Practical Applications of Motivational Interviewing in Advising

1. Practical Applications of Motivational Interviewingin Advising Robert F. Pettay, PhD Kansas State University pet7@k-state.edu

2. Objectives -Become familiar with the fundamental spirit and principles of MI- Learn practical guidelines for the application of MI in advising- Understand use of empathetic counseling skills in advising- Understand the Stages of Behavior Change and MI strategies for each stage- Examine, apply, and discuss practice applications of MI with students in an advising session including behavior change, advancement and careers

3. Why change? • Until one is committed, there is hesitancy, the chance to draw back, always ineffectiveness, concerning all acts of initiative and creation. There is one elementary truth, the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then Providence moves too. All sorts of things occur to help one that would never otherwise have occurred. A whole stream of events issues from the decision. • Johann Wolfgang Von Goethe

4. Change

5. Advising approaches • How can an advisor help facilitate change in the student? • - Prescriptive advising approach • Tell them what to do • - Developmental advising approach • Help them figure out what they can do, and find motivation to do it.

6. Developmental advising • Acknowledges the individuality of students • Helps them integrate life, career, and educational goals • Connects curricular and co-curricular aspects of their educational experiences • Provides scaffolding that gives them opportunities to practice decision-making and problem solving skills • Supports motivation to make change* • (Smith & Allen, 2006)

7. Motivation is fundamental to change • Change occurs naturally • Interventions mirror natural change • The likelihood that change will occur is influenced by interpersonal interactions • Behavior change in treatment happens within the first few sessions • The clinician influences dropout, retention, adherence, and outcome • An empathetic style seems to facilitate change • People who believe they are likely to change do so • What people say about change is important

8. Motivational interviewing • A ‘directive, client-centered, counseling style for eliciting behavior change by helping clients explore and resolve ambivalence’ • Miller & Rollnick (1991) • Helping clients recognize and do something about their current or potential problems

9. Learning Motivational Interviewing • There are no tricks for getting people to do things • MI is a systematic and collaborative method for helping people explore their own values and motivations, and how these may be served by status quo or behavior change. • MI communicates “you have what you need” • (Hettema, Steele, & Miller, 2005)

10. Dancing not Wrestling • Motivational interviewing has one leading in a way that is subtle, gentle, responsive, and imaginative. • Miller and Rollnick, 1991

11. Three kinds of Behavior Change Interventions • Brief advice • Initiate thinking about change • Behavior change counseling • Build motivation for change • Motivational interviewing • Elicit commitment to change

12. 8 stages in learning MI • The spirit of Motivational Interviewing • OARS • Recognizing change talk • Eliciting and reinforcing change talk • Rolling with resistance • Developing a change plan • Consolidating client commitment • Integrating MI with other methods • Miller & Rollnick (2006)

13. Where to use MI in Advising Finding a major Career choices Academic probation Time management issues Changing a limiting behavior …?

14. Theory of MI • MI will increase client change talk • MI will diminish client resistance • The extent to which clients defend the status quo will be inversely related to behavior change • The extent to which clients verbally argue for change will be directly related to behavior change

15. For change to occur (RAW) • Client must be : • Ready • A matter of priorities • Able • Confidence for change • Willing • Recognize the importance of change

16. Avoid the Righting Reflex • Why don’t you want to change? • How can you tell me you don’t have a problem? • What makes you think you are not at risk? • Why don’t you just… • Why can’t you…

17. Eliciting Change Talk - Questions • Disadvantages of the status quo • What do you think will happen if you don’t decide on a career? • What worries you about being on academic probation? • If you don’t change, what do you think will eventually happen to you? • Advantages of change • What would be the benefits of choosing a major? • If you were off academic probation, how would your life be different? • What would be good about deciding on a career? • Optimism about change • If you decided to make this change, what makes you believe it is possible? • Tell me a situation where you have overcome similar challenges successfully? • Who is available to provide you support to make this change? • Intention to change • How are you feeling about your academic situation at this time? • What changes are you willing to try? • What do you intend to do now?

