Bill miller and steve rollnick equipoise and equanimity

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Bill miller and steve rollnick equipoise and equanimity

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

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