Building motivation for change as a platform for return to work


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Explores the principles of Motivational Interviewing as a means of assisting an injured worker back to work.

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Building motivation for change as a platform for return to work

  1. 1. Michael Sainsbury
  2. 2. “I’m in too much pain to work “I’m in too much pain to work – IIdon’t think IIcould ever go – don’t think could ever go back!” back!” “There’s no point searching for aa “There’s no point searching for job job – no one’s going to employ me!” – no one’s going to employ me!”“I’m too scared to do anything “I’m too scared to do anything– because IImight reinjure myself!” – because might reinjure myself!” 2
  3. 3. “Afterall, when you seek advice from someone, it’s certainly not because you want them to give it. You just want them to be there while you talk to yourself.”“People are more likely to be persuaded by the reasons they have themselves discovered, than by those that come into the minds of others.” 3
  4. 4. It’s not that the individual is ‘unmotivated’! What drives the individual?What is it that motivates their behaviour? 4
  5. 5. Willingness to changeAbility to changeReadiness for change 5
  6. 6. Ambivalence“I want to, but I don’t want to”dilemmaExplore the individual’s feelings of ambivalence tounderstand their motivationsFor what is the injured worker motivated? 6
  7. 7. Motivational InterviewingA worker-centred, directive method for enhancingintrinsic motivation to change by exploring & resolvingambivalenceA soft way of asking workers to take a hard look atthemselves 7
  8. 8. Develop DiscrepancyExpress EmpathyAvoid ArguingRoll with ResistanceSupport Self-Efficacy 8
  9. 9. Develop DiscrepancyMotivation for change can occur when the workerrecognises the discrepancy between where they’re at &where they want to be in their lifeExplore ‘looking back’ & ‘looking forward’ 9
  10. 10. Express EmpathyReflective listening to understand & acceptthe worker’s perspective-without judging, criticising or blamingWhen the worker feels understood-more able to open up & share their experiencesAcceptance & respect facilitates a positiveworking relationship- builds self-esteem for promoting change 10
  11. 11. Low Empathy High EmpathyLow Control High ControlLow Empathy HIGH EMPATHYHigh Control LOW CONTROL 11
  12. 12. Avoid ArgumentsPositive approach that avoidsdirect confrontation & arguingDon’t push for change 12
  13. 13. Roll with ResistanceAvoid challenging the worker’s resistance to change-‘roll with it’ or it may lead to strongly defending theircurrent positionUse the worker’s ‘momentum’ to further explore theirviews 13
  14. 14. Support Self-EfficacyIndividual’s belief in their ability to succeedWorker’s belief that change is possible is animportant motivatorHighlight changes the worker has previously made in theirlives to develop a belief that change is possibleEnhance the worker’s confidence in their capacity to copewith obstacles & succeed in change 14
  15. 15. Stages of Change 15
  16. 16. 16