welcome welcome the use of motivational interviewing working with women clients’
TRANSCRIPT
WELCOME
The Use of Motivational Interviewing working with
Women Clients’
COMMON FACTORS
40%--CLIENT TRAITS– Strengths, Resources, Client Perceptions
30%--THERAPEUTIC RELATIONSHIP– Empathy, Acceptance, Mutual Affirmation,
Encouragement, Respect & Warmth 15%--HOPE-EXPECTANCY
– Belief in possibility of change 15%--TECHNIQUES/ORIENTATION
Women’s Treatment
Elements for Engagement/RetentionAvailable Child Care &
TransportationRelationship-BasedFamily/Couples CounselingDomestic Violence ServicesEmployment Services
TerminationTermination
MaintenanceMaintenanceActioActionn
PreparationPreparationContemplatiContemplationon
PrecontemplationPrecontemplationStages of ChangeProchaska et al, 1991
Why Enhance Motivation?
Inspire Motivation Assist Individuals
Readiness for Change
Keep People in Treatment
Improve Individuals Experiences in Treatment
Improve Outcomes Increase Return Rate
KEY TO CHANGE
MULTIDIMENSIONAL
CAN BE MODIFIED
DYNAMIC & FLUCTUATES
INFLUENCED BY OTHERS
STYLE OF CLINICIAN INFLUENCES
IS ELICITED & ENHANCED
Directive Client-centered Counseling style Elicits behavior
change
Client ambivalence
Communication style
Autonomy respected
Express Empathy
Develop Discrepancy
Roll with Resistance
Support Self-efficacy
Motivational Interviewing
PHASE I: BUILDING
MOTIVATION
PHASE II: STRENGTHENING
COMMITMENT TO CHANGE
Phase One StrategiesBuilding Motivation
Open-ended Questions
Affirmation
Reflective Listening
Summary
Eliciting Change Talk
Open-– Requires more than a yes or no response– Eliciting – more person centered– Aides individual cognitions
Closed-– Quick, easier, & efficient– Less person centered– Less engaging
Affirmations
Client Focused Build on Client StrengthsHighlight Client SuccessExpress Empathy
What is Reflective Listening?
•Hearing meaning behind the client’s words•Building Hypothesis vs. Making Assumptions•Creating a non-judgmental, accepting environment•Genuineness
REFLECTIVE LISTENING
Levels of depth --Level One: RepeatLevel Two:
RephraseLevel Three:
Paraphrase
Reflections Options
Some Starting Points It sounds like you . . . .
You’re feeling . . . .
It seems to you that . . . .
So you . . . .
Summarizing
Special form of reflection Provider chooses what to include and
emphasize Includes: concerns about change, problem
recognition, optimism about change, ambivalence about change
Client knows you are listening Invite client to respond to your summary
Change Talk CategoriesSelf-Motivational Statement
Problem Recognition
Statements of Concern
Intention to Change
Optimistic about Change
Phase TwoStrengthening Commitment
Recognizing ReadinessTransitional SummaryKey Questions Information & AdviseNegotiating a Plan
Motivation Exercise
•Listener –
Ask – What is something you are motivated to change?
Use active listening, open-ended statements or questions
• Speaker- respond
Maintenance
Termination
Action
Preparation
Contemplation
Precontemplation
MI-SOC ROADMAP TOMLIN/RICHARDSON-2000
SPIRAL OF CHANGE DEVELOPED BY PROCHASKA, et al, ‘94OARS IS A TERM DEVELOPED BY MILLER et al, ‘00
OARS
OARS OARS
CHANGE CHANGE TALKTALK
Summary & Key Questions
OARS
SS
RRAA
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