Motivational Interviewing for Difficult Conversations

Cathy Cole, MSSW, LCSWMember, Motivational Interviewing

Network of Trainers, Inc.ASWB Provider 1177

http://www.cathycoletraining.comcathy@cathycoletraining.com

Motivational Interviewing is the work of William Miller and Stephen RollnickI am honored to teach MI.

Difficult Conversations

• What are they?• How do they get initiated?• What happens then?• Worst possible outcome?• Best possible outcome?

Discord = Not Being Understood!

Discord Shows Up!• Client: ‘Being made to come

here is just not fair.’• You:

Understanding/meeting the client: ‘You feel very pushed; however you feel is okay. I hope we can find a way to make the time useful for you around this issue.’

• Client: ‘Being made to come here is just not fair.’

• You: Understanding/meeting the client: ‘You feel very pushed; however you feel is okay. I hope we can find a way to make the time useful for you around this issue.’

You Create Discord!• Client: ‘Well, that may be

what you think I should do, but you can’t make me!’

• You: Understanding/meeting the client: ‘You are totally correct and I apologize for pushing you. Let’s back track. What would be most helpful right now?’

• Client: ‘Well, that may be what you think I should do, but you can’t make me!’

• You: Understanding/meeting the client: ‘You are totally correct and I apologize for pushing you. Let’s back track. What would be most helpful right now?’

Motivational Interviewing Defined: A Directional Method

Motivational Interviewing is a collaborative style of communication for strengthening a person’s own motivation and commitment to change.

MI is a person-centered counseling method for addressing the common problem of ambivalence about behavior change.

MI is a collaborative, goal oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.

Motivational Interviewing, Helping People Change, Miller and Rollnick, 3rd Edition, Guilford, 2013

Spirit of MI

The Person with Whom We are

Interacting

Partnership

Acceptance

Compassion

Evocation

Engaging: Connecting with and understanding the perspective/concerns of the other person

Focusing: Based on those concerns, what direction are we headed in?

Focusing: Based on those concerns, what direction are we headed in?

Evoking: Where is the person in the process of change?

Planning: when “yes” to moving ahead, what will that look like?

Planning: when “yes” to moving ahead, what will that look like?

Four Processes of MI

What to Avoid

• Going too fast• Not giving the parent time to respond• Missing the point• Trying to get too much done at one time• Coming across as blaming• Providing, as opposed to, eliciting solutions

What Might Help

• Being clear about any constraints you have• Understanding and honoring cultural

perspective• Demonstrating a non judgmental attitude• Agreeing on any small change

A Useful MI Tool

• Elicit, Provide, Elicit– What do you know? May I share some information?

Where does that leave you now?– I’d like to talk about …..with you if that is okay. I have

a concern about……What’s it like for me to bring that up?

– If you were going to do anything differently, what would that be? If you can’t think of anything, may I offer some ideas? Out of those, what might work or what other ideas does this bring up for you?

Resources

• Motivational Interviewing, Helping People Change, Miller and Rollnick, 2013 Guilford

• Further training: www.cathycoletraining.com • cathy@cathycoletraining.com • 919-360-3071