developed by ndri, inc. ndri joe lunievicz, ba, ryt director training institute
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What Keeps Adolescents Moving Forward in Treatment? Motivational Interviewing Techniques in Juvenile Drug Court. Developed by NDRI, Inc. www.ndri.org Joe Lunievicz, BA, RYT Director Training Institute. Dyads: What Motivated You?. What was most important to you: When you were 13? - PowerPoint PPT PresentationTRANSCRIPT
+ What Keeps Adolescents
Moving Forward in Treatment?
Motivational Interviewing Techniques in Juvenile Drug
Court
Developed by NDRI, Inc.www.ndri.org
Joe Lunievicz, BA, RYTDirector Training Institute
Lunievicz/MI/
+Dyads: What Motivated You?
What was most important to you:•When you were 13?
•When you were 16?
•When you were 19?
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+
What Motivates your participants to move towards graduation?
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+Important Considerations
Adolescence is about identity.
Autonomy issues are powerful.
The adolescent brain is still developing.
Adolescent culture and values are different than adult culture and values.
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+Why not just change?
Keep in mind the family dynamics adolescents go home to: Do their parents use? Were they born addicted? Are they safe? Have they witnessed the unimaginable? Are there co-occuring mental health issues? Are there learning disabilities? How early did they start using?
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+Motivational InterviewingA directive, client-centered
counseling style for eliciting
behavior change by helping clients
to explore and resolve
ambivalence. It is a style of
helping that uses a set of specific
strategies.Lunievicz/MI/
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+Motivational Interviewing (Cont.)
Motivation- or presumed lack of it- is not viewed as a personality problem or character trait, but as a state of readiness for change that can be influenced by a helping relationship.
Rollnick & Miller, 1995
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+MI Basic Principles
Expressing Empathy
Developing Discrepancy
Rolling with Resistance
Supporting Self-Efficacy
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+Why use MI in Drug Court?
Better EngagementMore Information
Better Assessments
More Relevant Recommendations
More Successful Outcomes
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+
“You don’t understand.”
“You won’t understand.”
- Anonymous Adolescent
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Seek first to understand, then to be understood.
-Stephen R. Covey
7 Habits for Highly Effective People
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+MI Strategies - OARS
Open Ended questions
Affirm
Reflection
Summarize
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+Impact of Communication
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+Open Ended Questions
Who, what, where, when
Tell me about…
How did you…
Redirect: Now tell me about…
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+Open-ended Examples:
What worries you about your current situation?
What difficulties have you had with your drug use?
What do you think will happen if you don’t change?
How has your anger interfered with your life?
What would your life be like 5 years from now?
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+Practice:
Open-ended Questions
Interview your partner by asking only open ended questions.
Buzzer sounds whenever a closed ended question is asked.
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+Affirm (but don’t flatter)Strengths based technique
Verbally supports or validates a participant’s thoughts, emotions, or actions
Demonstrates: Appreciation, Understanding, Support
When you see a strength, notice it
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+Affirmation Example:
1. Participant arrives on time for his case management appointment.
“You’re punctual. That will be a big help in this program.”
2. Participant: “I don’t want to do anything more than I need to. I just want to finish the program and get on with my life.”
“Determination is a good characteristic to have in treatment. It will help to keep you focused.”
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+Practice: Affirming
Read the statement to your partner and your partner must respond with a strength’s based affirmation.
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+Reflective Listening
Rationale Conveys willingness to try to understand
Serves as a perception check
Clarifies feelings Leads to more exploration
Demonstrates empathy
Common Errors Not listening
closely Limited feeling
vocabulary Monotone vocal
qualities Premature focus
on problem solving
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+Reflection
Expressing Empathy:“So, what I hear you saying is…”Reflecting Conflict:“On the one hand…but on the other hand…”“So what you’re saying is…but you are not able to…”Rolling with resistance:“You don’t have to do anything you don’t want to.”
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+Practice: Reflection
1. Paraphrase2. Reflect conflict3. Roll with resistance
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+Summarizing
The set-up statementLet me see if I understand correctly…
Reflection, Reflection, Reflection
Open ended QuestionWhat did I miss?What other concerns do you have?
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+Practice:
Summarize
• Let me see if I understand correctly…
• Reflection• Reflection• Reflection
• What did I miss?
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+Questioning SkillsEffective vs. Ineffective Questions
Ineffective Too many questions Accusatory questions: Why? Multiple questions Explanatory questions Closed questions
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+ Questioning SkillsEffective vs. Ineffective Questions
EffectiveHave specific objectives in mindState background for questionUse language of the clientCheck out whether client is understandingAsk openly: Who, What, When, Where & How
Use open-ended questionsParaphrase; Reflect; Summarize
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+Resources: EBPs that Address Adolescents Behavior Therapy (BT)
Cognitive-Behavioral Therapy (CBT)
Motivational Interviewing (MI) Motivational Enhancement Therapy/Cognitive Behavioral
Therapy (MET/CBT
Relapse Prevention Therapy (RPT)
Adolescent Community Reinforcement Approach (A-CRA)
Seeking Safety (SS)
National Registry of Evidence-based Programs and Practices, SAMHSA
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+Resources: EBTs that Address Familial Issues
Multisystemic Therapy (MST) Addresses COD issues also
Brief Strategic Family Therapy (BSFT)
Functional Family Therapy (FFT)
Family Behavior Therapy (FBT) Addresses COD issues also
From: Evidence-Based Practice Recommendations for Juvenile Drug Courts by the National Center for Mental Health and Juvenile Justice in collaboration with the Louisiana Supreme Court Drug Court Office - 2009
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+Resources: EBTs that Address CODs
Trauma Focused Cognitive Behavioral Therapy ( Individual, outpatient modality
Motivational Enhancement Treatment (MET, CBTS) Individual and Group sessions
Continuous, Comprehensive, Integrated System of Care Nodel (CCISC) A set of practice guidelines for dual diagnosis treatment
From: Evidence-Based Practice Recommendations for Juvenile Drug Courts by the National Center for Mental Health and Juvenile Justice in collaboration with the Louisiana Supreme Court Drug Court Office - 2009
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