18. Four general principles of MI • 1- Express empathy – active listening • Acceptance facilitates change • 2- Develop discrepancy • Client provides arguments for change • 3- Roll with resistance • Avoid arguing for change • 4- Support self-efficacy • Belief in the person’s ability to change

19. Express empathy • Acceptance facilitates change • Skillful reflective listening is fundamental • Ambivalence is good

20. Develop discrepancy • The student rather than the advisor should present arguments for change • Change is motivated by a perceived discrepancy between present behavior and important personal goals or values

21. Roll with resistance • Avoid arguing for change • Resistance is not directly opposed • New perspectives are invited but not imposed • The student is the primary resource in finding answers and solutions • Resistance is a signal to respond differently

22. Support self-efficacy • A person’s belief in the possibility of change is an important motivator • The student is responsible for choosing and carrying out the change • The advisors own belief in the student’s ability to change becomes a self-fulfilling prophecy

23. Students as teachers • Talk less than your student does • Offer 2 or 3 reflections for every question you ask • Ask twice as many open-ended questions as closed questions • More than half of reflections should be deeper, more complex reflections

24. Goal is to elicit change talk • How important would you say it is for you to ____________? • And how confident would you say you are, that if you decided to ____________, you could do it? • Scale: 0 not at all important to10 extremely important

25. Establish Rapport Set the Agenda Assess Importance and Confidence Explore Importance/ Values and Build Confidence Exchange Information Reduce Resistance Open Questions Affirmation Reflective Listening Summarizing Encourage Change Talk Enhance Motivation to Change

26. Strength of Commitment Scale High • I will/promise/swear/guarantee • I intend to/agree to/ am ready to • I plan/expect resolve/aim to • I hope to/will try to/will see about • I guess/think/suppose I will Low

27. Questions to evoke commitment • Is that what you want to do? • Can you do it? • Is there reason enough to do it? • Is it important enough to do it? • Will you do it? • So what do you think you’ll do? • Why do you want to do it? • Is that what you need to do?

28. Transtheoretical model and Behavior Change • One issue that impacts the process is the where the client is in the change process. • Transtheoretical model of intentional behavior change • (DiClemente & Prochaska, 1985) • Change is viewed as a progression

29. Stages of change • Path to change

30. Stages of change Precontemplation : behavior is not a problem, not considering change Contemplation : acknowledge possibility of need for change Preparation : making a decision to change Action : implementing a plan for change Maintenance : comfortable with change

35. Summarize arguments for change/acknowledge reluctance Ask a key question, like “What do you think you will do now?” Provide information and advice Set Goals Consider change options Make a plan Elicit Commitment to the Plan Support Commitment to the Plan Review and Revise Plan, If Needed

36. The first session • First session sets tone and expectations • Rapport in the first session influence whether the person comes back • Opening structure • The amount of time you have available • An explanation of your role and goals • A description of the student’s role • A mention of details to be attended to • An open-ended question

37. Strengthening change talk –key questions • What do you think you will do? What are you thinking at this point about ____? • What changes, if any, are you thinking about making? • What could you do? What are your options • What happens next? • Where do you go from here? • How would you like things to turn out now, ideally? • What would be some good things about making this change?

38. Making a change plan • Setting goals • Considering change options • Arriving at a plan • Eliciting commitment

39. References Bem, D.J. (1972). Self-perception theory. In L. Berkowitz (Eds.) Advances in Experimental Social Psychology, (pp. 1-62). New York: Academic. Crookston, B.B. (1972). A developmental view of academic advising as teaching. Journal of College Student Personnel, 13, 12-17. DiClemente, C. C, & Prochaska, J. O. (1985). Processes and stages of change: Coping and competence in smoking behavior change. In S.Shiffman & T. A. Wills (Eds.), Coping and substance abuse (pp. 319-343). San Diego, CA: Academic Press. Hettema, J., Steele, J., & Miller, W.R. (2005). Motivational Interviewing. Annual Review of Clinical Psychology, 1, 91-111. Miller, W.R. (1983). Motivational Interviewing with problem drinkers. Behavioral Psychotherapy, 11,147-172. Miller, W.R., and Rollnick, S.(1991) . Motivational Interviewing: Preparing People To Change Addictive Behavior. New York: Guilford Press. Miller, W.R., & Rollnick S. (2006). Eight stages in learning motivational interviewing. Journal of Teaching to the Addictions. Miller, W.R., & Rollnick, S. (2009). Ten things that Motivational Interviewing is not. Behavioural and Cognitive Psychotherapy, 37, 129-140. Smith, C.L. & Allen, J.M. (Spring, 2006). Essential functions of academic advising : What students want and get. The Journal of the National Academic Advising Association, 26(1). 56-66. Winston, R.B. & Sandor, J.A. (1984). Developmental academic advising : What do students want? NACADA Journal, 4(1), 5-13. http://www.motivationalinterview.org/