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.
Training for drug and alcohol counselors on using motivational interviewing counseling techniques to improve retention in treatment and move clients through the stages of change model.
Training for drug and alcohol counselors on using motivational interviewing counseling techniques to improve retention in treatment and move clients through the stages of change model.
Review of motivational interviewing techniques and strategies most useful at each phase of change. NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Patrick McKiernan
Motivational interviewing is a technique that uses a dialogue between a counselor and a client who needs to
change behaviors in his or her life. The purpose of this technique is to be non-confrontational, non-adversarial and
non-judgmental, and uses open-ended questions and reflective listening to forge a relationship between counselor
and client built on trust and empathy. This session will present basic information on how to help increase motivation
to change with individuals considering but uncommitted to change. The discussion will include background, theory,
and techniques related to the change process.
Financial counselors and educators find themselves in a quandary. They offer their clients a wealth of information about how to overcome financial obstacles and achieve financial goals. However, clients often lack the motivation to act on this information. Good information is necessary but often insufficient to motivate action. Motivational Interviewing, or MI, provides a powerful set of tools any helping professional can use to motivate change. MI has been refined by 30 years of research resulting in over 200 published studies with a variety of populations. MI has been found effective wherever helping professionals need to motivate behavior change.
Register for webinar, find supportive materials and join the webinar here: https://learn.extension.org/events/2638
Motivational Interviewing 2015: Empowering Patients in Self-careDr. Umi Adzlin Silim
Motivational Interviewing for Behavioural Changes. Presented at Seminar Clinical Dietetic Updates in Cardiovascular Disease & Hypertension, Kementerian Kesihatan Malaysia. 17-18 August 2015.
Motivational Interviewing in Health PromotionIt Sounds Like.docxgilpinleeanna
Motivational Interviewing in Health Promotion:
It Sounds Like Something Is Changing
Ken Resnicow, Colleen DiIorio,
and Johanna E. Soet
Emory University
Belinda Borrelli and Jacki Hecht
Brown University
Denise Ernst
Kaiser Permanente Center for Health Research
Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been
applied in public health, medical, and health promotion settings. This article provides an overview of MI,
outlining its philosophic orientation and essential strategies. Major outcome studies are reviewed,
nuances associated with the use of MI in health promotion and chronic disease prevention are described,
and future directions are offered.
Key words: motivational interviewing, health promotion, counseling, behavioral medicine,
health psychology, public health
Motivational interviewing (MI), originally described by Miller
in 1983 and more fully discussed in a seminal text by Miller and
Rollnick in 1991, has been used extensively in the addiction field
(Dunn, Deroo, & Rivara, 2001; Noonan & Moyers, 1997). There
has been considerable recent interest on the part of public health,
health psychology, and medical professionals in adapting MI to
address other health behaviors and conditions, such as smoking,
diet, physical activity, screening, sexual behavior, diabetes control,
and medical adherence (Emmons & Rollnick, 2001; Resnicow,
DiIorio, et al., 2002).
This article provides an overview of MI, describing its philo-
sophic orientation and essential strategies, with an emphasis on
application to health promotion and chronic disease prevention.
Major outcome studies in which MI has been used in the context
of health promotion and behavioral medicine are reviewed. Nu-
ances that distinguish its use for changing chronic disease and
nonaddictive behaviors are addressed, and future directions are
offered.
MI Overview
MI is neither a discrete nor entirely new intervention paradigm
but an amalgam of principles and techniques drawn from existing
models of psychotherapy and behavior change theory. MI can be
thought of as an egalitarian interpersonal orientation, a client-
centered counseling style that manifests through specific tech-
niques and strategies. A key goal of MI is to assist individuals to
work through their ambivalence about behavior change, and it
appears to be particularly effective for individuals who are initially
low in terms of readiness to change (Butler et al., 1999; Heather,
Rollnick, Bell, & Richmond, 1996; Miller & Rollnick, 1991;
Resnicow, Jackson, Wang, Dudley, & Baranowski, 2001; Rollnick
& Miller, 1995).
