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Addiction: A Pathology of Motivation and the Role of Motivational Interviewing in Substance Abuse Treatment
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Addiction: A Pathology of Motivation and the Role of Motivational Interviewing in Substance Abuse Treatment

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Final presentation for the Scaife Advanced Student Medical Seminar by Angela Condo

Final presentation for the Scaife Advanced Student Medical Seminar by Angela Condo

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Addiction: A Pathology of Motivation and the Role of Motivational Interviewing in Substance Abuse Treatment Presentation Transcript

  • 1. Primary Chronic DiseaseMotivation Choice
  • 2. What is Motivational Interviewing?
  • 3. Transtheoretical Model of Change
  • 4. I can control my behavior. I know my triggers and how to handle them. I am making changes. I avoid people, places, and things. I want to change. I can… Yeah, I have a problem; but it’s too hard to change or I don’t want to change.I don’t have a problem.I can stop if I want to.
  • 5. Principles of Motivational Interviewing• Express Empathy – “Put yourself in my shoes.”• Support Self Efficacy – Previous successes not failures• Roll with Resistance – “dancing, rather than wrestling”• Develop Discrepancy – Current Behavior and Values – Current Circumstances and Future Goals
  • 6. Spirit of Motivational Interviewing• Collaboration • Not hierarchy• Evocation • Not imposing or externally driven• Client Autonomy • Not authority or coercion
  • 7. MI: Progression through the Stages of Change Open ended questions Affirmations Reflections Summaries
  • 8. Role of Motivational InterviewingIncrease Change Talk & Readiness to ChangeIncrease Client Exp. Of Discrepancy Increase Client Engagement Decrease Resistance Improve Retention, Motivation, and Outcomes
  • 9. Role of Primary Care PhysiciansMotivational interviewing is an effective substance abuseintervention when used by clinicians such as primary carephysicians who are non-specialists in substance abusetreatment; it can enhance entry to and engagement in moreintensive substance abuse treatments. (Dunn et al, 2001)Form a Therapeutic AllianceAdhere to the spirit of MIBegin a discussion of change
  • 10. ReferencesAmerican Society of Addiction Medicine [ASAM]. (2011). Definition of addiction. Retrieved fromhttp://www.asam.org/research-treatment/definition-of-addictionApodaca, T. R., & Longabaugh, R. (2009). Mechanisms of change in motivational interviewing: areview and preliminary evaluation of the evidence. Addiction, 104, 705-715.Britt, E., Hudson, S. M., & Blampied, N. M. (2003). Motivational interviewing in health settings: areview. Patient Education and Counseling, 53, 147-155.DiClemente, C.C., Nidecker, M., & Bellack, A. S. (2008). Motivation and the stages of change amongindividuals with severe mental illness and substance abuse disorders. Journal of SubstanceAbuse Treatment, 34, 25-35.DiClemente, C. C., Schlundt, D., & Gemmell, L. (2004). Readiness and stages of change in addictiontreatment. The American Journal on Addiction, 13, 103-119.Dunn, C., Deroo, L., & Rivara, F. P. (2001). The use of brief interventions adapted from motivationalinterviewing across behavioral domains: a systematic review. Addiction, 96, 1725-1742.Jensen, C. D., Cushing, C. C., Aylward, B. S., Craig, J. T., Sorell, D. M., & Steele, R. G. (2011).Effectiveness of motivational interviewing interventions for adolescent substance use behaviorchange: a meta-analytic review. Journal of Counseling and Clinical Pyschology, 79, 433-440.Kalivas, P. W., Volkow, N. D. (2005). The neural basis of addiction: a pathology of motivation andchoice. American Journal of Psychiatry, 162, 1403-1413.
  • 11. Kazdin, A. E., & Nock, M. K. (2003). Delineating mechanisms of change in child and adolescent therapy: Methodological issues and research recommendations. Journal of Child Psychology and Psychiatry, 44, 1116-1129.Miller, W. (2004). Toward a theory of motivational interviewing. Retrieved fromhttp://www.motivationalinterview.orgMiller, W. R., Baca, C., Compton, W. M., Ernst, D., Manuel, J. K., Pringle, B., Schermer, C. R.,Weiss, R. D., Willenbring, M. L., and Zweben, A. (2006). Addressing substance abuse in health care settings. Alcoholism: Clinical and Experimental Research, 30, 292-302.Miller, W. & Rollnick, W. (2010). What’s new since MI-2? Retrieved fromhttp://www.motivationalinterview.orgMiller, W. R., Yahne, C. E., & Tonigan, S. (2003). Motivational interviewing in drug abuse services: a randomized trial, Journal of Consulting and Clinical Psychology, 71, 754-763.Motivational Interviewing. (2012). Overview of motivational interviewing. Retrieved from http://www.motivationalinterview.orgMoyers, T. B., Miller, W. R., & Hendrickson, S. M. L. (2005). How does motivational interviewing work? Therapist interpersonal skill predicts client involvement within motivational interviewing sessions. Journal of Consulting and Clinical Psychology, 73, 590-598.Velicer, W. F, Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998). Smokingcessation and stress management: Applications of the Transtheoretical Model of behavior change. Homeostasis, 38, 216-233.