The document shows graphs comparing estimated time spent in minutes for assessments and motivational interviewing/motivational enhancement therapy (MI/MET) sessions over multiple time periods for three clinical trials (CTN 004, CTN 005, and CTN 013) testing MI interventions for various health behaviors. The graphs indicate that time spent on assessments was generally higher than time spent on MI/MET sessions at most time periods measured across the three trials.
Presentation paolo tranchina teodori icmi venezia 2012Magnus Johansson
The document outlines the history of psychiatric reform in Italy, known as Law 180 or the Basaglia Law of 1978. It discusses the socio-political context leading up to the law, including the resistance movement against fascism, workers' rights campaigns, and student protests of 1968. The law aimed to eliminate psychiatric hospitals and establish community-based mental health services. It was influenced by phenomenology and the therapeutic community model. The reform emphasized patients' dignity, starting treatment with the most severe cases, and involving patients, families, and communities in care. The document also describes how art created by psychiatric patients came to be marketed publicly rather than used solely for therapy.
The document shows graphs comparing estimated time spent in minutes for assessments and motivational interviewing/motivational enhancement therapy (MI/MET) sessions over multiple time periods for three clinical trials (CTN 004, CTN 005, and CTN 013) testing MI interventions for various health behaviors. The graphs indicate that time spent on assessments was generally higher than time spent on MI/MET sessions at most time periods measured across the three trials.
Presentation paolo tranchina teodori icmi venezia 2012Magnus Johansson
The document outlines the history of psychiatric reform in Italy, known as Law 180 or the Basaglia Law of 1978. It discusses the socio-political context leading up to the law, including the resistance movement against fascism, workers' rights campaigns, and student protests of 1968. The law aimed to eliminate psychiatric hospitals and establish community-based mental health services. It was influenced by phenomenology and the therapeutic community model. The reform emphasized patients' dignity, starting treatment with the most severe cases, and involving patients, families, and communities in care. The document also describes how art created by psychiatric patients came to be marketed publicly rather than used solely for therapy.
This document provides an overview of Italy and Italians through various topics:
- Italians are described as "Saints, Poets, and Sailors" and sometimes referred to as "Latin Lovers".
- Italy has challenges like high levels of politicians under criminal investigation, but also contributions such as Nobel Prizes, Oscar-winning actors and directors, and renowned musicians, architects, and landmarks.
- The document discusses organizing the International Conference on Motivational Interviewing in Venice, Italy, which required help from people outside Italy due to Italians' tendency towards quarreling. It concludes by welcoming attendees to the conference in Venice.
MET vs TAU in 4 large multisite RCTs found:
1) No main effect on retention or substance use for outpatient treatment.
2) One study found a small effect on early retention but not substance use.
3) Studies of pregnant drug users and Spanish speakers also found no main effects of MET vs TAU.
The findings suggest MET may not produce meaningful improvements over TAU in typical substance abuse treatment settings based on these high quality trials.
The document discusses key points from a presentation at ICMI 2012 on motivational interviewing (MI). It touches on the relational, technical, and strategic components of MI and questions the relative importance of each. It also questions the evidence for MI training's effects on trainees and clients in real-world settings, as well as whether past times without standards to live up to were better for MI.
The document shows graphs comparing estimated time spent in minutes for assessments and motivational interviewing/motivational enhancement therapy (MI/MET) sessions over multiple time periods for three clinical trials involving behavioral counseling for obesity or weight management. CTN 004 involved 3 MI/MET sessions versus treatment as usual, CTN 005 compared MI to usual intake, and CTN 013 looked at 3 MI/MET sessions versus treatment as usual for pregnant women. The graphs indicate that time spent on assessments was generally greater than time spent in MI/MET sessions according to the estimated minutes across each trial period.
The document discusses the speaker's journey with motivational interviewing (MI) and new applications of MI. It outlines how MI can be applied to disorders like anxiety, PTSD, depression, and more. It also describes how MI serves as an integrative framework for other therapies by returning humanistic values like empathy. Finally, it discusses teaching MI to non-professionals to improve relationships.
1) Therapist empathy and interpersonal skills have a significant impact on client outcomes, accounting for up to 15% of the variance in some studies.
2) Training studies show that baseline empathy can predict future counseling performance, even after standardized MI training. Those with higher baseline empathy had better outcomes.
3) Selecting and training counselors based on relational and empathy skills may be important for effective dissemination and implementation of MI and other psychosocial treatments.
