Addiction and Motivation; what works?
Presentation at the 2012 Europad conference in Barcelona.
Three main points:
- Evidence base for Motivational Interviewing
- Practitioner competency
- Implementation issues
This document discusses addiction and dependence from several perspectives:
1. Addiction is debated as either a disease or a choice, with arguments on both sides. If a disease, it would be similar to mental illnesses and involve genetic or environmental factors.
2. Dependence involves physiological and psychological components. Physiological dependence results in withdrawal symptoms when use stops due to tolerance. Psychological dependence involves compulsive drug seeking despite negative consequences.
3. The mesolimbic dopamine system is involved in motivation and reward processing. Drugs of abuse activate this system in an intense and unnaturally rewarding way, potentially leading to psychological dependence over time through learning processes.
This document summarizes several theories of motivation:
1. Maslow's hierarchy of needs proposes that people are motivated to fulfill basic physiological needs, safety needs, social needs, esteem needs, and self-actualization needs.
2. Herzberg's two-factor theory distinguishes between motivators like achievement and responsibility that provide job satisfaction, and hygiene factors like salary and working conditions that prevent dissatisfaction.
3. Vroom's expectancy theory proposes that motivation depends on expectancy (effort will lead to performance), instrumentality (performance will lead to rewards), and valence (attractiveness of rewards).
There are three main groups of motivational theories: internal theories that focus on individual variables, process theories that examine the interaction between individuals and their environment, and external theories that emphasize environmental factors. Some key motivational theories discussed include Maslow's hierarchy of needs, McGregor's Theory X and Y, Herzberg's two-factor theory, and expectancy theory. Motivation is influenced by an individual's needs, values, and beliefs about whether their efforts will lead to desired rewards.
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
2008 Smoking Cessation Health Promotion Power point filled with history of glamour movie stars who died from smoking, medical/military history, statistics and facts, myth/truth, perception/reality, Nurses' role, Health effects of smoking, Helps to quit: web sites, medications: Zyban, Chantix, Addiction notations. Factual/non-fiction.
14 slides plus 2 reference slides. 2008.
This document discusses smoking cessation and provides information to help people quit smoking. It discusses the harms of smoking and tactics that tobacco companies use. It also addresses common reasons and excuses for not quitting. The document outlines the physical, emotional, behavioral, social, and cognitive effects of the quitting process. It discusses stages of behavioral change and notes that many people think they can quit smoking at any time when that is often not the case. The document concludes by listing available help options for quitting smoking, including support groups, medications, health professionals, and online resources.
This document introduces the inaugural issue of the journal Motivational Interviewing: Training, Research, Implementation, Practice. It provides a brief history of publications related to motivational interviewing, from the original Motivational Interviewing Newsletter for Trainers to the current journal. It explains that the journal aims to provide an outlet for the worldwide MI community and allow communication among members. The introduction welcomes readers and contributors to share in the open and creative spirit that characterizes both MI and its community.
Motivational interviewing for the prevention of alcohol misuse in young adult...Health Evidence™
Health Evidence™ hosted a 60 minute webinar examining the effectiveness of motivational interviewing (MI) for the prevention of alcohol misuse and alcohol-related problems in young adults. Click here for access to the audio recording for this webinar: https://youtu.be/c9EHJ-Ks28c
Dr. David Foxcroft, President, European Society for Prevention Research (EUSPR), Professor of Community Psychology and Public Health, Department of Psychology, Social Work and Public Health, Oxford Brookes University led the session and presented findings from his recent Cochrane review:
Foxcroft D, Coombes L, Wood S, Allen D, Almeida Santimano N, & Moreira M. (2016). Motivational interviewing for the prevention of alcohol misuse in young adults. Cochrane Database of Systematic Reviews, 2016(7), CD007025. https://www.healthevidence.org/view-article.aspx?a=motivational-interviewing-prevention-alcohol-misuse-young-adults-29645
According to the World Health Organization, alcohol is responsible for approximately 9% of deaths within the 15-29 year old age bracket. This review examines the effectiveness of MI interventions for preventing alcohol misuse and alcohol-related problems in young adults. Eighty-four trials with 22,872 participants were included in this review. Findings suggest that MI interventions only slightly reduce quantity of alcohol consumed, frequency of alcohol consumption, and peak blood alcohol concentration, and only marginally reduce alcohol problems in young adults aged up to 25 years, compared to no intervention/placebo/treatment as usual. This webinar provided an overview of the effectiveness of MI interventions in preventing alcohol misuse and alcohol-related problems in young adults.