The tone of the MI encounter is nonjudgmental, empathetic, and
encouraging. Counselors establish a nonconfrontational and sup-
portive climate in which clients feel comfortable expressing both
the positive and negative aspects of their current behavior. Unlike
some psychotherapeutic models that rely heavily on therapist
insight or traditional patient education ...
Review of motivational interviewing techniques and strategies most useful at each phase of change. NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Patrick McKiernan
Motivational interviewing is a technique that uses a dialogue between a counselor and a client who needs to
change behaviors in his or her life. The purpose of this technique is to be non-confrontational, non-adversarial and
non-judgmental, and uses open-ended questions and reflective listening to forge a relationship between counselor
and client built on trust and empathy. This session will present basic information on how to help increase motivation
to change with individuals considering but uncommitted to change. The discussion will include background, theory,
and techniques related to the change process.
Financial counselors and educators find themselves in a quandary. They offer their clients a wealth of information about how to overcome financial obstacles and achieve financial goals. However, clients often lack the motivation to act on this information. Good information is necessary but often insufficient to motivate action. Motivational Interviewing, or MI, provides a powerful set of tools any helping professional can use to motivate change. MI has been refined by 30 years of research resulting in over 200 published studies with a variety of populations. MI has been found effective wherever helping professionals need to motivate behavior change.
Register for webinar, find supportive materials and join the webinar here: https://learn.extension.org/events/2638
Motivational Interviewing 2015: Empowering Patients in Self-careDr. Umi Adzlin Silim
Motivational Interviewing for Behavioural Changes. Presented at Seminar Clinical Dietetic Updates in Cardiovascular Disease & Hypertension, Kementerian Kesihatan Malaysia. 17-18 August 2015.
Motivational Interviewing in Health PromotionIt Sounds Like.docxgilpinleeanna
Motivational Interviewing in Health Promotion:
It Sounds Like Something Is Changing
Ken Resnicow, Colleen DiIorio,
and Johanna E. Soet
Emory University
Belinda Borrelli and Jacki Hecht
Brown University
Denise Ernst
Kaiser Permanente Center for Health Research
Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been
applied in public health, medical, and health promotion settings. This article provides an overview of MI,
outlining its philosophic orientation and essential strategies. Major outcome studies are reviewed,
nuances associated with the use of MI in health promotion and chronic disease prevention are described,
and future directions are offered.
Key words: motivational interviewing, health promotion, counseling, behavioral medicine,
health psychology, public health
Motivational interviewing (MI), originally described by Miller
in 1983 and more fully discussed in a seminal text by Miller and
Rollnick in 1991, has been used extensively in the addiction field
(Dunn, Deroo, & Rivara, 2001; Noonan & Moyers, 1997). There
has been considerable recent interest on the part of public health,
health psychology, and medical professionals in adapting MI to
address other health behaviors and conditions, such as smoking,
diet, physical activity, screening, sexual behavior, diabetes control,
and medical adherence (Emmons & Rollnick, 2001; Resnicow,
DiIorio, et al., 2002).
This article provides an overview of MI, describing its philo-
sophic orientation and essential strategies, with an emphasis on
application to health promotion and chronic disease prevention.
Major outcome studies in which MI has been used in the context
of health promotion and behavioral medicine are reviewed. Nu-
ances that distinguish its use for changing chronic disease and
nonaddictive behaviors are addressed, and future directions are
offered.
MI Overview
MI is neither a discrete nor entirely new intervention paradigm
but an amalgam of principles and techniques drawn from existing
models of psychotherapy and behavior change theory. MI can be
thought of as an egalitarian interpersonal orientation, a client-
centered counseling style that manifests through specific tech-
niques and strategies. A key goal of MI is to assist individuals to
work through their ambivalence about behavior change, and it
appears to be particularly effective for individuals who are initially
low in terms of readiness to change (Butler et al., 1999; Heather,
Rollnick, Bell, & Richmond, 1996; Miller & Rollnick, 1991;
Resnicow, Jackson, Wang, Dudley, & Baranowski, 2001; Rollnick
& Miller, 1995).
The tone of the MI encounter is nonjudgmental, empathetic, and
encouraging. Counselors establish a nonconfrontational and sup-
portive climate in which clients feel comfortable expressing both
the positive and negative aspects of their current behavior. Unlike
some psychotherapeutic models that rely heavily on therapist
insight or traditional patient education ...
