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Motivational Interviewing Club - The 4 MI Processes


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Engaging, Focusing, Evoking and Planning in Motivational Interviewing - A structure with which we can help people to consider change -

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Motivational Interviewing Club - The 4 MI Processes

  1. 1. December 2016 with John Russell / Follow us on Twitter @miinlondon / Tweet #miinlondon 1 Topic: The 4 MI Processes Welcome to MI Club
  2. 2. Four MI Processes 2 Aims and Objec0ves
  3. 3. 3 Aims of today 1.  To recognise the 4 processes in MI. 2.  To learn how to flow through each process and recognise they are not always linear. 3.  To practise open questions in each process. 4.  To watch a trainer demonstration. 5.  Have a laugh! This is a safe place to practise.
  4. 4. Objectives 4 •  18:00 – 4 Processes (Ps): Your experience •  18:10 – 4 Ps: What are they / Why use them? •  18:20 – Practise (yay!) •  18:40 – Trainer Demonstration •  18:50 – Debrief
  5. 5. Four MI Processes 5 What does good look like?
  6. 6. 6 Think about a time when someone tries to make a plan or set a goal with you, but you’re not ready to. 1.  How do you react? 2.  Have you ever tried to make a plan with someone who you thought was ready but wasn’t. How did this go? 3.  Talk to the person/people next to you to discuss (5 mins) 4.  Then we’ll all have the chance to feedback as a group Send us a Tweet: @MIinlondon
  7. 7. Four MI Processes 7 What does MI literature say?
  8. 8. 8 The 4 MI Processes Send us a Tweet: @MIinlondon Engaging Focusing Evoking Planning
  9. 9. 9 The 4 MI Processes Send us a Tweet: @MIinlondon Following the 4 MI Processes set’s an informal structure of where to guide your client. We may use different uses of OARS throughout. Today we’ll focus on open questions, and how these may differ through each of the processes.
  10. 10. 10 Process 1: Engaging “Engaging is the process by which both parties establish a helpful connection and a working relationship” – Miller and Rollnick, 2012 Send us a Tweet: @MIinlondon
  11. 11. TIP 11 Remove the ‘Chat Trap’ “In one treatment study, higher levels of in-session informal chat predicted lower levels of client motivation for change” (Bamatter et al., 2010)
  12. 12. 12 Process 1: Engaging WHAT MIGHT YOU BE ASKING IN THIS PROCESS “What is is that’s brought you here today?” “What’s been your experience of XYZ condition?” “I’m wondering how things have gone for you since we spoke?” NEXT: FOCUSING Send us a Tweet: @MIinlondon
  13. 13. 13 Process 2: Focusing “Focusing is the process by which you develop and maintain a specific direction in the conversation about change” – Miller and Rollnick, 2012 Send us a Tweet: @MIinlondon
  14. 14. 14 Send us a Tweet: @MIinlondon
  15. 15. 15 Process 2: Focusing WHAT MIGHT YOU BE ASKING IN THIS PROCESS “Would you be willing to go thorugh an agenda map?” “I have some things I’d like to chat about today [such as XYZ], what are some of the things you might like to discuss?” NEXT: EVOKING Send us a Tweet: @MIinlondon
  16. 16. 16 Process 3: Evoking “Evoking is having the person voice the arguments for change” – Miller and Rollnick, 2012 Send us a Tweet: @MIinlondon
  17. 17. 17 Step 3: Evoking Send us a Tweet: @MIinlondon Evoke: “To elicit or draw forth”
  18. 18. 18 Step 3: Evoking WHAT MIGHT YOU BE ASKING IN THIS PROCESS “Would would some advantages be of XYZ change?” “What might get worse if things stayed the same?” “How might life be different for you if you did change?” NEXT: PLANNING Send us a Tweet: @MIinlondon
  19. 19. 19 Process 4: Planning “Planning is a process of negotiation and collaboration drawing on the client's expertise (as well as your own).” – Miller and Rollnick, 2012 Send us a Tweet: @MIinlondon
  20. 20. TIP 20 Don’t plan too soon! “If you try to develop a change plan before the client is sufficiently ready you may undo whatever progress you have made through engaging, focusing and evoking.”
  21. 21. 21 Process 4: Planning WHAT MIGHT YOU BE ASKING IN THIS PROCESS “What do you think would be some ways to take this forward?” NEXT: LET’S PRACTISE Send us a Tweet: @MIinlondon
  22. 22. Four MI Processes 22 MI Skills Prac0se
  23. 23. MI Snakes and Ladders (MI is 10% theory, 90% practise) 23 Send us a Tweet: @MIinlondon
  24. 24. 10 minutes group practise. Using open questions •  Please get into groups of 3! 24
  25. 25. 4 Processes Snakes & Ladders: 1.  Receive a game board & one set of colours 2.  Choose a counter per person 3.  Choose who goes first, this is the person whose birthday is nearest to Christmas! 4.  This person is player 1, to the left of you is player 2, to the next left is player 3. 25
  26. 26. 4 Processes Snakes & Ladders: 1.  I will draw two cards in place of dice, these added together will be the number of squares moved by whomever’s go is next. 2.  We will then go to player 2 and repeat, etc. 3.  This will continue until we have a winner from each team! 26
  27. 27. Debrief in your groups Discuss: 1.  Did you find any one process more difficult the others? 2.  How might you work on that in the future? 27
  28. 28. Debrief as a full team What comments, questions or observations do you have? 28
  29. 29. Four MI Processes 29 Trainer Demonstra0on
  30. 30. Live Trainer Demo Can I have a volunteer? 4 Processes on next slide… 30 Send us a Tweet: @MIinlondon
  31. 31. 31 The 4 MI Processes Send us a Tweet: @MIinlondon Engaging Focusing Evoking Planning
  32. 32. Four MI Processes 32 Summary of today + Ques0ons
  33. 33. Ques1ons Q: How do you know when the right 1me is go towards the planning stage? A: Whilst there are always opportune moments to veer towards the collabora1ve joy that is the planning there are plenty of piDalls to avoid. As we discussed during the ‘mul1ple op1ons’ during the trainer demonstra1on today, trying to planning too soon, and on the interviewers agenda can set the conversa1on back and cause the other person to withdraw. Moving towards planning can be achieved through the process of recapitula1on, the art of giving a skilled transi1onal summary that is awash with change talk. This allows you to ‘test the water’ and offer a key ques1on (one that is open, searching but noncommiMal in nature). Such as “where does this leave you” or “What do you think of all this”, “I wonder what you might decide to do?”, “What might someone in your situa1on do next?”, “What’s in your mind at the moment?”, “What are you thinking about at this point?”. Let the person decide what is next for them, let them tell you. 33 Send us a Tweet: @MIinlondon
  34. 34. 34 Merry Christmas! Have a one.
  35. 35. 35 See you on Tuesday 7th February 2017 Thanks for coming! Send us an email: