motivational interviewing. objectives to understand the concept of motivational interviewing. to...

Motivational InterviewingMotivational Interviewing

ObjectivesObjectives

• To understand the concept of To understand the concept of motivational interviewing.motivational interviewing.

• To be able to discuss some of the To be able to discuss some of the general principles.general principles.

• To be able to begin to use some of To be able to begin to use some of the concepts in practicethe concepts in practice

What is Motivational What is Motivational Interviewing?Interviewing?

What is Motivational What is Motivational interviewing?interviewing?

What is Motivational What is Motivational Interviewing?Interviewing?

• Client –centred counselling style for Client –centred counselling style for changing behaviour by helping clients changing behaviour by helping clients explore/resolve ambivalence.explore/resolve ambivalence.

• A approach to help individuals develop a A approach to help individuals develop a commitment to changing problematic commitment to changing problematic behaviour.behaviour.

• A motivation to change that comes from A motivation to change that comes from the client.the client.

Be aware of…………Be aware of…………

• Assuming that the client wants to Assuming that the client wants to change.change.

• Assuming the client’s health is the Assuming the client’s health is the prime motivating factor from them.prime motivating factor from them.

• That if the client does not decide to That if the client does not decide to change then the intervention has failed.change then the intervention has failed.

5 General principles5 General principles

• Express sympathyExpress sympathy

• Develop discrepancyDevelop discrepancy

• Avoid argumentsAvoid arguments

• Roll with resistanceRoll with resistance• support self efficacy support self efficacy (believe one is capable of (believe one is capable of

performing in a certain manner)performing in a certain manner)

Strategies of MIStrategies of MI

• Elicit - Elicit - draw outdraw out

• Clarify – Clarify – make clearmake clear

• Resolve ambivalence – Resolve ambivalence – simultaneous simultaneous attraction + revulsion towards an object/ action ( I do but I attraction + revulsion towards an object/ action ( I do but I don’t!)don’t!)

For a client to change they For a client to change they need to………need to………

• Recognise the current behaviour is a Recognise the current behaviour is a problem or concern.problem or concern.

• Believe that they will be better off if Believe that they will be better off if they change.they change.

• Believe that they are able to change.Believe that they are able to change.

Process of change

Worker skillsWorker skills

• Express empathy through reflective listening.Express empathy through reflective listening.• Communicate respect for and acceptance of their Communicate respect for and acceptance of their

feelings.feelings.• Establish a non judgemental relationship with client.Establish a non judgemental relationship with client.• Be complimentary not punitive.Be complimentary not punitive.• Listen rather than tell.Listen rather than tell.• Gently persuade ( change is up to the client.)Gently persuade ( change is up to the client.)• Develop discrepancy between clients goals and Develop discrepancy between clients goals and

values and their current behaviour.values and their current behaviour.• Focus on clients strengths to support and optimising Focus on clients strengths to support and optimising

needed to change.needed to change.

Undertaking an interviewUndertaking an interview

• Examine the good things about the Examine the good things about the clients behaviour.clients behaviour.

• Examine the less good things and Examine the less good things and compare the two.compare the two.

• Explore how much of a concern the Explore how much of a concern the less good things are.less good things are.

Decisional balance sheetDecisional balance sheet

Positives of ………Positives of ………

Less good things Less good things about…….about…….

Positives of not ……..Positives of not …….. Less good things Less good things about not ………….about not ………….

Tool kit!Tool kit!

• Be empathic – non judgementalBe empathic – non judgemental

• Use open QuestioningUse open Questioning

• Reflective listeningReflective listening

• SummarizeSummarize

• Use decisional balance sheetUse decisional balance sheet

Some good phrases to use!Some good phrases to use!

• Tell me about your ……………Tell me about your ……………

• What do you like about ………………What do you like about ………………

• What is positive about your……..for you?What is positive about your……..for you?

• Do you have any concerns about……………Do you have any concerns about……………

SummarySummary

• Sowing a seed!!Sowing a seed!!

• Helping people to maintain change Helping people to maintain change

• Client centred Client centred

• Non confrontationalNon confrontational

• OpportunistOpportunist

• Can be delivered by non-specialist Can be delivered by non-specialist