Motivational Interviewing

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Motivational Interviewing

  1. 1. Motivational Interviewing for Addictive Behaviors Cosette Rae Christopher Salas-Wright Amber Garnett Allie Armstrong Celia Viveros February 19, 2009
  2. 2. What is Motivational Interviewing? <ul><li>“ directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence” ~ Miller and Rollnick(1991) </li></ul><ul><li>An approach designed to help clients build upon commitment and reach a decision to change. </li></ul><ul><li>Useful for clients that are reluctant to change and ambivalent about changing. </li></ul><ul><li>Broadly applicable in the management of diseases that are associated with behavior: alcohol abuse, drug addiction, smoking cessation, weight loss and many more </li></ul>
  3. 3. The Motivational Interviewing Approach <ul><li>De-emphasis on labels </li></ul><ul><li>Emphasis on personal choice and responsibility for deciding future behavior </li></ul><ul><li>Therapist conducts evaluation, but focuses on eliciting the client’s own concerns </li></ul><ul><li>Resistance is met with reflection </li></ul><ul><li>Treatment goals and change strategies are negotiated between client and therapist; client’s involvement in and acceptance of goals are seen as vital </li></ul>
  4. 4. Basic Principles of MI <ul><li>Clinical principles underlying motivational interviewing: </li></ul><ul><ul><li>Express empathy </li></ul></ul><ul><ul><li>Develop discrepancy </li></ul></ul><ul><ul><li>Avoid argumentation </li></ul></ul><ul><ul><li>Roll with resistance </li></ul></ul><ul><ul><li>Support self-efficacy </li></ul></ul>
  5. 5. Expressing Empathy <ul><li>Empathic warmth and reflective listening used throughout process of MI </li></ul><ul><li>Acceptance facilitates change </li></ul><ul><li>Ambivalence is normal </li></ul>
  6. 6. Develop Discrepancy <ul><li>Create and amplify, in the client’s mind a discrepancy between present behavior and broader goals to motivate change </li></ul><ul><li>Awareness of consequences is important </li></ul><ul><li>The client should present the arguments for change </li></ul>
  7. 7. Avoid Argumentation <ul><li>Arguments are counterproductive </li></ul><ul><li>Defending breeds defensiveness </li></ul><ul><li>Resistance is signal to change strategies </li></ul><ul><li>Labeling is unnecessary </li></ul>
  8. 8. Roll with Resistance <ul><li>Statements that a client offers can be turned or reframed slightly to create a new momentum toward change </li></ul><ul><li>Momentum can be used to good advantage </li></ul><ul><li>Perceptions can be shifted </li></ul><ul><li>New perspectives are invited but not imposed </li></ul><ul><li>The client is a valuable resource in finding solutions to problems </li></ul>
  9. 9. Support Self-Efficacy <ul><li>Self-efficacy refers to a person’s belief in his or her ability to carry out and succeed with a specific task </li></ul><ul><li>Belief in the possibility of change is an important motivator </li></ul><ul><li>The client is responsible for choosing and carrying out personal change </li></ul><ul><li>There is hope in the range of alternative approaches </li></ul>
  10. 10. Stages of Change
  11. 11. PRE-CONTEMPLATION
  12. 12. Reluctant
  13. 13. Rebellious
  14. 14. Resigned
  15. 15. Rationalization
  16. 16. CONTEMPLATION
  17. 17. PREPARATION
  18. 18. ACTION
  19. 19. MAINTENANCE
  20. 20. RELAPSE
  21. 21. Pros and Cons Exercise
  22. 22. Readiness Ruler
  23. 23. “Real” Play
  24. 24. Effectiveness of MI <ul><li>Many “adaptations” of motivational interviewing (AMI) </li></ul><ul><li>Mounting empirical research has proven the effectiveness of AMI in a variety of clinical problems. </li></ul><ul><li>The majority of studies have been done on alcohol problems and drug addiction AMI, research in other areas support efficacy in other problems. </li></ul><ul><li>In about 80% of studies, MI used in a scientific setting has been proven to outperform traditional advice giving </li></ul><ul><li>Can be effective even in brief encounters(15 min) </li></ul><ul><li>Internal Validity-can be variable, sometimes weak </li></ul><ul><li>External Validity- very strong </li></ul>

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