motivational interviewing refresher
DESCRIPTION
Motivational Interviewing refresher. Kathryn I. Pollak, PhD Duke University. Overview. Motivational Interviewing techniques Role plays (yikes!!). How to Counsel: MI. What is MI? Patient-centered Directive Patient is expert, not physician. MI Spirit: Collaboration. - PowerPoint PPT PresentationTRANSCRIPT
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Motivational Interviewing Motivational Interviewing refresherrefresher
Kathryn I. Pollak, PhDDuke University
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OverviewMotivational Interviewing
techniquesRole plays (yikes!!)
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How to Counsel: MIWhat is MI?
◦Patient-centered◦Directive◦Patient is expert, not physician
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MI Spirit: CollaborationMI Spirit: Collaboration
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MI Spirit: AcceptanceMI Spirit: Acceptance
“Could a greater miracle take place than for us to look through each other’s eyes for an instant?”
- Henry David Thoreau
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MI Spirit: EvocationMI Spirit: Evocation
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MI Spirit: CompassionMI Spirit: Compassion
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Interaction techniques (OARS)Open-ended questions
Affirm
Reflective listening
Summarize
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How to Counsel: MIOpen-ended questions
◦Cannot be answered with yes/no
◦Start with Why, What, and How
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How to Counsel: MIAffirm
◦Praise opportunities
◦Reinforce positives rather than negatives
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How to Counsel: MI
Reflective listening
◦Statements, not questions
◦Helps continue conversation
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How to Counsel: MISummarize
◦Series of reflections
◦Often ends with a check-in
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Principles of MIExpress empathy
Develop discrepancy
Roll with resistance
Support self-efficacy
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Empathy: NURSENameUnderstandRespectSupport ExploreI wish
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Develop discrepancyOpen-ended questions
Reflective listening
Good and not so good things
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Rolling with resistanceRolling with resistance
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Rolling with resistanceNaming and reframing
Emphasize personal choice and control
Query extremes
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Supporting self-efficacy Recognize and affirm past successes
Reframe negative thoughts
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How do you do this in 3 min??? 5 A’s
◦Ask◦Advise◦Assess◦Assist◦Arrange
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AskAskOpen-ended question to see what
your patient thinks about his/her behavior
“What do you think about your weight?”
Reflect thoughts back
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AdviseAdviseAsk permission
Non-judgmentally express your concern
“As your physician, I need to tell you that I’m concerned about your weight. The best thing you could do for your health right now is to lose weight.”
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AssessAssessAssess how willing patient will
change
“What would you like to do about your weight right now?”
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AssistAssistAssist patients regardless of how
willing they are◦Importance ruler◦Confidence ruler◦Commitment ruler
Write down patient’s motivations in his/her chart
Summarize and have patient set a goal
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ArrangeArrangeArrange a follow-up visit to check
on goal
“You have made some great goals. I’d like to see you back in 2 months to see how you are doing. Please don’t worry if it doesn’t go exactly as you planned. I’m here to help you problem-solve and come up with new plans if these don’t work.”
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Let’s Role Play!!Let’s Role Play!!