This document discusses addiction and dependence from several perspectives:
1. Addiction is debated as either a disease or a choice, with arguments on both sides. If a disease, it would be similar to mental illnesses and involve genetic or environmental factors.
2. Dependence involves physiological and psychological components. Physiological dependence results in withdrawal symptoms when use stops due to tolerance. Psychological dependence involves compulsive drug seeking despite negative consequences.
3. The mesolimbic dopamine system is involved in motivation and reward processing. Drugs of abuse activate this system in an intense and unnaturally rewarding way, potentially leading to psychological dependence over time through learning processes.
This document summarizes several theories of motivation:
1. Maslow's hierarchy of needs proposes that people are motivated to fulfill basic physiological needs, safety needs, social needs, esteem needs, and self-actualization needs.
2. Herzberg's two-factor theory distinguishes between motivators like achievement and responsibility that provide job satisfaction, and hygiene factors like salary and working conditions that prevent dissatisfaction.
3. Vroom's expectancy theory proposes that motivation depends on expectancy (effort will lead to performance), instrumentality (performance will lead to rewards), and valence (attractiveness of rewards).
There are three main groups of motivational theories: internal theories that focus on individual variables, process theories that examine the interaction between individuals and their environment, and external theories that emphasize environmental factors. Some key motivational theories discussed include Maslow's hierarchy of needs, McGregor's Theory X and Y, Herzberg's two-factor theory, and expectancy theory. Motivation is influenced by an individual's needs, values, and beliefs about whether their efforts will lead to desired rewards.
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
2008 Smoking Cessation Health Promotion Power point filled with history of glamour movie stars who died from smoking, medical/military history, statistics and facts, myth/truth, perception/reality, Nurses' role, Health effects of smoking, Helps to quit: web sites, medications: Zyban, Chantix, Addiction notations. Factual/non-fiction.
14 slides plus 2 reference slides. 2008.
This document discusses smoking cessation and provides information to help people quit smoking. It discusses the harms of smoking and tactics that tobacco companies use. It also addresses common reasons and excuses for not quitting. The document outlines the physical, emotional, behavioral, social, and cognitive effects of the quitting process. It discusses stages of behavioral change and notes that many people think they can quit smoking at any time when that is often not the case. The document concludes by listing available help options for quitting smoking, including support groups, medications, health professionals, and online resources.
This document introduces the inaugural issue of the journal Motivational Interviewing: Training, Research, Implementation, Practice. It provides a brief history of publications related to motivational interviewing, from the original Motivational Interviewing Newsletter for Trainers to the current journal. It explains that the journal aims to provide an outlet for the worldwide MI community and allow communication among members. The introduction welcomes readers and contributors to share in the open and creative spirit that characterizes both MI and its community.
Motivational interviewing for the prevention of alcohol misuse in young adult...Health Evidence™
Health Evidence™ hosted a 60 minute webinar examining the effectiveness of motivational interviewing (MI) for the prevention of alcohol misuse and alcohol-related problems in young adults. Click here for access to the audio recording for this webinar: https://youtu.be/c9EHJ-Ks28c
Dr. David Foxcroft, President, European Society for Prevention Research (EUSPR), Professor of Community Psychology and Public Health, Department of Psychology, Social Work and Public Health, Oxford Brookes University led the session and presented findings from his recent Cochrane review:
Foxcroft D, Coombes L, Wood S, Allen D, Almeida Santimano N, & Moreira M. (2016). Motivational interviewing for the prevention of alcohol misuse in young adults. Cochrane Database of Systematic Reviews, 2016(7), CD007025. https://www.healthevidence.org/view-article.aspx?a=motivational-interviewing-prevention-alcohol-misuse-young-adults-29645
According to the World Health Organization, alcohol is responsible for approximately 9% of deaths within the 15-29 year old age bracket. This review examines the effectiveness of MI interventions for preventing alcohol misuse and alcohol-related problems in young adults. Eighty-four trials with 22,872 participants were included in this review. Findings suggest that MI interventions only slightly reduce quantity of alcohol consumed, frequency of alcohol consumption, and peak blood alcohol concentration, and only marginally reduce alcohol problems in young adults aged up to 25 years, compared to no intervention/placebo/treatment as usual. This webinar provided an overview of the effectiveness of MI interventions in preventing alcohol misuse and alcohol-related problems in young adults.
