener:

• Listen and try to understand but give no advice.

• Use these 4 questions: 1. “Why would you want to make a change in _____?

2. “How might you go about changing?”

3. “What are the best reasons to change _____?”

4. “How will your life be better if you change _____?”

• Reflect back and summarize what you heard.

• Then ask:

“So, what do you think you’ll do”?


Enhancing Motivation

Pre-Contemplation

Contemplation

Maintenance

Action

Preparation


Enhancing Motivation:

Explore the pros and cons

“What do you like about smoking?”

Followed by:

“What are some not so good things about smoking?”

Then summarize both sides:

“So, on the one hand ____, and on the other hand, ____.”



Assess Importance or Readiness

“On a scale of 0 -10 how important is it to cut back on your drinking?”

THEN RESPOND

“What makes you a __ and not a lower number?”



Assess Confidence

“On a scale of 0 -10, how confident are you that you can cut back your drinking if you decide to?”

THEN RESPOND “What could help you feel more confident?”


Engaging Questions

“What do you think about this information?”

“How would you know if it was a good idea to quit?”

“Let’s say you did decide to make a change in….,

what’s the first step you would take?”

“How does smoking fit with what matters most to you?”


The very unmotivated person

It’s usually about ambivalence.

It may also be about low confidence.

A conversation is not a failure

if change doesn’t happen

right away.


The most important thing

is to get the person

talking about change.


Listen for CHANGE TALK

Desire

Ability

Reasons

Need


10 Strategies to Elicit Change Talk


Round Robin


Role Play: Groups of 3


www.improvinghealthcolorado.org

For questions or more information contact:

Carolyn Swenson, MSPH, MSN

Manager, Training and Consultation, SBIRT

Colorado

303-369-0039 x 227

motivational interviewing: spirit and practice€¦ · dedicated to quality, accessible prevention...

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