Richard Saitz discussed several potential reasons for the spectacular failures seen with motivational interviewing (MI) in some studies and clinical settings. In 3 sentences: MI may fail due to unclear outcomes being measured, effects of assessment on self-reported outcomes, poor fidelity of MI implementation in real-world settings, treating patients of varying severity levels where MI may not be enough, and implementing MI in contexts like emergency departments or trauma centers where expectations differ from primary care settings aimed at prevention. Saitz reviewed evidence on these potential factors from multiple studies to explain when and why MI has not shown effects in some trials and clinical situations.
- Motivational interviewing is reaching its peak dissemination but questions remain about how to screen for and train empathy, which is difficult to measure.
- While empathy training can improve outcomes, it is unclear if empathy is the most important clinician factor or if some clinicians are simply born with strong relational skills.
- Effective measurement of empathy is still challenging as inter-rater reliability on global empathy ratings remains low.
This document discusses concepts related to motivational interviewing (MI) including complexity, chaos theory, and self-regulation as a limited resource. It notes that MI may not be the preferred method in all situations, such as when clients are fully motivated or prefer a more directive style. The document also suggests incorporating concepts like sudden/unplanned change, autonomy preferences, and moving from a focus on "why" to change to "how" to change into MI.
This document discusses motivational interviewing (MI) as a complex intervention and proposes applying a complex interventions perspective to better understand MI. It suggests that thinking of MI as a complex intervention and using systematic reviews and studies of heterogeneity can help address the large variability seen in MI's effectiveness between studies. The document provides some examples of meta-analyses looking at whether certain factors like medical setting, provider training, or measurement type moderate MI outcomes. It argues that more systematic reviews and methods are needed to better understand MI when implemented in real-world settings.
The document discusses reflections from attending the ICMI3 conference on motivational interviewing. Some key points:
1) The conference explored the theory and practice of motivational interviewing, how to measure its effects, and how to best train clinicians to deliver it.
2) Studies presented showed motivational interviewing can be effective, for example reducing diabetes, vascular disease, and deaths, but more research is still needed, especially on measuring treatment fidelity.
3) Adopting healthy behaviors like not smoking, maintaining a healthy weight, diet, exercise and alcohol intake was associated with significant reductions in health issues over 30 years in one study.
4) Motivational interviewing shows promise for
The document summarizes several systematic reviews and studies on the use of motivational interviewing (MI) with offenders and clients in treatment for personality disorders. The reviews found that MI is effective at:
1) Improving retention in substance abuse treatment programs and motivation for change.
2) Potentially reducing substance use, especially when combined with other treatments like contingency management.
3) However, the evidence is mixed on whether MI can reduce recidivism and change offending behavior.
The document discusses the concept of "equipoise" in motivational interviewing, which refers to a state of balanced ambivalence where a client is equally torn between two or more options. It questions whether MI can be done without focusing on a specific target behavior. The document concludes that equipoise does not mean an absence of a target behavior, as MI can help clients resolve ambivalence about a specific decision, such as whether to stay in their current community or move for a new job, without the counselor preferring one option over the other.
This document summarizes a presentation on using motivational interviewing (MI) to address ambivalence in living organ donors. The presentation discusses:
1) How residual pre-donation ambivalence is the strongest predictor of poor psychosocial outcomes for donors, compared to other factors.
2) A proposed two-session MI intervention to be delivered by phone, aimed at resolving donors' ambivalence by strengthening their commitment to donate or not donate.
3) Preliminary plans to conduct a randomized controlled trial comparing the MI intervention to enhanced standard care, measuring impacts on ambivalence and donor outcomes.
The document discusses the differences and relationships between motivational interviewing (MI) and client-centered therapy. It explores how definitions of MI have evolved over time from a set of concepts and precepts to a more directive method for enhancing motivation. The document also examines debates around key terms like "equipoise" and whether a binary or fuzzy logic is more appropriate for understanding MI. Clarifying definitions is important for research on evidence-based practices and ensuring interventions are implemented with fidelity.
The document discusses the differences and relationships between motivational interviewing (MI) and client-centered therapy. It explores how definitions of MI have evolved over time from a set of concepts and precepts to a more directive method for enhancing motivation. The document also examines debates around key terms like "equipoise" and whether a binary or fuzzy logic is more appropriate for understanding MI. Clarifying definitions is important for research on evidence-based practices and ensuring interventions are implemented with fidelity.
Lundahl final icmi motivational interviewing 25 yearsMagnus Johansson
This meta-analysis examined 119 studies on motivational interviewing (MI) from the past 25 years. The analysis found that MI had a statistically significant advantage over weak comparison treatments for 11 of 14 targeted behaviors. Compared to strong active treatments, MI was generally equivalent, with a few exceptions. The effects of MI also tended to last over time. While not superior to all other treatments, MI was found to be an effective and efficient approach across a wide range of populations and behaviors.
