Hank: “ I have things I need to do to improve my marriage, my health, and my financial situation, but I honestly believe that I have zero chance of actually making any of those three things get better.”
laser questions • How will you know when your most important relationship has improved significantly? • Who will be the first person to notice that you’re happier, … what exactly will they notice? • How much better do you think your grades can get? And how can you reach that goal while having some fun at the same time? • What’s really great about this that I have not really noticed before?
laser questions • What changes will you need to make in order to get the most out of our work together? • How much stress will the copay for these sessions cause you? • What’s the most empowering thing that I can do during our sessions? • What would have happened if you’d not decided to do this work? • What is one regret you don’t want to have in this lifetime?
What our clients want most • make and keep more money • Get more done in less time • Communicate more effectively • Feel better physically and emotionally • Feel closer with others • Manage hassles and stressors • Find and stay on a path
“…they realized what thesolution was and were terrified”
The Five Reasons That People DoAnything That They Do
The Two Reasons That People DoAnything That They Do
The Two Reasons That People DoAnything That They Do R P REWARD PUNISHMENT
The One Reason That People DoAnything That They Do R REWARD P “W HAT ’ S THEIR PAIN ?”
Which Techniques Should AbsolutelyBe Avoided with Under-motivatedClients x
Which Techniques ShouldAbsolutely Be Avoided with Under-motivated Clients • Finessing our Questions x
Dangers of Failing to RecognizeOur Clients Stage of Change
Yes or No ?#1. I solved my biggest problem more than six months ago.#2. I have taken action on my problem within the past six months.#3. I am intending to take action in the next month. #4. I am intending to take action in the next six months.
Stages of ChangePrecontemplationContemplationPreparationActionMaintenance
Stages of ChangePrecontemplationContemplationPreparationActionMaintenance Appendix F
What Key Motivational InterviewingTechniques Can Be Applied to AnyClinical Situation?
What Key Motivational InterviewingTechniques Can Be Applied to AnyClinical Situation? • Express empathy • Create discrepancy • Roll with resistance • Support self-efficacy
Is relapse inevitable?
A completeRETHINKING OF BEHAVIORALPROBLEMS Strategic Behavioral Inquiry
What’s the kid’s deal?
The Magic IfWhat "Method Actors "Have ToTeach Clinicians
Inna: student struggling with difficult assignments, feeling demoralized and anxious.
Inna: “I just get blank. I usually start sitting more slouched, hold my head with my left hand…you freeze and instead of being able to think of alternatives, you start thinking to yourself that you cannot find a logical answer and you are tempted to avoid it as if it poses a threat somehow to you.”
The reward-and-planning system • Anticipate goal • Identify tasks • Sequence / problem-solve • Block out distractions • Get the reward
Alicia R. Ruelaz, M.D.: “the biggest issue for me, and others Ive seen, has been maintaining motivation between the excitement of setting a goal and not losing interest before it is completed.”
Juzer : “my biggest problem is that I want to do everything all at once!”
Preferred states inventory • Archeology of a Memory, Appendix H
Connecting with Return to WorkClients around the Key HumanNeeds Served by Employment Marie Jahoda
• 1. It imposes a time structure on the day.• 2. It enlarges the scope of relationships.• 3. It provides shared purposes and activities of a social group.• 4. It assigns social status and clarifies personal identity.• 5. It requires regular activity.RTW
• The Rule of ThirdsRTW
The Three Donts of EmploymentAssistance • Don’t talk about work • Don’t present work as a goal in itself • Don’t impose our values on clients
Four Signs That You Are WorkingHarder Than Your Clients • Fighting with client • Client is “yes butting” you • You worry more than they do • You dread the session
Four Signs That You Are WorkingHarder Than Your Clients And what you might be thinking….
How to Get Clients to Start Talkingabout Change • Slow down (tolerate silence) • Respect resistance • Be agnostic • Encourage agnosia • Why, specifrically, is this a problem? • Identify exceptions to the problem • Frame goals in the positive • Help clients talk like behaviorists
How to Get Clients to Start Talkingabout Change • Slow down • Respect resistance • Be agnostic • Encourage agnosia • Why, specifrically, is this a problem? • Identify exceptions to the problem • Frame goals in the positive • Help clients talk like behaviorists – More of what and less of what?
How to Get Clients to Start Talkingabout ChangeAccurate empathy + “more of what”Connecting the dots…
Connecting the Dots: Linking upTreatment Goals to What OurClient Already Loves • “Sell me on why this absolutely positively must change…” • Letter from the future x