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
Self disclosure in addiction counseling: To tell or not to tell?wrule1154
This is also an NYS OASAS approved continuing education course for renewal certification.
More info and online course catalog at: https://imustnotuse.com
For our second edition of our brand new e-zine, we’re shining the spotlight on the intriguing topic of patient insights. We discuss the role of patient insights and what impact it has on improving patient outcomes, and highlight new ways pharma can engage with patients.
So what are you waiting for? Head over to the website now for the latest edition of Spotlight On. Again, if you like what you see, feel free to share it with others. And if the first edition passed you by, don’t worry, it’s still available to read. Enjoy!
learning objectives 16 16.1 Who seeks therapy and what are the goa.docxcroysierkathey
learning objectives 16 16.1 Who seeks therapy and what are the goals of therapy? 16.2 How is the success of psychotherapy measured? 16.3 What are some of the factors that must be considered to provide optimal treatment? 16.4 What psychological approaches are used to treat abnormal behavior? 16.5 What roles do social values and culture play in psychotherapy? 16.6 What biological approaches to treating abnormal behavior are available? Most of us have experienced a time or situation when we were dramatically helped by talking things over with a relative or friend. Most therapists, like all good listeners, rely on receptiveness, warmth, and empathy and take a nonjudgmental approach to the problems their clients present. But there is more to therapy than just giving someone an opportunity to talk. Therapists also introduce into the relationship psychological interventions that are designed to promote new understandings, behaviors, or both on the client’s part. The fact that these interventions are deliberately planned and systematically guided by certain theoretical preconceptions is what distinguishes professional therapy from more informal helping relationships. An Overview of Treatment The belief that people with psychological problems can change—can learn more adaptive ways of perceiving, evaluating, and behaving—is the conviction underlying all psychotherapy. Achieving these changes is by no means easy. Sometimes a person’s view of the world and her or his self-concept are distorted because of pathological early relationships that have been reinforced by years of negative life experiences. In other instances, environmental factors such as an unsatisfying job, an unhappy relationship, or financial stresses must be the focus of attention in addition to psychotherapy. Because change can be hard, people sometimes find it easier to bear their present problems than to challenge themselves to chart a different life course. Therapy also takes time. Even a highly skilled and experienced therapist cannot undo a person’s entire past history and, within a short time, prepare him or her to cope adequately with difficult life situations. Therapy offers no magical transformations. Nevertheless, it holds promise even for the most severe mental disorders. Moreover, contrary to common opinion, psychotherapy can be less expensive in the long run than alternative modes of intervention (Dobson et al., 2008; Gabbard et al., 1997). Numerous therapeutic approaches exist, ranging from psychoanalysis to Zen meditation. However, the era of managed care has prompted new and increasingly stringent demands that the efficacy of treatments be empirically demonstrated. This chapter will explore some of the most widely accepted psychological and biological treatment approaches in use today. Although we recognize that different groups of mental health professionals often have their own preferences with respect to the use of the terms client and patient, in this chapter we use ...
Motivational Interviewing as Client Engagement Tool Raya Arbiol, MBA
This presentation will help participants understands Motivational Interviewing (MI) as a counseling approach that facilitates and engages a person's intrinsic motivation in order to change behavior. Participants will learn how Motivational Interviewing is a goal-oriented, client-centered counseling style that elicits behavior change by helping clients explore and resolve ambivalence.
Brief therapy, sometimes also referred to as short term therapy (usually 10 to 20 sessions) , is a generic label for any form of therapy in which time is an explicit element in treatment planning.
Attendees will gain insight into the stigma that is attached to individuals who have dual diagnosis and criminal justice involvement, as well as, the importance of instilling power and hope to the individual. They will increase knowledge of the stages of change and utilizing motivational interviewing techniques to assist the individual through their path of recovery from mental illness, substance abuse, and criminal justice involvement.
