Incorporating Frederickson’s Broaden-and-Build Model into Motivational Interviewing Groups

1. Incorporating Frederickson’s Broaden-and-Build Model into Motivational Interviewing Groups Karen Ingersoll1 and Chris Wagner2 1University of Virginia Department of Psychiatry and Neurobehavioral Sciences 2Virginia Commonwealth University Department of Rehabilitation Counseling Symposium presentation at the 3rd World Congress on Positive Psychology, Los Angeles, California Saturday, June 29, 2013

2. Frederickson’s Broaden and Build Model • Evolutionary perspective on positive emotions • Negative emotions have obvious functions in response to dangers • Alert, Fight, Flight • Positive emotions have functions beyond indicating well-being • Experienced during times of no danger • Build resources for the individual and tribe • Spiral up from interest to hope, creativity, joy • Can lead to broader views, persistent efforts • Over time, related to generative efforts that build infrastructure and culture

3. Psychotherapy and Negative Emotion People seeking help feel stuck People seeking help feel demoralized Traditionally focuses on distress and/or problems Typically seek a reason in the past for current negative emotions

4. Positive emotions “…broadenpeople's momentary thought-action repertoires, widening the array of the thoughts and actions that come to mind (Fredrickson, 1998; Fredrickson & Branigan, 2001)...” Frederickson, 2001, American Psychologist, 56(3): 218–226.

5. Psychotherapy and Positive Emotion • Can focus on building strength, moving toward better future • Motivational Interviewing • Does not seek deep insight from history • Focuses on present and near future • Does not install strengths or skills into a “damaged” person • Relies on eliciting from within a person • Uses client-centered (existential-humanistic) perspective

6. Individual and Group MI Similarities Motivate change through resolving ambivalence Balance client-centered and focus elements Avoid instructive, prescriptive, or directive clinician behaviors Balance focusing on current issues with staying open to new directions

7. Motivational Interviewing Groups Integrate MI techniques & strategies with group psychotherapy processes

8. Integrating MI Techniques & Strategies with Group Processes • Group MI uses similar techniques as individual MI • Open questions, Affirmations, Reflections, Summaries • Group MI uses similar strategies as individual MI • Exploring, Envisioning, Hypothetical change, Overt planning

9. Integrating MI Techniques & Strategies with Group Processes • Group MI uses group therapy processes • Linking members’ experiences and themes • Encourages group member ownership of the group • Encourages positive social norms within the group • Mutual respect • Constructive interactions • Providing support

10. Four Phase Model of MI Groups • Engaging the Group • Exploring Perspectives • Broadening Perspectives • Moving into Action

11. Four Phase Model of MI Groups • Engaging the Group • Attending to group climate of inclusion, welcoming, “we” • Decontaminating the referral process • Developing working relationships and norms within the group • Eliciting group guidelines

12. Four Phase Model of MI Groups • Exploring Perspectives • Open the group with a focus on the whole person, not the “problem” • Exploring participants’ perspectives on their lives and issues • Exploring Lifestyles • Exploring Ambivalence • Exploring Values

13. Four Phase Model of MI Groups • Broadening Perspectives • Envisioning a more satisfying future • Considering options for change • Exploring and enhancing confidence

14. Four Phase Model of MI Groups • Moving into Action • Defining, planning and implementing changes to improve life • Importance/Confidence review • Hypothetical change • Change planning • Strengthening commitment to change • Getting started • Dealing with challenges and setbacks

15. Summary: Broadening and Building Across MI Group Phases • Engaging the Group • welcoming, eliciting • Exploring Perspectives • holistic exploration • Broadening Perspectives • envisioning, options, increasing hope/confidence • Moving into Action • embracing life change, committing, beginning anew

16. Structuring MI Groups • Group types • Support, Psychoeducational, Psychotherapeutic • Structured to unstructured • Homogeneity vs. heterogeneity • Time-limited vs. open-ended duration • Closed membership to open enrollment

17. Questions? Comments? kareningersoll@virginia.edu

18. References Wagner, C.C. & Ingersoll, K.S. (2013). Motivational Interviewing in Groups. New York: Guilford Press. Barbara L. Frederickson, (2004). The Broaden and Build Theory of Positive Emotions. Philosophical Transactions of the Royal Society, 359 (1449): 1367-1377. Barbara L. Frederickson, (2001). The Role of Positive Emotions in Positive Psychology: The Broaden-and-Build Theory of Positive Emotions. American Psychologist, 56(3): 218–226.