Motivational InterviewingMotivational Interviewing

A Brief IntroductionA Brief Introduction

The Evolution ofThe Evolution ofMotivational InterviewingMotivational Interviewing

Crisis Intervention Theory – People Crisis Intervention Theory – People have different levels of motivation. It have different levels of motivation. It is much easier to help them when is much easier to help them when their motivation to make a change is their motivation to make a change is high.high.

The Evolution ofThe Evolution ofMotivational InterviewingMotivational Interviewing

The Transtheoretical Model – The Transtheoretical Model – Researchers discovered that people Researchers discovered that people actually go through five separate actually go through five separate stages in the change process and stages in the change process and they move through these stages in they move through these stages in different ways.different ways.

The Evolution ofThe Evolution ofMotivational InterviewingMotivational Interviewing

Motivational Interviewing – Perhaps Motivational Interviewing – Perhaps we can develop therapeutic we can develop therapeutic techniques that would help us to help techniques that would help us to help people raise their motivation levels. people raise their motivation levels. This would, in turn, help them to get This would, in turn, help them to get better.better.

Motivational Interviewing is one Motivational Interviewing is one of the most research-based of the most research-based

treatment models ever treatment models ever developeddeveloped

It is always necessary to use It is always necessary to use Motivational Interviewing principles Motivational Interviewing principles no matter what no matter what otherother theoretical theoretical model you might use (CBT, DBT, model you might use (CBT, DBT,

Rogerian, etc….)Rogerian, etc….)

Understanding MotivationUnderstanding Motivation

Ambivalence about change is normalAmbivalence about change is normal Change is often nonlinearChange is often nonlinear Readiness is not staticReadiness is not static Attend to readiness in your workAttend to readiness in your work

Why the use of Motivational Why the use of Motivational Interviewing is so importantInterviewing is so important

Each individual will be at a different Each individual will be at a different point with their motivation to changepoint with their motivation to change

This is a perfectly normal part of being This is a perfectly normal part of being human – we shouldn’t treat somebody human – we shouldn’t treat somebody as being sick or wrong simply because as being sick or wrong simply because they aren’t motivated to change as they aren’t motivated to change as much as we believe that they “should” much as we believe that they “should” bebe

Why the use of Motivational Why the use of Motivational Interviewing is so importantInterviewing is so important

It is the clinician’s job to HELP the It is the clinician’s job to HELP the consumer with his or her motivation consumer with his or her motivation levellevel

This process starts by learning to “meet This process starts by learning to “meet the consumer where he/she is at the the consumer where he/she is at the time”time”

Why the use of Motivational Why the use of Motivational Interviewing is so importantInterviewing is so important

Many of our consumers feel hopeless Many of our consumers feel hopeless about the possibility of recoveryabout the possibility of recovery

It is our job to provide hope when It is our job to provide hope when the consumer has none!the consumer has none!

How many people does it How many people does it take to change a light bulb?take to change a light bulb?

Only one, but the light bulb must Only one, but the light bulb must really want to change!really want to change!

The most important Skill The most important Skill Sets for Motivational Sets for Motivational

InterviewingInterviewing Identifying the stage of changeIdentifying the stage of change Using the four foundational Using the four foundational

principlesprinciples

The Stages of ChangeThe Stages of Change At a minimum, all clinicians at At a minimum, all clinicians at

Cummins will have a basic, working Cummins will have a basic, working familiarity with the stages of changefamiliarity with the stages of change

But to truly “master” Motivational But to truly “master” Motivational Interviewing, you need to be able to Interviewing, you need to be able to monitor the consumer’s stage of monitor the consumer’s stage of change constantly and change constantly and adapt your adapt your approach accordingly.approach accordingly.

The Stages of ChangeThe Stages of Change

PrecontemplationPrecontemplation ContemplationContemplation Preparation/PlanningPreparation/Planning ActionAction MaintenanceMaintenance

Four Foundational PrinciplesFour Foundational Principles

Express empathyExpress empathy Develop discrepancyDevelop discrepancy Roll with resistanceRoll with resistance Support self-efficacySupport self-efficacy

Of these four principles, “Developing Of these four principles, “Developing Discrepancy” is the one that Discrepancy” is the one that

actually gets things resolved. And actually gets things resolved. And please notice that it is the please notice that it is the

CONSUMER who resolves the CONSUMER who resolves the discrepancy, not the clinician.discrepancy, not the clinician.

This is an incrediblyThis is an incrediblypowerful approach!powerful approach!

After all, the consumer is the one After all, the consumer is the one who stands to benefit from the who stands to benefit from the change and is the one who will have change and is the one who will have to change the behaviors.to change the behaviors.

Therefore, it is only the Therefore, it is only the consumer’sconsumer’s reasons for making the change that reasons for making the change that matter, not the clinician’s.matter, not the clinician’s.

This means thatThis means thatMotivational Interviewing is:Motivational Interviewing is:

A A collaborativecollaborative approach, not a approach, not a confrontational approachconfrontational approach

Accomplishes its goal through Accomplishes its goal through the the empowermentempowerment of the of the consumerconsumer

SummarySummary MI is evidence-based and is built upon a MI is evidence-based and is built upon a

realistic understanding of how human realistic understanding of how human motivation works.motivation works.

It can be used along with any other It can be used along with any other treatment model.treatment model.

It is a collaborative model built upon It is a collaborative model built upon empowering the consumer and helping empowering the consumer and helping him/her find his/her own reasons to make him/her find his/her own reasons to make a positive change, and then reinforcing a positive change, and then reinforcing these reasons.these reasons.

Questions? / Comments?Questions? / Comments?

Thank you for your Thank you for your participation!participation!

Additional ResourcesAdditional Resources

Motivational Interviewing: Preparing Motivational Interviewing: Preparing people to change addictive behavior, people to change addictive behavior, Miller & Rollnick, 1991Miller & Rollnick, 1991

Building Motivational Interviewing Building Motivational Interviewing Skills: A practitioner workbook, Skills: A practitioner workbook, Rosengren, 2009Rosengren, 2009

A Toolkit of Motivational Skills, A Toolkit of Motivational Skills, second edition, Fuller & Taylor, 2008second edition, Fuller & Taylor, 2008