The objections of this presentation include: to experience and practice motivational interviewing, learn motivational interviewing styles and principles and see how it integrates into everyday practice.
DBT is a cognitive behavioral treatment approach that blends acceptance-based strategies with problem-solving skills training. It emphasizes dialectical processes and teaches skills to help manage emotions and function effectively. DBT is recommended for several conditions and is the top evidence-based treatment for suicide prevention. Research on DBT outcomes receives high ratings for quality. Treatment involves individual therapy, skills groups, phone coaching and provider consultation to support a unified treatment approach.
A discussion of motivational interviewing: what is it, how does it work, and how can we start to use it with students face forced behavior change in academics?
This document discusses obsessive compulsive disorder (OCD) and its treatment using cognitive behavioral therapy (CBT). It defines OCD as being characterized by obsessions and/or compulsions. Common obsessions include contamination, symmetry, forbidden thoughts, and harm. Biological and environmental factors can contribute to OCD. The cognitive model of OCD is described, involving triggers, appraisals, bodily sensations, and behavioral inclinations. CBT techniques for treating OCD include psychoeducation, relaxation, exposure and response prevention, thought distraction/stopping, and identifying cognitive errors. Exposure therapy aims to reduce anxiety through habituation. Relapse prevention is also discussed.
As research into the applications of mindfulness progresses, both in the medical field for problems like pain and chronic illness management, and in the mental health field through therapies such as Dialectical Behavior Therapy, Acceptance & Commitment Therapy, and Mindfulness-Based Cognitive Therapy continue to increase the empirical support for the efficacy of this approach in a variety of conditions, it behooves us to learn more about this and apply it in our own lives and practices.
Kevin Drab
The document discusses using cognitive behavioral therapy (CBT) and mindfulness techniques in addiction treatment. It provides an overview of how CBT can be used to identify and modify dysfunctional thought patterns. Mindfulness is presented as a way to become more aware of thoughts and reduce judgment. Specific CBT and mindfulness strategies are outlined, such as keeping a thought record, challenging automatic thoughts, and practicing non-judgment.
Motivational Interviewing has been described as “simple but not easy”. Continued practice and coaching are key to increasing practitioners’ MI proficiency, particularly in our intentional and strategic application of the spirit and skills of MI. This immersive, practice-based session builds on the two-day introductory Motivational Interviewing workshop by guiding participants through a series of structured, scaffolded activities that directly relate to your challenging client encounters in your day-to-day work. You will leave this fun and dynamic workshop with a renewed and deeper understanding of how to enhance your clients’ motivation for change by taking your MI skills to the next level!
Learning Objectives:
At the end of this day of applied practice, you will be able to:
1. Assess your areas of MI proficiency and further development
2. Practice OARS to evoke client change talk
3. Practice OARS to respond to clients’ change talk
4. Apply strategies to respond to clients’ sustain talk and enhance motivation for change.
DBT in a concise form. This presentation covers the basics of DBT, the core strategies and the treatment strategies in DBT. Also highlights why DBT was preferred to CBT in patients with borderline personality disorders.
This document provides an overview of solution-focused therapy. It discusses the founders of solution-focused therapy, Steven De Shazer and Insoo Kim Berg, and how solution-focused therapy differs from problem-focused approaches by focusing on solutions and the client's goals rather than problems. The document also outlines common techniques used in solution-focused therapy, such as the miracle question, and explains the therapeutic process of solution-focused therapy which involves goal analysis, measuring desired behaviors, and evaluating progress each session.
DBT is a cognitive behavioral treatment approach that blends acceptance-based strategies with problem-solving skills training. It emphasizes dialectical processes and teaches skills to help manage emotions and function effectively. DBT is recommended for several conditions and is the top evidence-based treatment for suicide prevention. Research on DBT outcomes receives high ratings for quality. Treatment involves individual therapy, skills groups, phone coaching and provider consultation to support a unified treatment approach.
A discussion of motivational interviewing: what is it, how does it work, and how can we start to use it with students face forced behavior change in academics?
This document discusses obsessive compulsive disorder (OCD) and its treatment using cognitive behavioral therapy (CBT). It defines OCD as being characterized by obsessions and/or compulsions. Common obsessions include contamination, symmetry, forbidden thoughts, and harm. Biological and environmental factors can contribute to OCD. The cognitive model of OCD is described, involving triggers, appraisals, bodily sensations, and behavioral inclinations. CBT techniques for treating OCD include psychoeducation, relaxation, exposure and response prevention, thought distraction/stopping, and identifying cognitive errors. Exposure therapy aims to reduce anxiety through habituation. Relapse prevention is also discussed.