1. Running head: MOTIVATIONAL INTERVIEWING 1
Motivational Interview
Opiate Addiction
Cassandra Erickson
Saint Cloud State University
2. MOTIVATIONAL INTERVIEWING 2
In the field of clinical psychology, it is becoming ever more important to allow clients to
make their own choices. Using motivational interviewing (MI), a person centered skill designed
to illicit change, a client becomes in charge of their own health. MI is a tool that is often used in
addiction, with this paper focusing specifically on opioid addiction. Opioid use can be
prescription forms of codeine, oxycodone, and hydrocodone, or the non-prescription heroin.
Oftentimes in the case of prescription opiates opioid addiction stems from needing to relieve
pain. People will use heroin to obtain a euphoric high. According to SAMSHA, approximately
1.9 million Americans met criteria for prescription painkillers use disorder based on their use of
prescription painkillers, and 4.8 million people have used heroin at some point in their lives
(SAMSHA 2016). People who are regular users of prescription pain killers will turn at some
point in their life to heroin due to being a more inexpensive option, as well as being more widely
available. MI has shown to be an effective tool and should become standard in the counseling of
opioid addicts.
Motivational Interviewing
MI is a collaborative conversation used to illicit change by strengthening personal
motivation and creating attainable goals through exploration of needed change. Being a person
centered approach to counseling, MI collaborates between client and counselor in an effort to
create change talk. Change talk occurs after ambivalence, when the client realizes why they
want to change. A counselor trained in MI will know how to draw out and encourage change
talk in an effort to proceed with a plan on how to implement the change.
MI is focused on four key concepts; partnership, acceptance, compassion, and evocation.
These constitute the spirit of MI and what a counselor invokes when practicing the skill.
Partnership or collaboration happens when the counselor is working with a client. MI is not a
3. MOTIVATIONAL INTERVIEWING 3
superiority skill but rather an active partnership between two people with no one person more
knowledgeable than the other (Miller, Rollnick, 2013). This concept is important in MI because
it helps to build trust between the counselor and client. Acceptance does not mean as the
counselor approval of the clients behavior is necessary but rather understand and realize the
worth of every client as well as affirming the strengths and efforts of the client. It means taking
an active interest in the client’s life, and respecting a client’s wishes and honoring their
autonomy (Miller, Rollnick, 2013). Compassion is a relatively new element for MI, but is
extremely relevant for any counselor. When compassionate the counselor will actively seek to
enhance the client’s welfare, and give priority to the client’s needs. A counselor does not
necessarily need to have suffered alongside the client (Miller, Rollnick, 2013). Evocation is
probably the most fundamental portion of MI. It is the realization that clients have what they
need to survive, counselors only assist in the realization (Miller, Rollnick, 2013). When the
counselor evokes change talk, it becomes the point at which a client can take charge of their own
life, and will often proceed to creating the change the client desires.
MI follows a specific set of principles which are required for the therapy style to work.
The counselor can remember these principles using the acronym RULE. This acronym stands
for resisting the righting reflex, understanding the client motivation, listen with empathy, and
empower the client. When employing MI the counselor should never give advice. The change
must come from within the client with the counselor there to put the client in the right position.
Even if the counselor doesn’t agree with the motivations of the client they must not give advice,
by doing this they are listening with empathy. Oftentimes the client needs someone to show
care, at which point empathetic listening evokes the clients trust. When the client has reached
the point of change the counselor should empower the client to make those changes. If the
4. MOTIVATIONAL INTERVIEWING 4
counselor follows these principles and concepts of MI, the technique will be invaluable to
clients, and further increase rehabilitation.
Skill Sets for Opioid Addiction
MI revolves around many different skill sets used to evoke change talk. The change talk
desired in an Opiate Addict is to stop using and maintain sobriety. Determining if the client is
still in pain after going through detox is important as well as pain can drive the addiction. How
the counselor does this is important on whether the client will actually change. They key is not
to push too fast, if the client is still ambivalent about change the counselor must get the client to
begin thinking of change. The best way to do this is using MI micro-skills and other skill sets.
The micro-skills consist of open ended questions, affirmation, reflection, and summarization or
OARS. Perhaps the most important skill set is asking open ended questions. By asking these
questions it is possible to lead the client to change talk. By affirming this process it encourages
the client to think more about change and what it would mean for them.