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.
This document discusses the use of motivational interviewing (MI) to treat opioid addiction. MI is a collaborative counseling approach that aims to strengthen a client's personal motivation and goals for change without confrontation. The document outlines key concepts of MI including partnership, acceptance, compassion, and evocation. Studies have found MI can be an effective treatment for opioid addiction, particularly when used in short sessions over time with follow-up support. While MI has limitations like time and lack of follow-up, its strengths-based approach empowering clients to choose change make it a promising treatment model for addiction rehabilitation counseling.
This document provides an overview of a workshop on motivational interviewing (MI) given by Michael Fulop. The key points are:
- Michael Fulop is a psychologist who provides ongoing training on MI skills to diabetes educators.
- His agenda includes discussing the evidence for MI in psychotherapy, showing examples of MI in practice, and having attendees practice MI skills through role plays and discussions.
- MI is a collaborative communication style aimed at strengthening a person's own motivation and commitment to change. It is not a way to trick people into doing what they don't want or a standalone therapy, but can be used to enhance other treatments.
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.
To Chart a Course: How to Improve Our Adventure Therapy Practice Will Dobud
Presented at the 8th International International Adventure Therapy Conference in Sydney 2018.
In the most comprehensive adventure therapy study published to date, Bowen and Neill (2013) argued that “a small percentage of adventure therapy programs undergo empirical program evaluation” (p. 41), that being less than 1%. With about three decades of research supporting the efficacy of adventure therapy, though we still have questions about dose-effect and for who adventure therapy is most effective (Gass, Gillis, & Russell, 2012; Gillis & Speelman, 2008; Norton et al., 2014) and adventure therapy performing on par with other therapeutic modalities (Dobud & Harper, 2018), there is little question that adventure therapy stands as a bonafide option as a therapeutic treatment. That is the good news.
With the publication of the first meta-analysis of psychotherapy outcomes, Smith and Glass (1977) found that participants engaging in some type of therapy were bever off than 70-80% of those that received no therapy at all. These encouraging effect sizes were on par with or outperformed many common medical treatments, such as taking an ibuprofen for a headache (Miller, Hubble, Chow, & Seidel, 2013). The psychotherapy clinical trials were conducted with research participants randomly receiving either some type of therapeutic interventions or no treatment at all (Smith & Glass, 1977). The researchers further acknowledged that when participants were randomly selected to receive one of
two different therapies, such as Cogni`ve-Behavioural or Psychodynamic Therapy, no difference in outcomes could be
found despite the theoretical differences of the two. Despite the limited publications and dissertations where adventure therapy was compared to a therapeutic intervention containing no adventurous components, we have a similar issue that adventure therapy tends to perform on par, no greater and no worse, than its counterparts (Dobud & Harper, 2018; Harper, 2010). The specific differences that suggest certain therapies are unique hold little to no variance in outcomes (Ahn & Wampold, 2001). Since Smith and Glass' (1977) pinnacle study, outcomes across psychotherapy have flatlined. Despite a ballooning of new diagnostic criteria and mushrooming of empirically supported treatments, there has been no improvement in outcomes (Asay & Lambert, 1999; Miller et al., 2013; Wampold, 2001). This presentation will attempt to untangle some of the factors put forward by researchers over the last two decades to illustrate those factors most likely to lead to improved therapeutic outcomes, such as establishing goal consensus with clients, improving the therapeutic relationship, and monitoring outcomes (Lambert, 2010; Wampold, 2001). Though this workshop will present some of these important findings, the presentation will stage my experiential journey in reaching out to coaches, researchers, and supervisors in trying to improve my outcomes as a therapist, one client at a time.
This document discusses various addiction treatment models and approaches. It covers the disease model of addiction and neurobiological factors. It describes different treatment settings like inpatient vs outpatient and criteria for long-term inpatient care. Evidence-based therapies in the Matrix Model are outlined, including groups, motivational enhancement, and addressing relapse factors. Medication-assisted treatment is compared to no-medication models. Special techniques like integrated group therapy and contingency management are explained. The conclusion emphasizes considering psychopathology and neurobiology in design, using multidisciplinary teams, and addressing barriers to research.
