1 / 30

Motivational Interviewing An Empowerment approach

Motivational Interviewing An Empowerment approach. Dr. Annette Dunham MAPS School of Psychology Deakin University annette.dunham@deakin.edu.au. We will look at the principles and characteristics of Motivational Interviewing (MI) and discuss why MI is an empowerment approach.

jocelyn-zimmerman
Download Presentation

Motivational Interviewing An Empowerment approach

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Motivational Interviewing An Empowerment approach Dr. Annette Dunham MAPS School of Psychology Deakin University annette.dunham@deakin.edu.au

  2. We will look at the principles and characteristics of Motivational Interviewing (MI) and discuss why MI is an empowerment approach. • We will look at two of the four key processes in MI: • Engaging • Focusing • Evoking • Planning With particular emphasis on the EVOKING phase • We will practice some motivational interviewing skills. Overview

  3. “Health professionals should regularly advise obese patients about healthy living”. Dominion Post 09/06/14

  4. “Experts are trained to deliver prescriptions and advice, and they often work harder than we do trying to help us. But the expert approach actually lets us off the hook, sending the subtle message: ‘You aren’t in charge…’ When patients leave the clinic or office, they can and do veto recommendations a health professional makes”. (Glasgow & Anderson, 1999, pp. 2090-2092)

  5. Why Do We Need To Encourage Client self-management & Autonomy?

  6. Supported by five key principles: People want to remain autonomous People have potential to improve their capacity People's needs should be viewed in a holisticway HACC services should be organised around the person and carer; A person's needs are best met where there are strong partnerships and collaborative working relationships between the person, their carers and family, support workers and service providers The Active Service Modelhttp://www.bayside.vic.gov.au/community_services/smr_asm.htm

  7. Accept the client where they are today Guide clients towards building their self-efficacy Help clients define a meaningful purpose for health and wellbeing Ask clients to take charge –to take “the driver’s seat” in their own health management. Using a Coaching approachMoOre & Tschannen-Moran (2010)

  8. Comparing Models (Anderson & Funnell, 2005; Bodenheimer et al., 2002)

  9. (1) Motivational interviewing is a collaborative conversation style for strengthening a person’s own motivation and commitment to change. (2) Motivational interviewing is a person-centred counselling style for addressing the common problem of ambivalence about change. Miller & Rollnick (2012, p.29) Definition

  10. (3) Motivational interviewing 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. Miller & Rollnick (2012, p.29) Definition

  11. Why Motivational Interviewing?

  12. What Makes it Motivational Interviewing? 4 Key ProcessesMiller & Rollnick (2012)

  13. The “Spirit” of Motivational Interviewing Miller & Rollnick (2012) Collaboration Compassion Acceptance Evocation

  14. Resist the Righting ReflexMiller & Rollnick (2012)

  15. “Why would you want to make this change?” “How might you go about it in order to succeed?” “What are the three best reasons for you to do it?” “How important is it for you to make this change and why? “So what do you think you’ll do?” Five QuestionsMiller & Rollnick (2012, p.11)

  16. Engaging: OARSMiller & Rollnick (2012) • Open Questions • Affirmation • Reflection • Summaries

  17. FocusingMiller & Rollnick (2012) • “I know where we’re going, the focus is clear.” • Move to next steps: the evoking and planning processes • “There are several options - we need to decide.” • Work with client to identify possibilities and priorities • Agenda mapping may be useful with multi-issues • “The focus is unclear and we need to explore” • Use core skills to help client move from general to specific, e.g. OARS

  18. Agenda Mapping Miller & Rollnick (2012)

  19. Change and Sustain TalkMiller & Rollnick (2012)

  20. Evoking Change Talk: DARN CATS Miller & Rollnick (2012) Preparatory: Desire to change (want, like, wish…) Ability to change (can, could…) Reasons to change (If……then…….) Need to change (need, have to, got to…) Mobilising: Commitment (Intention, decision, promise) Activation (willing, ready, preparing) Taking Steps (doing)

  21. Desire: “How would you like things to change?” “What do you hope our work will accomplish?” Ability: “How might you do it?” “How confident are you that you could…?” Reasons: “What might be the best reasons for…?” “What might be good about quitting?” Need: “How important is it that you change?” “What do you think has to change?” EvokINg Change TalkMiller & Rollnick (2012)

  22. Evoking Change Talk Miller & Rollnick (2012) Importance Ruler: How important is the change?(1= Not important; 10= Extremely important)

  23. Evoking: Snatching Change Talk out of the Jaws of AmbivalenceMiller & Rollnick (2012) • Change talk is often inter-twined with sustain talk… • Show preferential reflection of change talk

  24. I really need to start having a regular walk to help maintain my weight, but I hate the thought of having to get up early to do it. You really don’t want to be bothered getting up early. You understand that you need to increase your exercise level to be healthy. You don’t think that you could keep this exercise going. Change Talk out of Ambivalence

  25. Evoking Confidence Miller & Rollnick (2012) Confidence Ruler:How confident are you that you can make this change? (1= Not confident at all; 10 = Extremely confident)

  26. Raising Challenges and Problems Miller & Rollnick (2012) • “What might you do if…?” • “How could you respond if…?” • “What do you think would happen if…?”

  27. Recognising ReadinessMiller & Rollnick (2012) • Diminished sustain talk • Resolve • Increased change talk • Questions about change • Envisioning • Taking steps Time for planning when: • Sufficient engagement • A clear shared change goal • Sufficient client motivation for change

  28. Evoking a Change PlanMiller & Rollnick (2012) • Setting goals • Considering change options • Arriving at a plan • Strengthening confidence • Eliciting confidence

  29. What Makes it Motivational Interviewing? 4 Key ProcessesMiller & Rollnick (2012)

  30. Anderson, B., & Funnell, M. (2005).The Art of Empowerment (2nd ed.). Alexandria, Virginia: American Diabetes Association. Bodenheimer, T., Lorig, K., Holman, H., & Grumbach, K. (2002). Patient self-management of chronic disease in primary care. Journal of the American Medical Association,288:19, pp.2469-2475. Miller, W. & Rollnick, S. (2012). Motivational Interviewing: Helping People Change (3rd ed.). New York, NY: Guildford Press Moore, M., & Tschannen-Moran, B. (2010). Coaching psychology manual. Philadelphia, PA: Lippincott, Williams & Wilkins. References

More Related