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Bill miller  and  steve rollnick equipoise and equanimity
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Bill miller and steve rollnick equipoise and equanimity

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  • 1. Equipoise and Equanimity in MI
    Bill Miller
    Stockholm, June 2010
  • 2. Equanimity as an Asset in Doing MI
    Emotional stability
    Composure
    Balance
  • 3. Counselor Aspiration
    Should I proceed strategically to favor the resolution of ambivalence in a particular direction?
    Or do I want to maintain equipoise/neutrality and not intentionally or inadvertently guide the person in one particular direction?
    MI was originally developed for the former situation
  • 4. Some Scenarios
    A woman deciding whether to have children
    An adolescent considering whether to use condoms
    A man injecting heroin and methamphetamine
    A drunk driver
    A soldier playing “Russian roulette”
    A sex offender contemplating new victims
    The waitress test
  • 5. Engaging and Guiding
    Identification of Change Goal
    A conscious choice
    Aspiration
    Equipoise
    ?
    Evoking Change Talk
    Planning
    Both choices involve equanimity,
    collaboration and autonomy
  • 6. Psycholinguistics of Choice
    Causing a person to argue for a particular position on a consequential issue, in the absence of salient demand context, increases the likelihood of movement in that direction
    Festinger’s cognitive dissonance theory
    Self-perception theory
    Rokeach’s value consistency theory
    MI process research
  • 7. Maintaining Equipoise
    Knowledge of the psycholinguistics of choice is relevant to keeping your balance
    Avoid eliciting differential change talk and thus inadvertently favoring one outcome
    This is different from client-centered theory, which offers few guidelines about what to reflect
    Truax (1966) found that Rogers inadvertently reinforced certain directions
  • 8. Keeping your balance
  • 9. Equipoise is where a classic decisional balance makes sense
    Giving consciously balanced attention to pros and cons in:
    Inquiry Elaboration Affirmation Reflection Summaries
  • 10. So is that MI?
    It is informed by MI research on language
    It involves engaging and skillful guiding (to explore pros and cons equally)
    OARS are key skills
    You are eliciting both sides of the dilemma
    Different from client-centered counseling
    According to Miller & Rollnick: No
    It’s MI when you have a change goal and are strategically guiding toward it
  • 11. Does it matter whether it’s MI?