Motivational Interviewing - Dr Igor Koutsenok MD, MSjames_harvey_phd
Session 1 "Motivational Interviewing Course: Assisting Patients in Making Sustainable Positive Lifestyle Changes"
Presented by Dr Igor Koutsenok MD, MS (University of California San Diego, Department of Psychiatry) on 05/06/2020 during the first session of an ISSUP virtual training on MI.
**PLEASE NOTE that video slides have been removed to reduce file size**
Presentation content and learning outcomes:
After orientation to the underlying spirit and principles of MI, practical exercises will help participants to strengthen empathy skills, recognize and elicit change talk, and roll with resistance. Research evidence will be reviewed for the efficacy of MI and for the importance of building a therapeutic relationship in clients’ outcomes. Integration of MI with other treatment modalities will be considered.
Learning outcomes:
Introduction: Motivation and behavioral change in addiction medicine
Review of the concepts of Ambivalence, Stages of change, the righting reflex, limits of persuasion.
Spirit of MI
Expressing empathy
Roadblocks to communication
Four Processes in MI
Full details: https://www.issup.net/about-issup/news/2020-05/motivational-interviewing-course
The document provides an update on the development of standards and credentialing for health and wellness coaches by Dr. Michael Arloski. It discusses the mission of the National Commission for Certifying Healthcare & Wellness Coaches (NCCHWC) to establish training, education standards, and certification for health and wellness coaches. It also lists leadership members of the NCCHWC and their qualifications.
- Psychotherapy has been shown to be effective based on meta-analyses, with effect sizes ranging from 0.75 to 0.85. Approximately three-quarters of patients benefit from therapy and 40-60% return to normal functioning.
- The benefits of psychotherapy have been found to last over time, though there is some decay, and to be equal or greater than medication for most disorders except schizophrenia and bipolar disorder.
- While not all patients respond equally well, psychotherapy works through common factors like the therapeutic relationship rather than specific techniques. Taking a biopsychosocial approach can help address client factors influencing outcomes.
The document provides an overview of motivational interviewing (MI), including its evolution, research supporting its effectiveness, core components, and processes. MI is a goal-oriented counseling approach developed to strengthen personal motivation for change. Key aspects of MI include developing a partnership between counselor and client, accepting client autonomy and perspectives without judgment, eliciting the client's own motivations for change, and having compassion for the client. The four processes of MI are engaging with the client, focusing discussions on a goal, evoking the client's own arguments for change, and planning steps toward change.
This document summarizes a meta-analysis of 206 studies on adventure therapy outcomes published between 1967 and 2012. The meta-analysis found that adventure therapy has a moderate positive effect on psychosocial outcomes, with an overall effect size of 0.50 for pre-post outcomes. Larger effects were found for outcomes related to self-concept, social development, and clinical measures. Moderator analyses found slightly larger effects for older participants and programs with an open group structure. The meta-analysis provides benchmarking data to evaluate adventure therapy program outcomes.
Psychology in Primary Care An Evaluation of Best Practices BASUHMO Research Network
This study examined appointment attendance patterns for psychology/mental health services across different care delivery models within a healthcare system. The three models studied were referral, co-located, and co-located/integrated. Logistic regression found that patients referred to the co-located/integrated clinics, which featured interaction between primary care and psychology providers, were more likely to attend their initial appointment. Being older increased the likelihood of attendance, while longer times between referral and scheduling decreased attendance odds. Limitations included a single co-located/integrated clinic being studied.
Achieving behaviour change for patient safety, Judith Dyson, Lecturer, Mental Health - University of Hull
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
This document discusses screening, brief intervention, and referral to treatment (SBIRT) programs. It provides an overview of SBIRT, including core components like screening instruments, brief interventions using motivational interviewing techniques, and referral to treatment for those who need higher levels of care. The document also discusses evidence and organizations that support SBIRT, lessons learned from SBIRT programs in Colorado, and solutions to common barriers in implementing SBIRT services.