The document summarizes research on the mechanisms of change and active ingredients of motivational interviewing. Key findings include:
1) Therapist use of MI-consistent behaviors and client change talk are robust predictors of positive treatment outcomes.
2) The presence of a supportive significant other can increase client change talk within motivational interviewing sessions.
3) Multiple mediators, including readiness to change, experience of discrepancy, self-efficacy, and treatment seeking, help explain how motivational interviewing leads to reduced substance use.
The document discusses client-centered direction in motivational interviewing (MI). It states that direction in MI is developed collaboratively by evoking the client's values and goals, not by imposing the practitioner's aspirations. MI advances Rogerian client-centered therapy by allowing for direction while keeping the client as the source of that direction. The document outlines how MI establishes direction through open-ended questions, affirmations, and selectively focusing on broad categories of change over time.
This document provides an overview of Italy and Italians through various topics:
- Italians are described as "Saints, Poets, and Sailors" and sometimes referred to as "Latin Lovers".
- Italy has challenges like high levels of politicians under criminal investigation, but also contributions such as Nobel Prizes, Oscar-winning actors and directors, and renowned musicians, architects, and landmarks.
- The document discusses organizing the International Conference on Motivational Interviewing in Venice, Italy, which required help from people outside Italy due to Italians' tendency towards quarreling. It concludes by welcoming attendees to the conference in Venice.
MET vs TAU in 4 large multisite RCTs found:
1) No main effect on retention or substance use for outpatient treatment.
2) One study found a small effect on early retention but not substance use.
3) Studies of pregnant drug users and Spanish speakers also found no main effects of MET vs TAU.
The findings suggest MET may not produce meaningful improvements over TAU in typical substance abuse treatment settings based on these high quality trials.
The document discusses key points from a presentation at ICMI 2012 on motivational interviewing (MI). It touches on the relational, technical, and strategic components of MI and questions the relative importance of each. It also questions the evidence for MI training's effects on trainees and clients in real-world settings, as well as whether past times without standards to live up to were better for MI.
The document shows graphs comparing estimated time spent in minutes for assessments and motivational interviewing/motivational enhancement therapy (MI/MET) sessions over multiple time periods for three clinical trials involving behavioral counseling for obesity or weight management. CTN 004 involved 3 MI/MET sessions versus treatment as usual, CTN 005 compared MI to usual intake, and CTN 013 looked at 3 MI/MET sessions versus treatment as usual for pregnant women. The graphs indicate that time spent on assessments was generally greater than time spent in MI/MET sessions according to the estimated minutes across each trial period.
The document discusses the speaker's journey with motivational interviewing (MI) and new applications of MI. It outlines how MI can be applied to disorders like anxiety, PTSD, depression, and more. It also describes how MI serves as an integrative framework for other therapies by returning humanistic values like empathy. Finally, it discusses teaching MI to non-professionals to improve relationships.
1) Therapist empathy and interpersonal skills have a significant impact on client outcomes, accounting for up to 15% of the variance in some studies.
2) Training studies show that baseline empathy can predict future counseling performance, even after standardized MI training. Those with higher baseline empathy had better outcomes.
3) Selecting and training counselors based on relational and empathy skills may be important for effective dissemination and implementation of MI and other psychosocial treatments.
Richard Saitz discussed several potential reasons for the spectacular failures seen with motivational interviewing (MI) in some studies and clinical settings. In 3 sentences: MI may fail due to unclear outcomes being measured, effects of assessment on self-reported outcomes, poor fidelity of MI implementation in real-world settings, treating patients of varying severity levels where MI may not be enough, and implementing MI in contexts like emergency departments or trauma centers where expectations differ from primary care settings aimed at prevention. Saitz reviewed evidence on these potential factors from multiple studies to explain when and why MI has not shown effects in some trials and clinical situations.
- Motivational interviewing is reaching its peak dissemination but questions remain about how to screen for and train empathy, which is difficult to measure.
- While empathy training can improve outcomes, it is unclear if empathy is the most important clinician factor or if some clinicians are simply born with strong relational skills.
- Effective measurement of empathy is still challenging as inter-rater reliability on global empathy ratings remains low.