The next skill set of importance to use in Opiate Addiction is confrontation. While the
counselor does not want to yell at the client it is preferable to push. When the client states
something which isn’t true, or in direct violation of their stated values it is important. Sometimes
the client may not recognize the importance or inconsistencies of what they are saying. For an
opiate addict who values their family the counselor could confront them with, “How can you
value your family if you are taking money from your kid’s piggy bank to pay for your heroin”.
This will encourage the client to either reevaluate their values or bring about change talk.
Oftentimes the client will stick to their perceived values and begin to question their activities
instead.
5. MOTIVATIONAL INTERVIEWING 5
Why MI for Opiate Addiction
Opioid is a complex issue requiring treatment. The increase in availability of narcotic
pain killers has caused an increase in the amount of people using. Often times the treatment of
Opioid Addiction will need to look at why the client began using the drug. If the client started
using prescription pain killers because they were in pain and then transitioned to heroin, or if
they are still only using pills, would be different if the client began using heroin. MI is effective
for Opioid Addiction because it allows the client to question the value of continued addiction and
if life would be different without the use of opiates.
MI for an Opioid Addict is useful as a treatment plan as shown in brief episodes of MI
therapy in treatment. In a study done by Saunders, Wilkinson, and Phillips (1995), they looked
at the intensity of using MI in short segments for opioid users at a methadone clinic. Saunders,
Wilkinson, and Phillips found a positive link between opioid users and a positive shift towards
change, even if it was a brief one (Saunders, Wilkinson, and Phillips, 1995). The overall effect
of MI on opioid users is positive, especially if able to continue treatment over a long period of
time.
When a debating what kind of treatment to pursue when the client is diagnosed as an
Opioid Addict it is better to pursue MI than to not pursue any kind of follow up therapy at all.
When MI is shown to be strongest immediately following intervention with it dwindling over
time if not continued (Smedslund, et al., 2011). To achieve long standing results of MI, the
counselor must continually enforce the principles. In this study it seems they did brief sessions.
Overall MI is an effective strategy for treatment. It would be beneficial to pair MI with another
form of therapy when considering Opioid Addiction, such as relapse prevention or goal setting.
6. MOTIVATIONAL INTERVIEWING 6
By teaching life skills and inviting change talk the counselor creates a positive environment
where the client is able to grow.
Weaknesses resulting from MI is the time table. Not every client will open up to the
counselor in the amount of time. Without the client – rapport it is unlikely for change talk to
happen. Another weakness is follow up. With MI being a behavioral change there is no follow
up to encourage following through on goals. When a client runs out of insurance reimbursement
they are often left without the affirmations. These weaknesses in MI can be circumvented given
an increase in counseling sessions as needed, and making an effort to provide follow ups as
needed for the client.
Acknowledging the strengths of MI is the change model. Recognizing when the client is
ready to change is important otherwise the client and counselor never get anywhere as they are
always fighting each other. MI is a strength based model. It encourages clients to look within
themselves to change because they already know how, they just have not fully realized it. This is
encouraging when most counseling techniques focus on the inability of the client to choose and
require the knowledge of the counselor to proceed. Focusing on the clients strengths allows
them proceed the stages of change at a much quicker pace.
Despite the limitations of MI in my future career as a rehabilitation counselor I see
myself continuing to explore and learn more about MI. The treatment shows to be effective in
the treatment of addiction with letting people set their own pace for change. This is important
because each individual has the right to know and understand how influential they are in their
own recovery.
7. MOTIVATIONAL INTERVIEWING 7
References
Miller, R. W., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd
ed.). New York, London: The Guilford Press.
Saunders, B., Wilkinson, C., & Phillips, M. (1995). The impact of a brief motivational
intervention with opiate users attending a methadone programme. Addiction, 90(3), 415.
doi:https://doi.org/10.1080/09652149542382
Smedslund, G., Berg, R. C., Hammerstrøm, K. T., Steiro, A., Leiknes, K. A., Dahl, H. M., &
Karlsen, K. (2011). Motivational interviewing for substance abuse. Cochrane Database
of Systematic Reviews, doi:10.1002/14651858.CD008063.pub2
Substance Abuse and Mental Health Services Administration (SAMSHA). (2016). Opioids.
Retrieved from http://www.samhsa.gov/atod/opioids