Cengage Learning Webinar, Psychology, New directions in self regulation theoryCengage Learning
Just when we thought we had worked out the main outlines of self-regulation theory, several new findings have emerged to challenge that picture. Dr. Roy Baumeister, Florida State University, presents results from laboratory, longitudinal, and meta-analytic studies on how high self-control may specialize less in resisting temptation than in avoiding it. Self-control, ego depletion, self-control and other topics are addressed
Tom Caplan operates the Caplan Therapy Centre in Montreal, which offers individual and group counseling services. The document provides an overview of Caplan's qualifications and experience, as well as the services offered through his private practice and affiliations. These include anger management groups, domestic violence counseling, marriage counseling, and training workshops on topics like behavior management and the Needs ABC intervention model. The Needs ABC model focuses on determining a client's relationship needs and collaborating on productive strategies to meet those needs while considering emotions.
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 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.
MICAS is a brief questionnaire which clients can fill out. As a result, the fidelity of their coach/HCP in the delivery of motivational interviewing will be reliably measured, within the framework of physical activity stimulation.
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.
This document discusses the use of motivational interviewing (MI) to treat opioid addiction. MI is a collaborative counseling approach that aims to strengthen a client's personal motivation and goals for change without confrontation. The document outlines key concepts of MI including partnership, acceptance, compassion, and evocation. Studies have found MI can be an effective treatment for opioid addiction, particularly when used in short sessions over time with follow-up support. While MI has limitations like time and lack of follow-up, its strengths-based approach empowering clients to choose change make it a promising treatment model for addiction rehabilitation counseling.
This document provides an overview of a workshop on motivational interviewing (MI) given by Michael Fulop. The key points are:
- Michael Fulop is a psychologist who provides ongoing training on MI skills to diabetes educators.
- His agenda includes discussing the evidence for MI in psychotherapy, showing examples of MI in practice, and having attendees practice MI skills through role plays and discussions.
- MI is a collaborative communication style aimed at strengthening a person's own motivation and commitment to change. It is not a way to trick people into doing what they don't want or a standalone therapy, but can be used to enhance other treatments.
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.
To Chart a Course: How to Improve Our Adventure Therapy Practice Will Dobud
Presented at the 8th International International Adventure Therapy Conference in Sydney 2018.
In the most comprehensive adventure therapy study published to date, Bowen and Neill (2013) argued that “a small percentage of adventure therapy programs undergo empirical program evaluation” (p. 41), that being less than 1%. With about three decades of research supporting the efficacy of adventure therapy, though we still have questions about dose-effect and for who adventure therapy is most effective (Gass, Gillis, & Russell, 2012; Gillis & Speelman, 2008; Norton et al., 2014) and adventure therapy performing on par with other therapeutic modalities (Dobud & Harper, 2018), there is little question that adventure therapy stands as a bonafide option as a therapeutic treatment. That is the good news.
With the publication of the first meta-analysis of psychotherapy outcomes, Smith and Glass (1977) found that participants engaging in some type of therapy were bever off than 70-80% of those that received no therapy at all. These encouraging effect sizes were on par with or outperformed many common medical treatments, such as taking an ibuprofen for a headache (Miller, Hubble, Chow, & Seidel, 2013). The psychotherapy clinical trials were conducted with research participants randomly receiving either some type of therapeutic interventions or no treatment at all (Smith & Glass, 1977). The researchers further acknowledged that when participants were randomly selected to receive one of
two different therapies, such as Cogni`ve-Behavioural or Psychodynamic Therapy, no difference in outcomes could be
found despite the theoretical differences of the two. Despite the limited publications and dissertations where adventure therapy was compared to a therapeutic intervention containing no adventurous components, we have a similar issue that adventure therapy tends to perform on par, no greater and no worse, than its counterparts (Dobud & Harper, 2018; Harper, 2010). The specific differences that suggest certain therapies are unique hold little to no variance in outcomes (Ahn & Wampold, 2001). Since Smith and Glass' (1977) pinnacle study, outcomes across psychotherapy have flatlined. Despite a ballooning of new diagnostic criteria and mushrooming of empirically supported treatments, there has been no improvement in outcomes (Asay & Lambert, 1999; Miller et al., 2013; Wampold, 2001). This presentation will attempt to untangle some of the factors put forward by researchers over the last two decades to illustrate those factors most likely to lead to improved therapeutic outcomes, such as establishing goal consensus with clients, improving the therapeutic relationship, and monitoring outcomes (Lambert, 2010; Wampold, 2001). Though this workshop will present some of these important findings, the presentation will stage my experiential journey in reaching out to coaches, researchers, and supervisors in trying to improve my outcomes as a therapist, one client at a time.
