Motivational Interviewing: A Brief Introduction

1. Motivational Interviewing: A Brief Introduction Presented by Ali Hall, member of the Motivational Interviewing Network of Trainers (MINT) 2011

2. Objectives • Increase our ability to enhance client importance, confidence and readiness for change • Increase our ability to ask effective, change-generating open questions • Identify options for increasing collaboration, evocation and autonomy support with clients

3. The most rewarding things?

4. And the challenges are…?

5. Motivational Interviewing • What works to increase another’s motivation? • What doesn’t work to increase another’s motivation?

6. Motivational Interviewing: A Working Definition Motivational Interviewing is a collaborative, person centered form of guiding to elicit and strengthen motivation for change (Miller and Rollnick, 2010)

7. Reasons for Practicing MI • It works! • It’s all in the welcoming, and welcoming is easy • It doesn’t cost much • Small intervention, big effect! • The opposite approach, confrontational counseling, has poor results • It fits well with other treatment interventions • It makes our jobs easier and more enjoyable

8. It Works! (continued) • Robust and enduring effects when MI is added at the beginning of treatment • MI increases treatment retention, adherence and perceived motivation • The effects of MI emerge quickly • The effects of MI tend to diminish over 12 months, except in additive studies

9. It Works! (continued) • Mean Combined Effect Size by problem area: 3 months: 12 months/follow up: • HIV risk: .72 .53 • Drug abuse: .51 .29 • Gambling: .44 .29 • Tx adherence: .42 .72 • Alcohol: .41 .26 • Diet/exercise: .14 .78 • Smoking: .04 .14

10. In order to be ready to change The person must be both willing and able Ready to Change? Willing= Importance Able= Confidence

11. Practice Exercise Scaling importance, confidence and readiness

13. MI Style • Collaboration • Evocation • Autonomy Support

14. Collaboration Evocation Autonomy Support Confrontation Education Authority Contrasting Styles

15. CONTRASTING COUNSELING STYLES Motivational Interviewing Confrontational Aggressive

16. Practice Exercise: Does MI Style Work? Contrasting Persuasion and the Motivational Conversation

17. Structure of an MI Conversation • Open questions • Affirmations • Reflections • Summaries

18. Practice Exercises • Change your questions, change the conversation • Affirm it, get more of it

19. What are your most important reasons for changing? For what are you motivated? What change do you want most? On a scale of 1 to 10,howimportantis it to you to change? In what ways are you already able to make the changes you want to make? What steps are you willing to take? How will you do it?

20. And the opportunities are…???

21. Debrief • Something I liked… • Something I learned… • The first thing I’ll try…

22. Excellent texts for further reading … Also: Arkowitz, H., Westra, H. A., Miller, W. R., & Rollnick, S. (Eds.). (2008). Motivational interviewing in treating psychological problems. New York: Guilford Press.

23. For Further Information and Assistance Ali Hall 415.238.2251 mi.consult.ahall@gmail.com