Acknowledgements

1. Acknowledgements Advancing Your Skills in Motivational Interviewing ken kraybill

2. Acknowledgements

3. You and MI

4. What it isWhere it came fromWhy it mattersWhat’s newHow you learn it Motivational Interviewing

6. Sound familiar? I give people myBEST ADVICE, but they won’t listen. IEDUCATEandGIVE OPTIONS. What else can I do? SheRESISTSeverything I suggest. Some folks just DON’T WANT TO BE HELPED. He’s inTOTAL DENIALabout his problems. Some people just needA GOOD TALKING TO!

7. Changing the Conversation

8. Dedicated to all who are weary... of trying to educate, advise, entice, convince, coax, cajole, persuade, sweet-talk, smooth-talk, guilt-trip, bribe, manipulate, or otherwise get people to change

9. hurts hopes nightmares dreams addictions desires delusions wisdom impairments strengths needs resources

10. Evoking from people what they already have? Giving people what they lack?

11. “People possess substantial personal expertise and wisdom regarding themselves and tend to develop in a positive direction, given the proper conditions and support.”Miller & Moyers, 2006

12. “You already have what you need, and together we will find it.”Miller & Rollnick, 2013

14. Is change possible?

15. Have you ever changed anyone? Yes, yourself... Text but no one else

16. What’s new?

17. “They say you can lead a horse to water, but you can’t make him drink. But I say, you can salt the oats.” • Madeline Hunter, author Can you make a difference?

18. A Brief History of MI

20. A Brief History of MI MI 1991 Focused primarily on addictions

21. A Brief History of MI MI 2002 Directed towards broad range of problem areas

22. A Brief History of MI MI 2013 Introduces new ways to conceptualize and teach MI

23. What’s new?

24. What’s new in MI3?Three definitionsFour elements of spiritFour broad processesBroadened focus of changeUnderlying processes of learning MI

25. 3 Definitions

26. Three definitions A collaborative conversation style for strengthening a person’s own motivation and commitment to change. Lay definition

27. Three definitions A person-centered counseling style for addressing the common problem of ambivalence about change. Practitioner’s definition

28. Three definitions 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. Technical definition

29. Okay, actually four A way of helping people talk themselves into changing

30. “Talking oneself into changing” MI conversation (spirit and skills)  Exploring ambivalence  Preparatory change talk  Commitment talk  Taking steps

31. What changes or decisions? Housing Employment Parenting approaches Children’s schooling Domestic violence Health/behavioral health issues Staying in/leaving a relationship Attitudes Attitudes Making tough decisions

32. 4 Elements of Spirit

33. The Spirit of MI A mind-set and heartset

34. “MI is not done on or to a person; it is done with and for a person.” • William R. Miller

35. Four Elements PARTNERSHIP ACCEPTANCE COMPASSION EVOCATION

36. PARTNERSHIP – demonstrating profound respect for the other; both parties have expertise; dancing rather than wrestling

37. PARTNERSHIP • Continuum of styles • - Directing • - Following • - Guiding

38. ACCEPTANCE - 1) Prizing the other’sinherent worth and potential 2) Providing accurate empathy 3) Supporting autonomy 4) Affirming strengths

39. People who experience themselves as unacceptable are often immobilized. When they experience being accepted as they are, they are freed to change.

40. ACCEPTANCE • 1) Prizing the other’s inherent worth and potential • An attitude of grace • Valuing others regardless of failings • Belief that people have within themselves the ability to change (without changing who they are)

41. ACCEPTANCE • 2) Providing accurate empathy • Taking an active interest in and seeking to understand the other’s inner frame of reference • Different from sympathy or identification with

42. ACCEPTANCE • 3) Supporting autonomy • Freedom to be and to choose

43. Telling people “you can’t” or “you must” tends to evoke defensiveness and their desire to reassert their freedom. On the other hand, directly acknowledging people’s freedom of choice, tends to decrease their defensiveness and facilitate change.

44. ACCEPTANCE • 4) Affirming strengths • Builds confidence, self-efficacy

45. COMPASSION - coming alongside in a person’s suffering; actively promoting the other’s welfare; giving priority to the other’s needs

46. “Let us not underestimate how hard it is to listen and to be compassionate. Compassion is hard because it requires the inner disposition to go with others to the place where they are weak, vulnerable, lonely and broken. But this is not our spontaneous response to suffering. What we desire most is to do away with suffering by fleeing from it or finding a quick cure for it.... And so we ignore our greatest gift, which is our ability to be there, to listen and to enter into solidarity with those who suffer.” • Henri J.M. Nouwen

47. Here is what we seek: a compassion that can stand in awe at what [homeless families] have to carry rather than stand in judgment at how they carry it.” Gregory Boyle, Tattoos on the Heart: The Power of Boundless Compassion

48. “Compassion is not a relationship between the healer and the wounded. It's a relationship between equals. Only when we know our own darkness well can we be present with the darkness of others. Compassion becomes real when we recognize our shared humanity.” • Ani Pema Chödrön

49. EVOCATION - eliciting the person’s own knowledge, wisdom, strengths, and motivation; “you have what you need and together we will find it”

50. 4 Broad Processes