This document discusses concepts related to motivational interviewing (MI) including complexity, chaos theory, and self-regulation as a limited resource. It notes that MI may not be the preferred method in all situations, such as when clients are fully motivated or prefer a more directive style. The document also suggests incorporating concepts like sudden/unplanned change, autonomy preferences, and moving from a focus on "why" to change to "how" to change into MI.
This document discusses motivational interviewing (MI) as a complex intervention and proposes applying a complex interventions perspective to better understand MI. It suggests that thinking of MI as a complex intervention and using systematic reviews and studies of heterogeneity can help address the large variability seen in MI's effectiveness between studies. The document provides some examples of meta-analyses looking at whether certain factors like medical setting, provider training, or measurement type moderate MI outcomes. It argues that more systematic reviews and methods are needed to better understand MI when implemented in real-world settings.
The document discusses reflections from attending the ICMI3 conference on motivational interviewing. Some key points:
1) The conference explored the theory and practice of motivational interviewing, how to measure its effects, and how to best train clinicians to deliver it.
2) Studies presented showed motivational interviewing can be effective, for example reducing diabetes, vascular disease, and deaths, but more research is still needed, especially on measuring treatment fidelity.
3) Adopting healthy behaviors like not smoking, maintaining a healthy weight, diet, exercise and alcohol intake was associated with significant reductions in health issues over 30 years in one study.
4) Motivational interviewing shows promise for
The document summarizes several systematic reviews and studies on the use of motivational interviewing (MI) with offenders and clients in treatment for personality disorders. The reviews found that MI is effective at:
1) Improving retention in substance abuse treatment programs and motivation for change.
2) Potentially reducing substance use, especially when combined with other treatments like contingency management.
3) However, the evidence is mixed on whether MI can reduce recidivism and change offending behavior.
The document discusses the concept of "equipoise" in motivational interviewing, which refers to a state of balanced ambivalence where a client is equally torn between two or more options. It questions whether MI can be done without focusing on a specific target behavior. The document concludes that equipoise does not mean an absence of a target behavior, as MI can help clients resolve ambivalence about a specific decision, such as whether to stay in their current community or move for a new job, without the counselor preferring one option over the other.
This document summarizes a presentation on using motivational interviewing (MI) to address ambivalence in living organ donors. The presentation discusses:
1) How residual pre-donation ambivalence is the strongest predictor of poor psychosocial outcomes for donors, compared to other factors.
2) A proposed two-session MI intervention to be delivered by phone, aimed at resolving donors' ambivalence by strengthening their commitment to donate or not donate.
3) Preliminary plans to conduct a randomized controlled trial comparing the MI intervention to enhanced standard care, measuring impacts on ambivalence and donor outcomes.
The document discusses the differences and relationships between motivational interviewing (MI) and client-centered therapy. It explores how definitions of MI have evolved over time from a set of concepts and precepts to a more directive method for enhancing motivation. The document also examines debates around key terms like "equipoise" and whether a binary or fuzzy logic is more appropriate for understanding MI. Clarifying definitions is important for research on evidence-based practices and ensuring interventions are implemented with fidelity.
The document discusses the differences and relationships between motivational interviewing (MI) and client-centered therapy. It explores how definitions of MI have evolved over time from a set of concepts and precepts to a more directive method for enhancing motivation. The document also examines debates around key terms like "equipoise" and whether a binary or fuzzy logic is more appropriate for understanding MI. Clarifying definitions is important for research on evidence-based practices and ensuring interventions are implemented with fidelity.
Lundahl final icmi motivational interviewing 25 yearsMagnus Johansson
This meta-analysis examined 119 studies on motivational interviewing (MI) from the past 25 years. The analysis found that MI had a statistically significant advantage over weak comparison treatments for 11 of 14 targeted behaviors. Compared to strong active treatments, MI was generally equivalent, with a few exceptions. The effects of MI also tended to last over time. While not superior to all other treatments, MI was found to be an effective and efficient approach across a wide range of populations and behaviors.
The document summarizes research on the mechanisms of change and active ingredients of motivational interviewing. Key findings include:
1) Therapist use of MI-consistent behaviors and client change talk are robust predictors of positive treatment outcomes.
2) The presence of a supportive significant other can increase client change talk within motivational interviewing sessions.
3) Multiple mediators, including readiness to change, experience of discrepancy, self-efficacy, and treatment seeking, help explain how motivational interviewing leads to reduced substance use.
The document discusses client-centered direction in motivational interviewing (MI). It states that direction in MI is developed collaboratively by evoking the client's values and goals, not by imposing the practitioner's aspirations. MI advances Rogerian client-centered therapy by allowing for direction while keeping the client as the source of that direction. The document outlines how MI establishes direction through open-ended questions, affirmations, and selectively focusing on broad categories of change over time.