As research into the applications of mindfulness progresses, both in the medical field for problems like pain and chronic illness management, and in the mental health field through therapies such as Dialectical Behavior Therapy, Acceptance & Commitment Therapy, and Mindfulness-Based Cognitive Therapy continue to increase the empirical support for the efficacy of this approach in a variety of conditions, it behooves us to learn more about this and apply it in our own lives and practices.
Kevin Drab
The document discusses using cognitive behavioral therapy (CBT) and mindfulness techniques in addiction treatment. It provides an overview of how CBT can be used to identify and modify dysfunctional thought patterns. Mindfulness is presented as a way to become more aware of thoughts and reduce judgment. Specific CBT and mindfulness strategies are outlined, such as keeping a thought record, challenging automatic thoughts, and practicing non-judgment.
Motivational Interviewing has been described as “simple but not easy”. Continued practice and coaching are key to increasing practitioners’ MI proficiency, particularly in our intentional and strategic application of the spirit and skills of MI. This immersive, practice-based session builds on the two-day introductory Motivational Interviewing workshop by guiding participants through a series of structured, scaffolded activities that directly relate to your challenging client encounters in your day-to-day work. You will leave this fun and dynamic workshop with a renewed and deeper understanding of how to enhance your clients’ motivation for change by taking your MI skills to the next level!
Learning Objectives:
At the end of this day of applied practice, you will be able to:
1. Assess your areas of MI proficiency and further development
2. Practice OARS to evoke client change talk
3. Practice OARS to respond to clients’ change talk
4. Apply strategies to respond to clients’ sustain talk and enhance motivation for change.
DBT in a concise form. This presentation covers the basics of DBT, the core strategies and the treatment strategies in DBT. Also highlights why DBT was preferred to CBT in patients with borderline personality disorders.
This document provides an overview of solution-focused therapy. It discusses the founders of solution-focused therapy, Steven De Shazer and Insoo Kim Berg, and how solution-focused therapy differs from problem-focused approaches by focusing on solutions and the client's goals rather than problems. The document also outlines common techniques used in solution-focused therapy, such as the miracle question, and explains the therapeutic process of solution-focused therapy which involves goal analysis, measuring desired behaviors, and evaluating progress each session.
This document provides an overview of solution-focused brief therapy (SFBT). Some key points:
- SFBT was developed in the 1980s and focuses on present and future goals rather than past problems. Therapists help clients identify exceptions, strengths, and solutions.
- Core principles include that clients are the experts in their own lives and change is constant. The future is uncertain but changeable. Therapists amplify what clients are already doing right.
- Common techniques include miracle questions to envision preferred futures, scaling questions to measure progress, and exploring exceptions when problems don't occur. The goal is for clients to do more of what works.
Carl Rogers developed client-centered therapy in the 1940s as an alternative to traditional psychoanalytic approaches. In client-centered therapy, the therapist takes a non-directive approach, actively listening without judgment to help clients gain self-understanding and acceptance. The therapist provides empathy, genuineness, and unconditional positive regard to create an environment where clients can explore their feelings and find their own answers. Research shows client-centered therapy can be as effective as cognitive behavioral therapy and has influenced other approaches like motivational interviewing. While criticism includes the lack of diagnoses, some find it less effective for certain disorders, client-centered therapy changed psychotherapy by making it more client-focused and flexible.
The document discusses motivational interviewing and how it can help clients change. It describes the stages of change clients go through when considering making a change, from pre-contemplation to maintenance. It also discusses communication styles in motivational interviewing, focusing on guiding rather than directing clients. The core principles of motivational interviewing are exploring discrepancies between current behavior and broader life goals, while supporting clients' self-efficacy to change.
Ellis was born in 1913 in Pittsburgh and raised in New York City. He had a difficult childhood due to family strife and health issues, which led him to focus on problem-solving through reading. In his early life, he aspired to be a novelist but was unable to get published. He then pursued psychoanalysis but grew dissatisfied with its limitations. He developed Rational Emotive Behavior Therapy (REBT), which argues that irrational beliefs cause emotional disturbances and that disputing these beliefs can resolve problems. REBT became popular through his many books and workshops. Ellis spent his career developing and promoting REBT until his death in 2007.
