Welcome to a brief introduction to Motivational Interviewing: Giving people a darn good listening to. Developing a conversational style to improve engagement and help others develop a desire for healthy attitudinal and behavioral change. Scott Janssen MSW, RSW MINT
“The greater part of instruction is being reminded of things you already know.” - Plato
You would think… …after a heart attack …after losing family …after 2nd DWI
Guiding Principles • Healthy behaviors are abnormal behaviors • People are influenced more by their own voice, than by others • Behavior is driven not by health outcomes but by social and psychological factors
Guiding Principles • Our task is to help people to become willing to do what is healthy • People are more interested in their own reasons to change, than ours
SMOKING: Good or Bad? …it’s not the message delivered, but the message received that is important. Smoking: Good or bad?
A Quick Look at ‘Change’;True or False? • 1. People dislike change. • 2. Repetitive patterns of self harming behavior are normal. • 3. If people can be made to feel guilty or fearful enough, resistance will break down and they will change.
Definitions of MI • MI is a collaborative conversation style for strengthening a person’s own motivation and commitment for change. • MI 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.
My personal favorite MI definition “MI is a gentle conversation about change.” -Stephen Rollnick
TTM: The Stages • Pre-contemplation “I won’t” • Contemplation “I might” • Preparation “I will” • Action “I am” • Maintenance “I have been”
A quick look at intrinsic motivation • People often learn what they believe by hearing ‘themselves’ speak. • The ‘Righting Reflex’. • The ‘Theory of Psychological Reactance’.
Case scenario 1:Eric 1. Patricia is a single parent after a very recent divorce. Her 16 year old son Eric just started his final year of high school and had always been a good student and was eager to get into Dalhousie to become an engineer. Patricia admits she has not been an attentive parent over the last year, but has now noticed Eric’s grades have plunged, and his mood is often sullen or agitated. Patricia learns from another parent that Eric has been drinking and partying with friends since his parents split. When you meet with Eric for the first time he tells you: “It’s not like I’m the only one doing it. A lot of my friends at school are the ones dragging me out on week nights. Let’s face it, I have the rest of my life to be boring. I’ll get serious about life later. I’ve always been able to do what I set my mind to do. My career goals have always been important, but right now is the time to play, while I’m young.”
The 3 Ingredients of Motivation • Priority (Ready) • Importance (Willing) • Confidence (Able)
The “Spirit” of Motivational Interviewing (Setting the PACE) • Partnership • Acceptance • Compassion • Evocation
The Four Processes of MI 1. Engagement 2. Focusing 3. Evocation 4. Planning
Five Early Methods of MI • 1. Open-ended questions • 2. Affirmations • 3. Reflective listening • 4. Summaries and • 5. Eliciting Change Talk
Change Talk: DARN CAT Mobilizing CT C Commitment A Activation T Taking Steps Preparatory CT D Desire A Ability R Reasons N Need
Beware of Traps:Six traps to avoid • 1. Question-Answer • 2. Taking Sides • 3. Expert • 4. Labeling • 5. Pre-mature Focus • 6. Blaming
“The most basic of human needs is the need to be understood. The best way to understand people is to listen to them.” – Ralph Nichols • “History repeats itself because no one listens the first time.”-Anonymous • “Sometimes people just need a darn good listening to.”
A Quick Review • Healthy behaviors are ___________ . • People are influenced more by_______. • “Sometimes people just need a darn good ________ to”. • A “Trap” refers to ___________________
Conclusion • Any last minute questions / comments?