Behandling av ungdomar och vuxna – erfarenheter av behandlingsarbete i några medelstora och små kommuner
1.
2. Personal Ex-it HAP Borlänge
Stina Thysell-Persson
Lena Bergens
Christer Damm
Samir Siraj
3. Några exempel på vilka vi besökte:
• Ungdomsgrupp
• Verdandi
• Missbruksgrupp • IOGT-NTO
• Ekonomigrupp • Klippan
• Kamratstödet
• Mottagningsgrupp • Polisens ungdomsgrupp och utryckningsenhet
• Alkohol- och drogrådgivningen
• Frivårdsmyndigheten
• Familjevårdsenheten
• Familjeterapeuterna • Allmänna häktet i Falun
• Ungdomsenheten • Barn och ungdomspsykiatrin
• Fältfritidsledarna
• Vuxenpsykiatrin
• Ungdomsmottagningen
• Cozmoz : all personal och ungdomsgrupper •Neuropsykiatriska teamet, ungdom
kontinuerligt
• KRIS
• Rektorer, kuratorer och fältare på samtliga • X-Cons
gymnasieskolor
• Mentorerna på IV-programmet • Föreningsrådet
• Personal vid högstadieskolor • Kursdagar och utbildningar för personal som möter
ungdomar i Borlänge
• Resursskolan
• Klasser och elevsammankomster efter begäran från
• Arbetsförmedlingen skolan
4. Haschavvänjningsprogram, HAP 6 v + uppföljning
18 samtal.
• Information
• Inskrivning -samtal nr 1
• 16 samtal som följer de 3 faserna i avvänjningen. Olika teman.
• Avslut -samtal nr 18
• Uppföljning -individuellt anpassad.
Familj och viktiga personer i nätverket involverade i minst 3 av samtalen.
5. Kortprogram ca 3 v + ev uppföljning
7-8 samtal, ibland fler.
• Information
• Inskrivning -samtal nr 1
• 6 samtal om cannabis , fakta samt fokus på ungdomens liv.
Hur har cannabis orsakat och spelat in i det som händer?
• Avslut -samtal nr 7
• Ev uppföljning vid behov och önskemål.
Föräldrar med på så många samtal de kan. Syskon.
6. Haschsamtal
4-6 samtal
• Information tillsammans med föräldrar.
• Inskrivning -samtal 1 Delar på ungdom och föräldrar.
• 4 samtal. Fakta om cannabis, hjärnan och utveckling. Framtiden.
Hur vill du att ditt liv ska se ut?
• Avslut -samtal 6
Föräldrar med på alla samtal.
11. • Svenska kyrkan • Ungdomsmottagningen
• Ungdomsöppenvården
• Folkhälsoplanerare
• Missbruksöppenvården
• Klippan, arbetslinjen
• IOGT-NTO
• Fältfritidsledare • RIA
• Verdandi
• RFHL
• X-cons , tidigare KRIS
• Länkarna
• Ungdomsenheten /COZMOZ
• NA • Frivården
• Familjeterapeuter
• Ungdomsgrupp, socialtjänst
• Samarbetsprojekt psykiatrin/socialtjänst
• Boxningsklubb
• Mottagningsgrupp, socialtjänst
• Integrationsprojekt med fotbollsskola
• På sikt: Idrottsklubbar, mm.
12. Framgångsfaktorer.
• Öppet intag • Bygg på det som fungerar. Lyfta
deras framgångar.
• Okomplicerad tillgänglighet så snabbt
som möjligt. • Göra dem synliga för viktiga
• Man ska kunna fråga oss om råd utan att personer.
vara inskriven eller registrerad
• Nätverket, att familjen har fått lära
• Icke värderande förhållningssätt sig samma saker som ungdomen.
• Vara tydliga med våra motiv. Ingen dold
agenda. Tala om varför vi gör olika • Att familjen känner till de bärande
moment. skälen för att ungdomen vill vara
drogfri, respektive känner till deras
• Skapa ett rum där den unge kan berätta risksituationer.
om vad som verkligen pågår
• Att ungdomen kan ingå i ett drogfritt,
socialt nätverk efter behandlingen.
13. Att tänka på för den som vill starta program eller just har
gjort det:
• Fungerande öppenvårdskedja. Nätverk efter behandlingen. Drogfria
miljöer.
• Se till att ni berättar för uppdragsgivare och samarbetspartners vad ni
gör hela tiden!
• Se till att någon annan utvärderar materialet som ni samlar in.