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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.
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Peer Assistance Services, Inc. 2015
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
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Peer Assistance Services, Inc. 2015
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.
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Peer Assistance Services, Inc. 2015
The plan
1. Explore the spirit of motivational interviewing.
2. Describe specific techniques to enhance motivation.
3. Practice short conversations about change.
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Peer Assistance Services, Inc. 2015
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Peer Assistance Services, Inc. 2015
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
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Peer Assistance Services, Inc. 2015
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
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Peer Assistance Services, Inc. 2015
Empathy acceptance ≠ approval
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Peer Assistance Services, Inc. 2015
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Peer Assistance Services, Inc. 2015
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Peer Assistance Services, Inc. 2015
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”?
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Peer Assistance Services, Inc. 2015
Enhancing Motivation
Pre-Contemplation
Contemplation
Maintenance
Action
Preparation
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Peer Assistance Services, Inc. 2015
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, ____.”
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Peer Assistance Services, Inc. 2015
Enhancing Motivation:
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?”
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Peer Assistance Services, Inc. 2015
Enhancing Motivation:
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?”
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Peer Assistance Services, Inc. 2015
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?”
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Peer Assistance Services, Inc. 2015
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.
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Peer Assistance Services, Inc. 2015
The most important thing
is to get the person
talking about change.
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Peer Assistance Services, Inc. 2015
Listen for CHANGE TALK
Desire
Ability
Reasons
Need
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Peer Assistance Services, Inc. 2015
10 Strategies to Elicit Change Talk
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Peer Assistance Services, Inc. 2015
Round Robin
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Peer Assistance Services, Inc. 2015
Role Play: Groups of 3
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Peer Assistance Services, Inc. 2015
www.improvinghealthcolorado.org
For questions or more information contact:
Carolyn Swenson, MSPH, MSN
Manager, Training and Consultation, SBIRT
Colorado
303-369-0039 x 227