This document discusses various addiction treatment models and approaches. It covers the disease model of addiction and neurobiological factors. It describes different treatment settings like inpatient vs outpatient and criteria for long-term inpatient care. Evidence-based therapies in the Matrix Model are outlined, including groups, motivational enhancement, and addressing relapse factors. Medication-assisted treatment is compared to no-medication models. Special techniques like integrated group therapy and contingency management are explained. The conclusion emphasizes considering psychopathology and neurobiology in design, using multidisciplinary teams, and addressing barriers to research.
Motivational Interviewing - Dr Igor Koutsenok MD, MSjames_harvey_phd
Session 1 "Motivational Interviewing Course: Assisting Patients in Making Sustainable Positive Lifestyle Changes"
Presented by Dr Igor Koutsenok MD, MS (University of California San Diego, Department of Psychiatry) on 05/06/2020 during the first session of an ISSUP virtual training on MI.
**PLEASE NOTE that video slides have been removed to reduce file size**
Presentation content and learning outcomes:
After orientation to the underlying spirit and principles of MI, practical exercises will help participants to strengthen empathy skills, recognize and elicit change talk, and roll with resistance. Research evidence will be reviewed for the efficacy of MI and for the importance of building a therapeutic relationship in clients’ outcomes. Integration of MI with other treatment modalities will be considered.
Learning outcomes:
Introduction: Motivation and behavioral change in addiction medicine
Review of the concepts of Ambivalence, Stages of change, the righting reflex, limits of persuasion.
Spirit of MI
Expressing empathy
Roadblocks to communication
Four Processes in MI
Full details: https://www.issup.net/about-issup/news/2020-05/motivational-interviewing-course
The document provides an update on the development of standards and credentialing for health and wellness coaches by Dr. Michael Arloski. It discusses the mission of the National Commission for Certifying Healthcare & Wellness Coaches (NCCHWC) to establish training, education standards, and certification for health and wellness coaches. It also lists leadership members of the NCCHWC and their qualifications.
- Psychotherapy has been shown to be effective based on meta-analyses, with effect sizes ranging from 0.75 to 0.85. Approximately three-quarters of patients benefit from therapy and 40-60% return to normal functioning.
- The benefits of psychotherapy have been found to last over time, though there is some decay, and to be equal or greater than medication for most disorders except schizophrenia and bipolar disorder.
- While not all patients respond equally well, psychotherapy works through common factors like the therapeutic relationship rather than specific techniques. Taking a biopsychosocial approach can help address client factors influencing outcomes.
The document provides an overview of motivational interviewing (MI), including its evolution, research supporting its effectiveness, core components, and processes. MI is a goal-oriented counseling approach developed to strengthen personal motivation for change. Key aspects of MI include developing a partnership between counselor and client, accepting client autonomy and perspectives without judgment, eliciting the client's own motivations for change, and having compassion for the client. The four processes of MI are engaging with the client, focusing discussions on a goal, evoking the client's own arguments for change, and planning steps toward change.
This document summarizes a meta-analysis of 206 studies on adventure therapy outcomes published between 1967 and 2012. The meta-analysis found that adventure therapy has a moderate positive effect on psychosocial outcomes, with an overall effect size of 0.50 for pre-post outcomes. Larger effects were found for outcomes related to self-concept, social development, and clinical measures. Moderator analyses found slightly larger effects for older participants and programs with an open group structure. The meta-analysis provides benchmarking data to evaluate adventure therapy program outcomes.
Psychology in Primary Care An Evaluation of Best Practices BASUHMO Research Network
This study examined appointment attendance patterns for psychology/mental health services across different care delivery models within a healthcare system. The three models studied were referral, co-located, and co-located/integrated. Logistic regression found that patients referred to the co-located/integrated clinics, which featured interaction between primary care and psychology providers, were more likely to attend their initial appointment. Being older increased the likelihood of attendance, while longer times between referral and scheduling decreased attendance odds. Limitations included a single co-located/integrated clinic being studied.
