Motivational Interviewing and Positive Psychology

1. Motivational Interviewing and Positive Psychology Chris Wagner, Ph.D. Licensed clinical psychologist Virginia commonwealth university

2. Motivational Interviewing • Empathic, goal-oriented approach that promotes change by resolving ambivalence • Draws from wide range of sources • Essentially pragmatic rather than theoretical • Both relational and technical components are integral • Relational components have emphasized positive elements; technical components mixed emphasis • No well-defined model of motivation

3. Motivation as Inspiration (Relational) • Rogerian basis: people are motivated toward growth/wellness • Rogerian conditions of empathy and unconditional acceptance facilitate positive growth/change • Supporting client autonomy facilitates positive change • Enhancing confidence promotes positive change

4. Ambivalence Status Quo or Negative Change Positive Change

5. Ambivalence Interest in Changing Positive emotions Vision/Confidence/Hope about Changing Focused Readiness to Change Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganized Other Priorities

6. Motivation as Discontent (Technical) • Cognitive Dissonance (Festinger)– Dissonant cognitions produce tension. • People are motivated to reduce dissonance between contradictory beliefs. • Values Clarification (Rokeach) – Discrepancy between values and behavior produces tension of lowered self-regard. • People are motivated to reduce tension from discrepancies between how they think they should act/be and how they actually do act. • Decisional Balance (Janis and Mann) – Ambivalence produces decisional conflict; apprehension, desires to escape, self-blame • People are motivated to resolve conflict by escaping, impulsive decision-making or careful consideration of pros and cons of options

7. Ambivalence • Developing Discrepancy • How do problem behaviors fit with your values? Identity? Interest in Changing Positive emotions Vision Confidence/Hope about Changing Readiness to Change Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganization Other Priorities

8. Ambivalence • Developing Discrepancy • How do problem behaviors fit with your values? Goals? Interest in Changing Positive emotions Vision Confidence/Hope about Changing Readiness to Change Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganization Other Priorities • Negative Reinforcement • Motivating person by increasing tension that person wants to escape or avoid by reducing discrepancy

9. Classic Emotions Theory • Negative emotions (anger, fear, sadness, disgust) • Increase tension • Narrow cognitive focus • Serve to protect people from present or near danger • Prime for action (action tendencies, “fight or flight”) • Anger – Attack • Fear – Escape • Sadness – Wall off • Disgust - Expel

10. Frederickson’s Positive Emotions Theory (Broaden and Build model) • Positive emotions (joy, curiosity, contentment) • Reduce tension • Broaden cognitive focus • Help people build resources for future threats • Prime for development (thought-action tendencies) • Joy – play – builds physical, socioemotional, intellectual skills • Curiosity – explore – increases knowledge and pscyhological complexity • Contentment – relax – builds resilience, appreciation, interpersonal bonds • Elevation – seek – increases inspiration, creativity, development

11. Frederickson’s Positive Emotions Theory (Broaden and Build model) • Finding positive meaning in adversity predicts greater well-being, better health • Upward spirals • Positive perspective/meaning fosters positive emotions • Positive emotions increase finding positive meaning through broadening perception • Upward spiral produces greater resilience and positivity

12. Ambivalence • Positive Discrepancy • What is your vision of how you’d like your life to be? • Negative Discrepancy • How do problem behaviors fit with your values? Identity? Interest in Changing Positive emotions Vision Confidence/Hope about Changing Readiness to Change Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganization Other Priorities • Negative Reinforcement • Motivating person by increasing tension that person wants to escape or avoid by reducing discrepancy

13. Ambivalence • Positive Discrepancy • What is your vision of how you’d like your life to be? • Negative Discrepancy • How do problem behaviors fit with your values? Identity? Interest in Changing Positive emotions Vision Confidence/Hope about Changing Readiness to Change Desire to Stay Same Negative Emotions Lack of Vision, Hope, Confidence Disorganization Other Priorities • Negative Reinforcement • Motivating person by increasing tension that person wants to escape or avoid by reducing discrepancy • Positive Reinforcement • Motivating person by increasing desire to move toward more fulfilling future

14. Negative vs. Positive Motivation

15. Negative vs. Positive Focus in MI

16. Positive Emotions and MI • Positive focus in MI • Soothes client defensiveness • Makes conversation a rewarding event • Broadens cognitive focus to consider previously overlooked or rejected perspectives, options, attitudes, identities • Cognitive flexibility helps resolve ambivalence and increases openness to engage in actions leading to health change • Can increase confidence, sense of accomplishment, self-esteem and mood • These serve as increased resources to draw upon in service of change

17. MI Groups (Wagner & Ingersoll, in press) • Four Phases • Engaging the Group • Exploring Members’ Perspectives • Broadening Members’ Perspectives • Moving Into Action • Focus on the Positives • Negative focus (dissatisfactions) riskier in group than individual – breeds conflict, harder to turn ship around • Positive focus increases sharing, support, altruism, creativity, confidence, connects members to wisdom and resources of the larger group and enhances group energy for change • Protecting factor for times of group stress or crisis

18. (8) Broadening Perspectives – Looking Forward/ Envisioning • Share a vision for how things might be different in the future. How they may desire things to be if they could choose. • Link together on content, motivation to change, specific visions. • Identify a few personal strengths; explore and link • How might those strengths help moving forward?