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NCCDpromotesjustandequitablesocialsystemsforindividuals,families,andcommunitiesthroughresearch,publicpolicy,andpractice.

(800) 306-6223 www.nccdglobal.org [email protected] @NCCDtweets

Texas Child Care Administrators Conference

Mission Possible: Strengthening Texas Families Wyndham San Antonio Riverwalk Hotel

San Antonio, TX

Session G – Wednesday, October 2, 9 to 10:30a.m.

Supporting Families and Youth with Motivational Interviewing: An Introduction to the What, Why and How of it.

Erin M. Espinosa, PhD

Senior Researcher National Council on Crime and Delinquency

[email protected]

NCCD is a nonprofit research and implementation support organization that specializes in improving systems and services for justice-involved, foster, and other disadvantaged youth populations. Since 1907, NCCD’s mission is to improve lives of all people through research, public policy, and practice. NCCD envisions a just society in which people are safe and supported in their communities and treated with dignity by the systems that serve them. We work to help protect children from abuse and neglect, to create safe and rehabilitative justice systems for youth and adults, and to address the needs of older adults and adults with disabilities.

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Did you know? Successful implementation of a new intervention such as Motivational Interviewing (MI) can be impacted by staffs’ views of their supervisor? Staff need to know their supervisor: 1.) Have a _________________________________________. 2.) Can set _________________________________________. 3.) Can ____________________________________________. 4.) Know ___________________________________________.


AND, Did you know…..? Successful implementation can be impacted by staffs’ belief that the model _______________________ and can ________________ meet the needs of the youth and families they are supporting.


What do we know about MI?

Think about a time someone told you that you had to change something:

Think about a time you decided to change something, and someone was there to help you through it:


Three Essential Elements in Any Definition of Motivational Interviewing (MI)

1. MI is a particular conversation about change (method of communication)

2. MI is collaborative (person-centered, partnership, honors autonomy,

(not expert- recipient roles)

3. MI is evocative, seeks to call forth the person’s own motivation and commitment

Defining MI Three levels of definition (of increasing specificity) 1) A layperson’s definition (What’s it for?)

Motivational Interviewing is a collaborative conversation to strengthen a person’s own motivation for and commitment to change.

2) A pragmatic practitioner’s definition (Why would I use it?)

Motivational Interviewing is a person-centered communication method for addressing the common problem of ambivalence about behavior change.

3) A technical, definition (How does it work?)

Motivational Interviewing is a collaborative, goal-oriented method of communication with particular attention to the language of change. It is intended to strengthen personal motivation for and commitment to a targeted behavior change by eliciting and exploring an individual’s own arguments for change.


Ten Things That MI is not … (Miller & Rollnick, 2008)

MI is not …

1. … based on the transtheoretical model of change. 2. … a way of tricking people into doing what you want them

to do 3. … a specific technique. (MI is a counseling method; no

specific technique is essential.) 4. … decisional balance, equally exploring pros and cons of

change 5. … assessment feedback. 6. … a form of cognitive-behavioral therapy 7. … just client-centered therapy. 8. … easy to learn. 9. … what you are already doing. 10. … a panacea for every clinical challenge and will not `

automatically change people or what they’re doing.


Four Fundamental Processes in MI

1. ENGAGING – The Relational Foundation * Person-centered style * LISTEN – with intent to understand client viewed dilemma and values

* Core reflective skills (aka: O A R S for the purpose of Eliciting Change Talk)

* This should be learned and practiced first.

Is it MI yet??? 2. GUIDING – The Strategic Focus * Agenda setting * Finding a focus * Information and Advice – with permission and caveat

Is it MI yet??? 3. EVOKING – The Transition to MI * Selective eliciting * Selective responding * Selective summaries

Is it MI yet??? 4. PLANNING – The Bridge to Change * Replacing prior Phase I and Phase II * Negotiating a Change Plan * Consolidating commitment

Is it MI yet???


What Makes it MI?

1. MI is a conversation ABOUT CHANGE. * Usually, but not necessarily about behavior change. * Change can be broadly defined. 2. MI has a particular PURPOSE.

* The purpose of MI is to evoke and strengthen the Client’s PERSONAL motivation for change.

3. MI is COLLABORATIVE. * Person-centered PARTNERSHIP. 4. MI HONORS AUTONOMY and Self-determination * People make their own choices and are very capable of doing so. 5. MI is EVOCATIVE * MI evokes the Client’s own motivations for change. 6. MI uses SPECIFIC SKILLS * MI applies specific helping skills in particular prescribed ways e.g. differential use of OARS 7. MI is GOAL-ORIENTED – MI moves towards a particular change goal. * Not merely exploring ambivalence * MI seeks to resolve ambivalence in the direction of change * Sometimes, MI involves creating ambivalence 8. MI attends to specific forms of SPEECH. MI is attuned to and guided by

particular aspects of client language. * Elicits and strengthens Client change talk * This is rather unique to MI * DARN-CAT and beyond 9. MI RESPONDS TO CHANGE-TALK in specific ways. * Elaboration * Affirmation * Reflection * Summary 10. MI RESPONDS TO RESISTANCE and sustain talk in specific ways. * Non-confrontational * Avoids argument


Most skill transfer occurs with interactive training followed by in vivo coaching within the practice setting…


Key organizational drivers must be in place to support implementation and ensure the positive outcomes expected occur.


Organizational leadership structures must ensure a facilitative and accountable system of support occur throughout implementation.


Things to consider in developing a supportive implementation climate… Areas supervisors should focus:

1. Commitment for change: __________________________________________________________________________________________________

2. Compatibility: __________________________________________________________________________________________________

3. Priority of installation: __________________________________________________________________________________________________

4. Rewards and incentives: __________________________________________________________________________________________________

5. Goals and feedback: __________________________________________________________________________________________________

6. Learning environment: __________________________________________________________________________________________________


*NOTES*

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