Motivational Interviewing


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A discussion of motivational interviewing: what is it, how does it work, and how can we start to use it with students face forced behavior change in academics?

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  • Welcome!Introduce myself (CSA Advisor) and topicMaster’s in counselingMy background with MI – structured research project
  • My friends joke with me that I need a lot of buffer/quiet time, so it wouldn’t be a presentation of mine if it didn’t include some introspection!We’ll be coming back to this throughout the presentation, and I’ll be asking you some questions that are in line with the MI style to give you a sense of what it’s like to answer those types of questions.
  • The idea is that there are many factors that might impact a student’s academic standing, and so lots of different kinds of changes to be made (flexibility)
  • We get stuck when there are two (or more) options/approaches that we can see working. We lose sight of what’s (really) important to us and become paralyzed. What does ambivalence look like with our students?(Note: ambivalence is normal!MI is used to propel a student out of ambivalence (feeling two ways about something).
  • In line with developmental advising: we’re building a relationship and forming a partnership (rather than prescriptive advising).Shared responsibility; in MI, this manifests in simply asking permission (ex with our scho pro documents).Identifying student’s goals and values – what’s important to YOU, and how does that compare to what people are telling you/what you are doing right now?I might not like the decisions the student makes! And that’s ok!
  • My background with binge drinking college students
  • One issue that impacts the process is where the student is in the change process.Transtheoretical model of intentional behavior changePrecontemplation: behavior is not a problem, not considering change; often labeled “resistant.” Not convinced that the negative aspects of the current or problem behavior outweigh the positive. When faced with forced change: Reluctant, rebellious, resignation, rationalization (4 R’s)Contemplation: acknowledge possibility of need for change; far from making a commitment to action, but is weighing options and gathering information. Hopeful, but the most ambivalence in this stage (paradox)Preparation: making a decision to change; developing action stepsAction: following through. Even the action stage is fragile and tenuous; can “relapse”
  • Decisional balance sheet, aka “Pro/con list” for us n00by types-Example of structuring conversation: when talking about status quo, let’s end on the costs (or negative);
  • Question: what makes you feel defensive?MI is used to help propel a student out of ambivalenceIncreasing change talk: the more I talk about doing something, the more likely I am to do it.The more time I spend defending something, the less likely I am to change.
  • In order for change to occur, a student must be RAW.When listening for change talk, listen for a student referring to these three areas(I’m ready, I’m confident in my ability, I want to change)
  • What are some examples of resistance that you’ve seen? What’s our natural response when that happens?
  • Remember, a resistance statement could be arguing for status quo, resistance to change, intention to stay the same, lack of confidence in ability to change.
  • Motivational Interviewing