Narrative therapy focuses on externalizing problems rather than internalizing them in clients. Therapists help clients develop alternative stories and new narratives by asking questions, exploring exceptions, and collaborating to reauthor their life stories in a preferred direction. The goal is to guide clients to see themselves as competent and separate from problems, and to envision new possibilities rather than being defined by problem-saturated stories from the past.
Cognitive-behavioral group therapy (CBGT) uses cognitive and behavioral techniques to help clients change maladaptive thought and behavior patterns. Key techniques include identifying automatic thoughts and cognitive distortions, monitoring moods and behaviors, relaxation, problem-solving, and relapse prevention. CBGT is effective because it allows clients to learn from others, get feedback, and practice skills in a social context while also receiving individual attention from the therapist.
This document provides an overview of motivational interviewing and its application in drug dependence treatment. Some key points:
- Motivational interviewing is a counseling approach used to increase a client's intrinsic motivation to change problematic behaviors like drug use. It is client-centered and directive.
- The therapist aims to express empathy, develop discrepancy between client goals and behaviors, roll with resistance, support self-efficacy, and avoid argumentation.
- Sessions involve engaging the client, focusing on desired changes, evoking motivation, and planning steps.
- The therapist elicits "change talk" using techniques like exploring problems/values, considering importance of change, and decisional balancing to help the client resolve
Utilizing Solution-Focused Brief Therapy Practices with Long-term Psychiatric Patients in an Out-patient Program.
The document discusses using Solution-Focused Brief Therapy (SFBT) techniques in an intensive outpatient program that treats patients with long-term psychiatric diagnoses like schizophrenia, bipolar disorder, and major depression. It outlines how SFBT questions, goal setting, scaling questions, and other practices are applied in group therapy sessions to help patients focus on solutions rather than problems and move towards achieving their goals.
The document outlines an ACT workshop for working with physical health problems. It discusses using ACT processes to help clients with issues like uncertainty, changes in identity, and avoiding difficult sensations. Specific techniques are explored like defusion, flexible perspective of self, and focusing on values-driven actions. The workshop also addresses challenges like treatment decisions, hopelessness, and caregiving burdens through an ACT lens.
Solution focused counseling for individual sessionsfrielsphd2013
1) Solution-focused counseling focuses on a client's strengths and abilities rather than weaknesses and problems.
2) It was developed in the late 1970s based on observations of what questions and techniques helped clients make progress in therapy sessions.
3) The approach empowers clients by recognizing them as the experts of their own lives and working with them to discover their own solutions.
Cognitive behavioral therapy (CBT) developed from behaviorism and the cognitive revolution. Rational emotive behavior therapy (REBT) was developed by Albert Ellis and focuses on identifying and disputing irrational beliefs. Aaron Beck developed cognitive therapy which posits that negative schemas cause depression. Both REBT and cognitive therapy aim to identify and change maladaptive thoughts by teaching patients to dispute irrational beliefs and substitute rational beliefs. Therapists act as collaborators with patients to test thoughts through socratic questioning. CBT is an empirically supported treatment for depression, anxiety disorders, and other conditions.
Reality therapy focuses on addressing clients' present unsatisfying relationships and ineffective behaviors by teaching them choice theory. The therapist guides clients to evaluate their current behaviors, identify their needs and wants, and make plans to behave more effectively. Reality therapy uses the WDEP method - exploring the client's wants, the direction of their behaviors, having them self-evaluate, and creating plans for change. The goal is for clients to learn how to better meet their needs and develop more satisfying relationships.
Narrative couples therapy developed in the 1990s by Michael White and David Epston. It is based on a social constructionist view that focuses on clients' experiences and meanings rather than pathological labels. The therapist takes a curious and collaborative approach to help clients explore alternative stories and develop new, more satisfying narratives about their relationship. Typical interventions include externalizing problems, highlighting unique outcomes, developing a history of the present, and having clients witness each other's stories. Through retelling and living out new multi-storied narratives, clients can change how they perceive themselves and their relationship.
Mindfulness training can benefit healthcare professionals and their patients. It reduces stress and improves quality of life for professionals. Mindfulness increases attention, emotional regulation, and a friendly attitude. It is associated with changes in brain regions involved in these processes. For patients, mindfulness reduces rumination, anxiety, and improves coping. Studies show professionals who received mindfulness training had patients who rated them higher and had better health outcomes. Mindfulness supports healing relationships and should be considered a characteristic of good clinical practice.
The document summarizes the basics of cognitive-behavioral therapy (CBT), including its model and techniques.