Achieving behaviour change for patient safety, Judith Dyson, Lecturer, Mental Health - University of Hull
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
This document discusses screening, brief intervention, and referral to treatment (SBIRT) programs. It provides an overview of SBIRT, including core components like screening instruments, brief interventions using motivational interviewing techniques, and referral to treatment for those who need higher levels of care. The document also discusses evidence and organizations that support SBIRT, lessons learned from SBIRT programs in Colorado, and solutions to common barriers in implementing SBIRT services.
Cengage Learning Webinar, Psychology, New directions in self regulation theoryCengage Learning
Just when we thought we had worked out the main outlines of self-regulation theory, several new findings have emerged to challenge that picture. Dr. Roy Baumeister, Florida State University, presents results from laboratory, longitudinal, and meta-analytic studies on how high self-control may specialize less in resisting temptation than in avoiding it. Self-control, ego depletion, self-control and other topics are addressed
Tom Caplan operates the Caplan Therapy Centre in Montreal, which offers individual and group counseling services. The document provides an overview of Caplan's qualifications and experience, as well as the services offered through his private practice and affiliations. These include anger management groups, domestic violence counseling, marriage counseling, and training workshops on topics like behavior management and the Needs ABC intervention model. The Needs ABC model focuses on determining a client's relationship needs and collaborating on productive strategies to meet those needs while considering emotions.
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 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.
MICAS is a brief questionnaire which clients can fill out. As a result, the fidelity of their coach/HCP in the delivery of motivational interviewing will be reliably measured, within the framework of physical activity stimulation.
1) Motivational interviewing (MI) arose from research on therapist empathy that found empathy strongly predicted client drinking outcomes.
2) MI was then developed as a clinical method focused on differentially responding to client speech to evoke and strengthen their own motivations for change.
3) Research found that MI alone or added to other treatments significantly increased client abstinence and retention in treatment programs for substance use issues. However, outcomes have varied across populations and studies.
Motivational Interviewing is an approach that uses a guiding style to engage patients and elicit their own motivations for behavior change. It has been shown to be effective across healthcare settings. Key aspects include practicing an engaging rather than directing style, developing strategies to understand patient motivations, and refining listening skills to encourage change talk. The approach aims to promote patient autonomy and work with their strengths to find solutions, rather than just focusing on problems.
The study analyzed weekly hospital admissions data in England from 2002-2008 to assess the short-term impact of smoke-free legislation introduced in July 2007. It found:
1) After adjusting for trends, seasonality, population size, temperature, and flu rates, emergency admissions for myocardial infarction (heart attacks) decreased by 2.4% (equivalent to 1,200 fewer admissions) following the legislation.
2) The reduction was greater in men and women aged 60 and over (3.1% for men, 3.8% for women) than in younger groups, though men under 60 also saw a significant decrease.
3) In total, the legislation was estimated to have prevented around 1,600
This document discusses supporting smoking cessation in healthcare. It explores gaps in understanding tobacco addiction and challenges in managing smoking cessation. The authors conducted a literature review and expert assessment to formulate recommendations. They found that smoking is not widely viewed as an addiction and few smokers seek help quitting from healthcare professionals. While professionals recognize advising patients to quit, barriers exist to doing so. Overall, more must be done to convince professionals that smoking is an addiction requiring treatment like other addictions.
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LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
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core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
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advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
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The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
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significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
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land.
The utilization of land is impacted by human needs and environmental factors. In countries
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to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
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providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
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A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
1. Addiction and Motivation:
What Works?
Rik Bes
Centre for Motivation and Change
Hilversum, the Netherlands
www.motivationalinterview.nl
www.motivationalinterviewing.org
2. Addiction and Motivation:
What Works?
• Motivational Interviewing; evidence base
• Practitioner’s competency
• Implementation in organizations
3. Addiction and Motivation:
What Works?
• Motivational Interviewing; evidence base
• Practitioner’s competency
• Implementation in organizations
5. MI and evidence-based research
Meta-analysis
Hettema JM, et al.
Annual Review of Clinical Psychology 2005;1:91–111
Hettema JM, et al.
