introduction to motivational interviewing symposium...session 1c and 2c - introduction to...
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Introduction to Motivational Interviewing
Presented byJulie Brown, MSWIndependent Living Program Director, YMCA Accelerator
Melanie G. Ferrer-Vaughn, MSWProgram Manager/Outreach Specialist, Seneca Family of Agencies
What is motivational interviewing?
• A client-centered disciplined method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.
• A collaborative conversation style for strengthening one’s person’s own motivation and commitment to change
• A person-centered counseling style for addressing the common problem of ambivalence about change
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 1 of 13
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The process of change…
How we used to thinkand sometimes still do
“People have to hit rock bottom first” Using the “stick” of authority – “You better or else!” Punitive approaches
Creating the Space for Change
Intrinsic motivation for change comes out of an accepting, empowering, safe atmosphere where the painful present
can be challenged.
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 2 of 13
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Stages of ChangePRE-
CONTEMPLATION
CONTEMPLATION
PREPARATION
ACTION
MAINTENANCE
RELAPSE
5 principles – DEARS
Develop discrepancyExpress empathy
Avoid argumentationRoll with resistance
Support self-efficacy
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 3 of 13
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5 skills – A ROSE
Affirmations
Reflective Listening
Open-ended Questions
Summarization
Eliciting Change Talk
Affirmation
• Affirming statements encourage, reinforce and acknowledge efforts and attempts made by the client
• Recognize the clients’ strengths, successes, and efforts to change
• A way to help to build rapport
• Something to keep in mind – affirmation vs. compliment
• Think about where the affirmation is located and how we might make it rest within the internal attributes of a client
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 4 of 13
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Reflective Listening
Training Manual Page 12
Simple ReflectionTake parts of what the person has shared and rephrase in your own words.
Reflection of EmotionParaphrase and utilize an emotional component to what they have shared.
Double Sided ReflectionHighlight ambivalence. This reflection acknowledges and amplify ambivalence.
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 5 of 13
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Open Ended Questions
• Closed ended questions are typically answered with finite responses
• Note that they can also clarify
“What is your favorite ice cream?”
• Open ended questions solicit additional info
• Create opportunities for details and depth to be revealed
“Why do you like that ice cream brand?
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 6 of 13
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• Partner Up!• Think about an ambivalent situation• Take turns being client & counselor • Use the skills we reviewed thus far
• Affirmations• Reflective Listening• Open Ended Questions
Activity: Real Play
Session 2
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 7 of 13
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Session 1 Recap
Reflection & Summary:
• How does the “spirit” of motivational interviewing resonate with you?
• What was difficult about the skills or concepts?
• What skills or concepts were new or helpful?
Transitional Summary & Major Summary
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 8 of 13
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Summarizing
• Transitional Summary Usually has 3 parts - 1) The pros 2) the cons 3) an invitation to
continue
• Major Summary Summary that comes at the end of a meeting or at a significant point in the session
“Let me see if I understand what you’ve told me so far…”“Okay, here’s what I’ve heard so far. Listen and tell me if I’ve missed anything important…”
Summarizing Exercise
Partner Up!
With someone new
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 9 of 13
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• Trio up!• Think about an ambivalent client (?) • Take turns being client, counselor & observer• Observer will utilize Observer Sheet to follow
statements• Use skills covered thus far
Activity: Trio Role Play
A / R / O / S
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 10 of 13
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1. Ordering, directing, or commanding2. Warning or threatening3. Giving advice, making suggestions, providing solutions4. Persuading with logic, arguing, or lecturing5. Moralizing, preaching, saying what they “should” do6. Disagreeing, judging, criticizing, or blaming7. Agreeing, approving, or praising8. Shaming or ridiculing9. Interpreting or analyzing10. Reassuring, sympathizing, or consoling11. Questioning or Probing 12. Withdrawing, distracting, humoring, or changing the subject
Thomas Gordon’s 12 Roadblocks
Eliciting Change Talk
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 11 of 13
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Eliciting Change Talk
• Ask evocative questions
• Ask for elaboration
• Explore pros and cons
• Imagine extremes
• Looking forward
• Looking backward
Putting the pieces together
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 12 of 13
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Activity: Group Role Play
Eliciting Change Talk
Reflective statement
CLIENT
Reflective statement
Reflective statement
• One participant role plays an ambivalent client. Your group can decide the topic
• The group will sit in a circle and each person rotate around the circle practicing a reflective statement or eliciting change talk questions.
Open-ended questions and summarizing can be
used,
but the focus is to practice eliciting change talk
questions.
RoadblocksThank you!
9th Annual Domestic Violence Symposium The Bigger Picture
Session 1C and 2C - Introduction to Motivational Interviewing Parts 1 and 2 Melanie Ferrer-Vaughn and Julie Brown
September 7 & 8, 2017 Page 13 of 13