Motivational Interviewing Implementation Workshop Jason Anderson EBP Program Administrator MN Department of Corrections August 26, 2011
THREE LEVELS OR TYPES OF IMPLEMENTATION: ‘Paper’ (nothing really changes) ‘Process’ (procedures change; not outcomes) ‘Performance’ (procedures & outcomes change) Fixsen et al. (2005).Implementation Research: A Synthesis of the Literature.
10 Things MI is NOT:Miller & Rollnick, 2009 • Transtheroretical Model • Stages of Change • A technique. • A way to trick people. • A Decisional Balance. • It does not require assessment feedback.
10 Things MI is Not (cont.): 6. A form of cognitive-behavioral therapy. 7. Just client-centered counseling. 8. Easy. 9. What you are already doing. 10. A panacea.
MI Defined: Motivational interviewing is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.
Stages of Learning Motivational Interviewing: Spirit OARS Recognizing Change Talk & Resistance Elicit/Strengthen Change Talk Roll w/Resistance Develop Change Plan Consolidate Commitment Transition/Blending
1. Overall Spirit: Collaboration Autonomy Evocation
2. OARS: (Client-Centered Listening Skills) Open-ended ?s Affirmations Reflections Summarizations
3. Recognizing Change Talk and Resistance Change Talk Sustain Talk Resistance
4. Eliciting and Strengthening Change Talk Evoke and Reinforce change talk Apply OARS strategically Missed Opportunities
5. Rolling with Resistance “Don’t wrestle with pigs…you’ll get muddy and the pigs love it.”
6. Developing a Case Plan: Case Planning: Emphasis is on… - Written plan - SMART format - Criminogenic behavior targets - Aligning, plan w/client’ motivation is optimal - Developing a case plan is an event Change Planning: Priorities are… - Alignment w/client’s motivation - Criminogenic needs of client are considered - Written plan is optional - Change planning is a process (not an event)
7. Consolidating Commitment Increasing strength of client’s commitment to change. Specify implementation intentions.
8. Transition and Blending Blending MI style with other interventions Transition between MI and other approaches
Implementation Considerations: • Training ≠ Implementation • Internal Capacity • Managerial Support • Ongoing measurement with coaching feedback.
Resources • <Motivational Interviewing Network of Trainers>http://motivationalinterviewing.org/ • <Stephen Rollnick>http://www.stephenrollnick.com/ • Jason Anderson, EBP Programs AdministratorJason.Allen.Anderson@state.mn.us