    1. 1. Rolling with ResistanceUsing Motivational Interviewing with Probationary Students Sarah McKay, M.Ed; Academic Advisor for UGS
    2. 2. Discussion Goals History and techniques of Motivational Interviewing (M.I.) Discuss stages of change for probationary students Discuss potential application of M.I. style
    3. 3. Reflection Time Think of one situation in your life that you’reconsidering changing, but haven’t taken action yet (write it down) (Don’t worry, you’re not being asked to share!) What worries you about your current situation?
    4. 4. Forced Behavior Change Students placed on probation are being told by UT Austin that the need to change in a limited amount of time/credit hours Factors contributing to academic difficulty:  Adjustment to UT expectations  Home/family issues  Study skills  Lack of effective time mangement  Lacking academic goals or future plans  Physical/mental illness  Inadequate finances  Many more!
    5. 5. M.I.: What is it?A “directive, client-centered, counseling style for elicitingbehavior change by helping clients explore and resolveambivalence”“Motivational interviewing has one leading in a way that issubtle, gentle, responsive, and imaginative.” (Miller and Rollnick, 1991 & 2002)
    6. 6. General Principles of M.I.1. Express empathy and active listening: use of open- ended questions, assess readiness to change2. Develop discrepancy: allow students to provide arguments for change, use affirmation, transitional summary, and key questions3. Roll with resistance: avoid arguing for change; use reflective listening and provide information4. Support self-efficacy: work on belief for change, use summaries and work on negotiating a change plan
    7. 7. The Spirit of M.I. Collaboration  Partnership, asking permission from student Evocation  “Intrinsic motivation for change is enhanced by drawing on the [student’s] own perceptions, goals, and values” (Miller and Rollnick, 2002) Autonomy  Student has the right to make decisions (regardless of the advisor’s opinions)
    8. 8. M.I. Research and Application Historically, M.I. has been researched and used in health behavior change programs:  Smoking cessation  Weight loss  Addiction and substance abuse  Disease management/adherence to treatment
    9. 9. Stages of Change: Transtheoretical Model Change is a progression; series of decisions rather than one moveStages: Precontemplation** Contemplation** Preparation Action Maintenance (DiClemente & Prochaska, 1985)
    10. 10. Reflection Time What would be the advantages of making a change?If you could magically fix the problem immediately, how might things be better for you? Dumbledore, preparing to get all magical on your problem
    11. 11. Ambivalence “I want to change, and I don’t want to change.” Ambivalence is normal, but it keeps us stuck!Tools: Decisional balance sheet  Weighs the benefits/costs of status quo, costs/benefits of change
    12. 12. M.I.: Arguing for ChangeM.I. will: Increase student change talk Diminish student resistance talk What makes you feel defensive? More time student spends defending the status quo = More likely to stay the same More time student spends arguing for change = More likely to change behavior
    13. 13. RAW Is now the right Ready: time? Priorities!Can I do this? Able: Confidence! What’s most Willing: important to me? Importance! “Change starts when someone sees the next step.” -William Drayton
    14. 14. Clarifying Goals and Values Identifying issues important to the student Highlighting intrinsic motivation rather than extrinsic Change more likely to happen if it comes from inside Tool: Importance Ruler “Change will not come if we wait for some other person, or if we wait for some other time. We are the ones weve been waiting for. We are the change that we seek.” ― Barack Obama
    15. 15. Reflection Time How important is your issue to you, on a scale from 1 to 10?1=not important at all 10=the most important *The Importance Ruler*
    16. 16. Rolling with Resistance Resistance is a sign to respond differently A good general principle is to respond to resistance with nonresistance. (This means avoiding arguing) Simple reflection: acknowledging Double-sided reflection: developing discrepancyAmplification: magnifying resistance statement to the absurd Shifting the focus: detour Reframing: interpreting with new meaning Agreeing with a twist: reflection with reframe Emphasizing personal choice: reinforcing autonomy
    17. 17. Resistance Talk vs. Change TalkResistance Talk Change Talk Advantages of the status  Disadvantages to the quo status quo Disadvantages of change  Advantages of change Intention to stay the same  Intention to change Pessimism about change  Optimism about change (RAW) “Change quote”
    18. 18. Open Questions to Evoke Change Talk Disadvantages to the Status Quo Why do you think that you need to do something about your academic performance? In what ways does this concern you? How has this stopped you from doing what you want to do in life? What do you think will happen if nothing changes?
    19. 19. Open Questions to Evoke Change Talk Advantages of Change How would you like for things to be different? What would be the good things about doing better academically? What would you like your life to be like 5 years from now? What would be the advantages of making this change?
    20. 20. Open Questions to Evoke Change Talk Optimism about Change What encourages you that you can change if you want to? What do you think would work for you if you decide to change? Who could offer you helpful support in making this change?
    21. 21. Open Questions to Evoke Change Talk Intention to Change What are you think about your academic performance at this point? What do you think you might do differently? What are some steps you would be willing to try? Nevermind the “how” right now – what do you want to have happen? What do you intend to do in the next (insert time frame)?
    22. 22. Reflection Time How confident are you that you can make a change?What personal strengths do you have that will help you succeed?
    23. 23. Pettay, R. & Hughey, J. (2011)
    24. 24. Pettay, R. & Hughey, J. (2011)
    25. 25. Pettay, R. & Hughey, J. (2011)
    26. 26. Pettay, R. & Hughey, J. (2011)
    27. 27. Reflection TimeWhat steps might you be willing to try in order to work toward the change?
    28. 28. Discussion In pairs Throw a resistance statement to your partner Partner will practice an MI technique (amplified reflection, double-sided reflection, reframe, etc) Then, discuss potential applications for your program or office
    29. 29. ReferencesDiClemente, 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.Miller, W.R. & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press.Pettay, R. & Hughey, J. (2011). A mountain to climb: Strategies for working with probationary students. PowerPoint lecture presented at NACADA Conference, October 2011.