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Motivational Interviewing: Nuts and Bolts
This document provides an overview of motivational interviewing (MI), including its definition, spirit, assumptions, tasks, goals, principles, and skills. MI is a collaborative communication method used to strengthen a person's intrinsic motivation for change. It assumes motivation is fluid and influenced by relationships and context. The main task is to guide conversations in a way that elicits motivation for change, with the goal of influencing health behaviors. Key principles include expressing empathy, amplifying ambivalence, avoiding arguments, supporting self-efficacy, and rolling with resistance. Skills involved are open-ended questions, affirmations, reflections, and summaries. The document also discusses ambivalence, change talk, commitment language, and behaviors related to health
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Motivational Interviewing: Nuts and Bolts
- 1. Stephen R. Andrew,LCSW LADC CCS
- 2. Engaging Patients Attitudes andbehaviors What you’ve done or witnessed
- 3. MI: What isit? Definition: Motivational interviewing is a collaborative, person-centered evidence- based, guiding method of communication for enhancing and strengthening intrinsic motivation for change. Spirit: Collaboration, Autonomy, Respect, Compassion
- 4. Motivational Interviewing... assumes motivation isfluid and can be influenced motivation is influenced in context of a relationship principle task: to guide conversation towards eliciting motivation for change goal: to influence change in the direction of health
- 5. Communication is hard... Hereare the places it can break down. Speaker Listener 1. What the speaker means 2. What the speaker says 3. What the listener hears 4. What the listener thinks the speaker means
- 6. What is listening? Focusall purpose, attention, and energy on understanding What is the person experiencing right now? Hearing what they are NOT saying
- 7. Five General Principles Expressaccurate empathy Amplify ambivalence Avoid arguments Support self-efficacy Roll with resistance
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- 10. Motivational Interviewing Process: TheStructure AmbivalenceAmbivalence CHANGE TALK Desire Ability Reason Need CHANGE TALK Desire Ability Reason Need COMMITMENT LANGUAGE COMMITMENT LANGUAGE CHANGE BEHAVIOR TOWARDS and/or HEATLH CHANGE BEHAVIOR TOWARDS and/or HEATLH IncreaseIncrease desiresdesires ObserveObserveNoticeNotice 1 LowerLower 10
- 11. The Skills “OARS” “OARS” O =open-ended questions A = affirm R = reflection S = summarize
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- 13. The Accuracy Functionof Reflection Speaker Listener 1. What the speaker means 2. What the speaker says 3. What the listener hears 4. What the listener thinks the speaker means Bridge the gap by reflection
- 14. The Case 53 year-oldmale came to clinic one week ago for concern of high blood pressure reading at work. He presents now for follow up and BP is in control.
- 15. “Now that wehave a plan to manage your blood pressure, Mr. Jones, I wonder if I can talk with you about some preventive health care. Specifically, I wanted to mention some recommendations for all patients over age 50 to undergo colon cancer screening. Would it be okay with you to talk a little about this today?”
- 16. Jones: “ Geez,doc, like I said, I only came in ‘cause my wife made me after that nurse at work got that abnormal blood pressure reading. I’m not here for the works. You know what I’m say-in’?”
- 17. What is thispatient telling you? How will you respond? How will you respond?
- 19. Next Steps We’ll teleportup to two sky platforms in order to practice your MI technique Click on your assigned color (red or blue) teleport device, to the left or right of the screen See you at 300 meters!