MotivationalInterviewing24seven Tobias Sandberg MI-trainer Memberof: MotivationalInterviewingNetworkofTrainers
MotivationalInterviewing • Developed by William R. Miller and Stephen Rollnick • Evidence-based method • Focus on motivation and change • Person-centered • Humanistic psychology
MotivationalInterviewing • Motivationalinterviewing is a collaborativeconversational style for strengthening a person’sown motivation and commitmenttochange.
A wayofbeing Structured conversation Influencing time (24seven)
A Continuumof Communication styles DirectingGuidingFollowing Allow Go along with Permit Listen Attend Stick to Elicit Collaborate Motivate Support Assist Inspire Command Decide Lead Rule Take charge Tell
Spirit of MI • Collaborativ • Evoking • Autonomy support • Empathy • Rule • Listen to me! • I decide • Antipathy X
We have to avoid… ”Roadblocks”/Righting reflex • Ordering, or commanding • Warning, or threatening • Giving advice • Telling people what to do • Shaming, ridiculing • Judging
Howto do… • Active listening • Try to understand the person’s dilemma Show Empathy
Empathy • Treatment provider who shows a high degree • of empathy in meeting with clients • increases the likelihood that: • "Resistance" is reduced. • Reduces relapse. • Reduction of interruptions in treatment. • Increases the change tendency. • Does not damage or worse treatment.
MI’s Communication skills Open questions Affirmations Reflections Summaries
When Worlds Collide Resistance/Discord
You are always nagging and complaining! I hate this place! I don’t know if I want to! I will always smoke weed!
Increases Resistance • Argue • Ignore • Raise our voice • Warn • Reduce • Feelings • Anger • Sadnes • Powerlessness • Frustration • Loneliness • Misunderstood • Reduce Resistance • Listen • Give choices • Confirm • Show empathy • Be present We can choose to try to reduce the resistance or cause it to increase
Someexamplesthatcanreduceresistance • You are always nagging and complaining! • You think I demand too much of you… • I will always smoke weed! • You think you’re going to smoke weed when you are forty… • - I don’t know if I want to! • You feel unsure about what you want… • I hate this place! • How do you think I can help you to feel a little better?
We try • Consistent and inconsistentwith MI • What do youthinkyouneedto do? • Youhavereallyexertedyourself. • Youare the onewhoknowyourself best. • If I'mabletohelpyou, you must do as I say. • I'mwarningyou! • I reallyappreciateyoutaking the time for this. • Nowyou listen tome! • How do yousee it?
Weuse the MI-spirit and MI’s Communication skillsto show Empathy and elicit the Clientsdilemma.
Change Talk “I want”, “I wish” Desire Ability Reasons Need Commitment Activation Taking Steps “I could do it”, “I am able to” “I want to live with my parents” “I must”, “I need to” “I've decided to ...”, “I am ready to…” “I went to the meeting this week”
Change Talk ………but……… It would feel good to practice, but I love to watch TV Change Talk and Sustain Talk “Other Side of the Coin”
It would be good for metotakemy medicine, but I ignoreit. I wantto stop drinking, but not now! I needhelp, butthis is no help.
We try • I actually have time to exercise • If I work out, I will be more alert • It's no fun to run in the rain • I'm too old to go to the gym. • I'll take the bike to work. • On Thursday I'll go out and run. • I will never find the strength to work out. • I know I can. • I've decided to start training
The first meeting Perhaps one of the most important encounter at the institution. We have to: • Remind us of the MI spirit • Be activelistenersand show empathy by using the OARS. • Make use of an MI strategy, Meny/Agenda
Meny/Agenda Call home Most important for you 4. 1. What happens next 3. Smoke 2. Råby 5.
Spirit of MI • Collaborativ • Evoking • Autonomy support • Empathy
The essens of MI The MI-Spirit Avoid confrontation and The righting reflex Elicit and respond Change talk
MI is simpel but not easy We need to train and assist each other in MI
Summaryof ”howto do” • The importance of MI-Spirit: • Collaborative, Evoking, Autonomy support, Empathy • MI is like dancing, you need to be controlling and following at the same time. • Most of the time use a guiding style • When we listen, we use active listening and try to show empathy • The first meeting is important • We can reduce resistance by our way of being • We listen and respond to change talk • We know that the more aperson expresses change talk the more likely it is that she makes a change
Thankyouverymuch! Tobias Sandberg MI-trainer Memberof: MotivationalInterviewingNetworkofTrainers Tobias.Sandberg@stat-inst.se