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.
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
Spirit of Motivational Interviewing• Collaboration • Not hierarchy• Evocation • Not imposing or externally driven• Client Autonomy • Not authority or coercion
MI: Progression through the Stages of Change Open ended questions Affirmations Reflections Summaries
Role of Motivational InterviewingIncrease Change Talk & Readiness to ChangeIncrease Client Exp. Of Discrepancy Increase Client Engagement Decrease Resistance Improve Retention, Motivation, and Outcomes
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
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