CBT is based on a bio-psycho-social model that views psychopathology as stemming from maladaptive cognitions and behaviors learned through "if-then" schemas. Treatment involves identifying distorted thoughts, or "automatic thoughts", in three cognitive categories - self, others/world, future. CBT aims to overcome "cognitive blockades" and replace distortions with evidence-based thinking through collaborative, Socratic questioning between the patient and therapist. Common techniques include activity scheduling, thought monitoring/challenging, and behavioral experiments.
Stress & Burnout Presentation April 2014Emma Hamel
A stress and burnout presentation which gives the signs of both and tools to deal with each. For more information contact Emma on emma@time2beme.co.za.
DBT was developed by Marsha Linehan for those with borderline personality disorder and self-harming behaviors. It combines standard cognitive-behavioral techniques with acceptance-based strategies and mindfulness. DBT therapy includes individual sessions, skills training groups, telephone coaching, and therapist consultation meetings. The goal is to decrease harmful behaviors while increasing functional coping skills through commitment to the treatment and its four stages: pre-therapy commitment, therapy, ending therapy, and post-therapy.
This document provides an overview of Solution Focused Brief Therapy (SFBT). It describes the goals and process of SFBT, how it differs from other treatments, key active ingredients and techniques used, and the nature of the client-therapist relationship in SFBT. Some of the main techniques discussed include focusing on solutions instead of problems, setting measurable goals, using future-oriented questions, scaling progress, and exploring past successes and exceptions to the present issue.
This presentation takes a look at the ethical responsibilities, training, strategic planning and other considerations that should be examined before entering the business of interventions.
Failure to Launch is a subject I recently addressed at the Innovations in Recovery Conference in April 2016.
According to Psychology Today, the term “failure to launch,” is an increasingly popular way to describe the difficulties some young adults face when transitioning into the next phase of development—a stage which involves greater independence and responsibility. Although this is how it is commonly thought of in industry, from my experience the seedling for this phenomena may have been planted in the early teen and young adult years by over-anxious and well-meaning parents (often called helicopter parents) who wanted a life much easier than they experienced for their offspring.
The effects of FTL can be clearly observed in 49-50-60 and, yes, even 70 years-old individuals who are in need of behavioral health care interventions. These individuals often still live at home or are supported by their parents and do not work. Even if they have been married and have children, they still act as if they were a child and take little responsibility for their financial well-being. My hope is that you find this presentation helpful as we work to reach this fascinating population!
This document provides an overview of solution-focused brief therapy (SFBT). Some key points:
- SFBT was developed in the 1980s and focuses on present and future goals rather than past problems. Therapists help clients identify exceptions, strengths, and solutions.
- Core principles include that clients are the experts in their own lives and change is constant. The future is uncertain but changeable. Therapists amplify what clients are already doing right.
- Common techniques include miracle questions to envision preferred futures, scaling questions to measure progress, and exploring exceptions when problems don't occur. The goal is for clients to do more of what works.
Carl Rogers developed client-centered therapy in the 1940s as an alternative to traditional psychoanalytic approaches. In client-centered therapy, the therapist takes a non-directive approach, actively listening without judgment to help clients gain self-understanding and acceptance. The therapist provides empathy, genuineness, and unconditional positive regard to create an environment where clients can explore their feelings and find their own answers. Research shows client-centered therapy can be as effective as cognitive behavioral therapy and has influenced other approaches like motivational interviewing. While criticism includes the lack of diagnoses, some find it less effective for certain disorders, client-centered therapy changed psychotherapy by making it more client-focused and flexible.
The document discusses motivational interviewing and how it can help clients change. It describes the stages of change clients go through when considering making a change, from pre-contemplation to maintenance. It also discusses communication styles in motivational interviewing, focusing on guiding rather than directing clients. The core principles of motivational interviewing are exploring discrepancies between current behavior and broader life goals, while supporting clients' self-efficacy to change.
Ellis was born in 1913 in Pittsburgh and raised in New York City. He had a difficult childhood due to family strife and health issues, which led him to focus on problem-solving through reading. In his early life, he aspired to be a novelist but was unable to get published. He then pursued psychoanalysis but grew dissatisfied with its limitations. He developed Rational Emotive Behavior Therapy (REBT), which argues that irrational beliefs cause emotional disturbances and that disputing these beliefs can resolve problems. REBT became popular through his many books and workshops. Ellis spent his career developing and promoting REBT until his death in 2007.
