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Motivational Interviewing: Helping People Change

Motivational Interviewing: Helping People Change. Jerica Berge, Ph.D., MPH, LMFT Assistant Professor Department of Family Medicine and Community Health University of Minnesota mohl0009@umn.edu. Disclosure Statement.

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Motivational Interviewing: Helping People Change

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  1. Motivational Interviewing: Helping People Change Jerica Berge, Ph.D., MPH, LMFT Assistant Professor Department of Family Medicine and Community Health University of Minnesota mohl0009@umn.edu

  2. Disclosure Statement I have no relevant financial relationships with the manufacturers(s) of any commercial products(s) and/or provider of commercial services discussed in this CME activity.

  3. Motivational Interviewing PREPARING PEOPLE FOR CHANGE

  4. Ambivalence The Dilemma of Change

  5. Ambivalence • State of having simultaneous, conflicting feelings: • Mixed Feelings • Uncertainty • Indecisiveness

  6. Consequences of Ambivalence • The result of being in a state of ambivalence can lead to avoidance or procrastination • OR…to deliberate attempts to resolve the ambivalence that may result in success or failure

  7. Ambivalence • Ambivalence about proposed behavior change is NORMAL • Direct persuasion or advice giving is NOT an effective method for resolving ambivalence for most patients

  8. The Righting Reflex Our desire to keep people from going down the wrong path, and to set things aright

  9. Righting Reflex vs. Ambivalence

  10. Advice Regarding Health Behavior Change • We like to give it • We’ve been trained to give it • It’s not very effective • We do it anyway

  11. Bad Example MI http://www.youtube.com/watch?v=80XyNE89eCs

  12. “Motivation to change is not a personality trait, but is affected by interpersonal interaction” Miller & Rollnick, 1991

  13. Four key principles • Express empathy • Develop discrepancy • Roll with resistance and avoid argumentation • Support self-efficacy

  14. Good Example of MI http://www.youtube.com/watch?v=URiKA7CKtfc

  15. What You Can’t Do with MI Ex. With a parent of a child who is overweight • In one given interaction you probably CANNOT: • Get the parent to totally change both the child’s eating AND exercise habits • Get the parent to change both the home food environment AND physical activity environment

  16. What You Can Do with MI You probably CAN: • Assess readiness for change • Engage with the parent so that she sees you as someone who would be willing to help if and when she wants help • Use reflective listening to encourage the parent to consider even a small step toward change • Plant the seed for behavior change by using the “confidence ruler” technique

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