motivational interviewing 24seven tobias sandberg mi-trainer member of: motivational interviewing...
TRANSCRIPT
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Motivational Interviewing
24seven
Tobias Sandberg
MI-trainer
Member of: Motivational Interviewing Network of Trainers
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Motivational Interviewing
• Developed by William R. Miller and Stephen Rollnick
• Evidence-based method• Focus on motivation and change• Person-centered• Humanistic psychology
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Motivational Interviewing • Motivational interviewing is a
collaborative conversational style for strengthening a person’s own motivation and commitment to change.
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A way of being
Structured conversation
Influencing time(24seven)
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A Continuum of Communication styles
Directing Guiding Following
CommandDecide LeadRuleTake chargeTell
ElicitCollaborateMotivateSupportAssistInspire
AllowGo along withPermitListenAttendStick to
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Directing Guiding Following0
1
2
3
4
5
6
7
InformingAskingListening
A Continuum of styles
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MI is like dancing
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Spirit of MI
• Collaborativ
• Evoking
• Autonomy support
• Empathy
• Rule• Listen to me!• I decide• Antipathy
X
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What we know
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We have to avoid…”Roadblocks”/Righting
reflex• Ordering, or commanding• Warning, or threatening• Giving advice• Telling people what to do• Shaming, ridiculing• Judging
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How to do…
• Active listening• Try to understand the person’s dilemma
Show Empathy
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Empathy
Treatment provider who shows a high degree of empathy in meeting with clients increases the likelihood that:
• "Resistance" is reduced.• Reduces relapse.• Reduction of interruptions in treatment.• Increases the change tendency.• Does not damage or worse treatment.
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MI’sCommunication skills
Open questionsAffirmationsReflectionsSummaries
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When Worlds CollideResistance/Discord
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You are always nagging and complaining!
I will always smoke weed!
I don’t know if I want to!
I hate this place!
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Feelings
• Anger• Sadnes• Powerlessness• Frustration• Loneliness• Misunderstood
Increases Resistance
• Argue• Ignore• Raise our voice• Warn• Reduce
Reduce Resistance
• Listen• Give choices• Confirm• Show empathy• Be present
We can choose to try to reduce the resistance or cause it to increase
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Some examples that can reduce resistance
- You are always nagging and complaining!- You think I demand too much of you…
- I will always smoke weed!- You think you’re going to smoke weed when you are forty…
- I don’t know if I want to!- You feel unsure about what you want…
- I hate this place!- How do you think I can help you to feel a little better?
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We try
Consistent and inconsistent with MI • What do you think you need to do?• You have really exerted yourself.• You are the one who know yourself best.• If I'm able to help you, you must do as I say.• I'm warning you!• I really appreciate you taking the time for this.• Now you listen to me!• How do you see it?
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We use the MI-spirit and MI’s
Communication skills to show Empathy and elicit the
Clients dilemma.
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Change TalkDesireAbilityReasonsNeed
Commitment ActivationTaking Steps
“I want”, “I wish”
“I could do it”, “I am able to”
“I want to live with my parents”
“I must”, “I need to”
“I've decided to ...”,
“I am ready to…”
“I went to the meeting this week”
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Change Talk
………but………It would feel good to practice, but I love to watch TV
Change Talk and Sustain Talk“Other Side of the Coin”
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It would be good for me to take my medicine, but I ignore it.
I want to stop drinking, but not now!
I need help, but this is no help.
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We try
• I actually have time to exercise• If I work out, I will be more alert• It's no fun to run in the rain• I'm too old to go to the gym.• I'll take the bike to work.• On Thursday I'll go out and run.• I will never find the strength to work
out.• I know I can.• I've decided to start training
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The first meeting Perhaps one of the most important encounter at the
institution.
We have to:
• Remind us of the MI spirit• Be active listeners and show empathy
by using the OARS.• Make use of an MI strategy,
Meny/Agenda
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Meny/Agenda
What happens nextSmoke
Call home
Råby
Most important for you1.
2.3.
4.
5.
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Spirit of MI
• Collaborativ
• Evoking
• Autonomy support
• Empathy
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The essens of MI
The MI-Spirit
Avoid confrontationand
The righting reflex
Elicit and respondChange talk
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MI is simpel but not easy
We need to train and assist each other in MI
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Summary of ”how to do”
• The importance of MI-Spirit:- Collaborative, Evoking, Autonomy support, Empathy- MI is like dancing, you need to be controlling and following
at the same time.• Most of the time use a guiding style• When we listen, we use active listening and try to show
empathy• The first meeting is important• We can reduce resistance by our way of being• We listen and respond to change talk• We know that the more a person expresses change talk
the more likely it is that she makes a change
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Thank you very much!
Tobias Sandberg
MI-trainer
Member of: Motivational Interviewing Network of Trainers