J of Cons Clin Psychol 2010;78(6):668–84
6. Mean combined effect size by problem area
(N = 72 RCT’s)
HIV risk 0.71
Drug abuse 0.51
Public health 0.51
Gambling 0.44
3 Months
Treatment adherence 0.42
Alcohol 0.41
Diet / exercise 0.14
Smoking 0.04
HIV risk 0.53
Drug abuse 0.29
Public health 0.3
Gambling 0.29
Follow-up
Treatment adherence 0.72
Alcohol 0.26
Diet / exercise 0.78
Smoking 0.14
0 0.2 0.4 0.6 0.8 1
7. Adoption Curve for Innovations
N umber of Adoptions
Source: Everett M. Rogers Diffusion of Innovations
8. Number of MI Publications
550
500
Number of Publications
450
400
350
300
250
200
150
100
50
0
83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5
Years
Source: www.motivationalinterviewing.org
Publications double about every three years
9. Adoption Curve for MI
Number of Adoptions
If Rogers’ curve holds, approximately 30% of those who will
ultimately adopt MI have done so
10. So, after 30 years of research we
have a treatment method that is:
• Evidence-based >90 RCT’s
• Relatively brief
• Specifiable (but be careful with manuals)
• Grounded in testable theory
• With specifiable mechanisms of action
• Generalizable across problem areas
• Complementary to other treatment
methods
• Learnable by a broad range of providers
• Verifiable – Is it being delivered properly?
11. Addiction and Motivation:
What Works?
• Motivational Interviewing; evidence base
• Practitioner’s competency
• Implementation in organizations
12. A continuum of styles
Directing Guiding Following
70
60
50
40
30
20
10
0
Informing Asking Reflective Listening
13. A working definition:
• Motivational interviewing is a collaborative,
• person-centered
• structured form of guiding
• to elicit and strengthen
• intrinsic motivation for change
14. Eight Stages in Learning MI
1. Getting the spirit of MI
2. Using client-centered skills (OARS)
3. Recognizing change talk
4. Eliciting and reinforcing change talk
5. Rolling with resistance
6. Developing a change plan
7. Consolidating client commitment
8. Integrating MI with other intervention methods
Miller, W. R., & Moyers, T. B. (2006). Eight stages in learning motivational
interviewing. Journal of Teaching in the Addictions
15. 10 things that MI is . . .
1. A refined form of guiding
2. in a conversation focused on change
3. that evokes and strengthens personal motivation
4. in a person-centered, autonomy-honoring way
5. using specific methods in certain ways
6. toward a particular change goal
7. that is attuned to and guided by client speech
8. and is relatively brief
9. adaptable across people, cultures and problems
10. and is specifiable and learnable
16. Where MI Clinicians Can Get
Stuck
1. Letting go of the expert role (righting
reflex)
2. Using complex reflections
3. Missing opportunities for MI
4. Giving insufficient direction
5. Opposing resistance
6. (Not) moving on to focusing and
planning
7. (Not) attending to commitment language
18. Learning MI
Some findings
• Reading about MI doesn’t affect
competency
• 2-3 day workshops will raise awareness and
interest; they won’t increase competency
enough to score ‘competency’ on MITI
• Advanced workshops help to get ‘un-stuck’
• Continued coaching and observed practice
lead – over time – to full competency
19. Addiction and Motivation:
What Works?
• Motivational Interviewing; evidence base
• Practitioner’s competency
• Implementation in organizations
20. Examples from MI
implementation
• Addiction services in the Netherlands
(mid 90’s)
• Various hospitals (2007 ->)
• Criminal Justice systems
(Netherlands, Sweden, UK) (2000 ->)
• Health Care standards (f.i. diabetes
care, smoking cessation)
21. Implementation challenges
• MI is not ‘easy’ to do for a practitioner,
neither for the organisation to implement
• Need for longer term planning
• Sustainability of competency:
• Professional peer support
• Intervision/supervision/coaching
• Life-long-learning
• More than what happens between patient
and therapist
22. Some helpful resources
• Monitoring and research
• Tailor-made:
• Teaching tools
• Peer-support solutions
• E-Learing and blended learning
• Webinars
• Online coaching
23. Addiction and Motivation:
What Works?
Rik Bes
Centre for Motivation and Change
Hilversum, the Netherlands
www.motivationalinterview.nl
www.motivationalinterviewing.org