Narrative therapy focuses on externalizing problems rather than internalizing them in clients. Therapists help clients develop alternative stories and new narratives by asking questions, exploring exceptions, and collaborating to reauthor their life stories in a preferred direction. The goal is to guide clients to see themselves as competent and separate from problems, and to envision new possibilities rather than being defined by problem-saturated stories from the past.
Cognitive-behavioral group therapy (CBGT) uses cognitive and behavioral techniques to help clients change maladaptive thought and behavior patterns. Key techniques include identifying automatic thoughts and cognitive distortions, monitoring moods and behaviors, relaxation, problem-solving, and relapse prevention. CBGT is effective because it allows clients to learn from others, get feedback, and practice skills in a social context while also receiving individual attention from the therapist.
This document provides an overview of motivational interviewing and its application in drug dependence treatment. Some key points:
- Motivational interviewing is a counseling approach used to increase a client's intrinsic motivation to change problematic behaviors like drug use. It is client-centered and directive.
- The therapist aims to express empathy, develop discrepancy between client goals and behaviors, roll with resistance, support self-efficacy, and avoid argumentation.
- Sessions involve engaging the client, focusing on desired changes, evoking motivation, and planning steps.
- The therapist elicits "change talk" using techniques like exploring problems/values, considering importance of change, and decisional balancing to help the client resolve
Utilizing Solution-Focused Brief Therapy Practices with Long-term Psychiatric Patients in an Out-patient Program.
The document discusses using Solution-Focused Brief Therapy (SFBT) techniques in an intensive outpatient program that treats patients with long-term psychiatric diagnoses like schizophrenia, bipolar disorder, and major depression. It outlines how SFBT questions, goal setting, scaling questions, and other practices are applied in group therapy sessions to help patients focus on solutions rather than problems and move towards achieving their goals.
The document outlines an ACT workshop for working with physical health problems. It discusses using ACT processes to help clients with issues like uncertainty, changes in identity, and avoiding difficult sensations. Specific techniques are explored like defusion, flexible perspective of self, and focusing on values-driven actions. The workshop also addresses challenges like treatment decisions, hopelessness, and caregiving burdens through an ACT lens.
Solution focused counseling for individual sessionsfrielsphd2013
1) Solution-focused counseling focuses on a client's strengths and abilities rather than weaknesses and problems.
2) It was developed in the late 1970s based on observations of what questions and techniques helped clients make progress in therapy sessions.
3) The approach empowers clients by recognizing them as the experts of their own lives and working with them to discover their own solutions.
Cognitive behavioral therapy (CBT) developed from behaviorism and the cognitive revolution. Rational emotive behavior therapy (REBT) was developed by Albert Ellis and focuses on identifying and disputing irrational beliefs. Aaron Beck developed cognitive therapy which posits that negative schemas cause depression. Both REBT and cognitive therapy aim to identify and change maladaptive thoughts by teaching patients to dispute irrational beliefs and substitute rational beliefs. Therapists act as collaborators with patients to test thoughts through socratic questioning. CBT is an empirically supported treatment for depression, anxiety disorders, and other conditions.
Reality therapy focuses on addressing clients' present unsatisfying relationships and ineffective behaviors by teaching them choice theory. The therapist guides clients to evaluate their current behaviors, identify their needs and wants, and make plans to behave more effectively. Reality therapy uses the WDEP method - exploring the client's wants, the direction of their behaviors, having them self-evaluate, and creating plans for change. The goal is for clients to learn how to better meet their needs and develop more satisfying relationships.
Narrative couples therapy developed in the 1990s by Michael White and David Epston. It is based on a social constructionist view that focuses on clients' experiences and meanings rather than pathological labels. The therapist takes a curious and collaborative approach to help clients explore alternative stories and develop new, more satisfying narratives about their relationship. Typical interventions include externalizing problems, highlighting unique outcomes, developing a history of the present, and having clients witness each other's stories. Through retelling and living out new multi-storied narratives, clients can change how they perceive themselves and their relationship.
Mindfulness training can benefit healthcare professionals and their patients. It reduces stress and improves quality of life for professionals. Mindfulness increases attention, emotional regulation, and a friendly attitude. It is associated with changes in brain regions involved in these processes. For patients, mindfulness reduces rumination, anxiety, and improves coping. Studies show professionals who received mindfulness training had patients who rated them higher and had better health outcomes. Mindfulness supports healing relationships and should be considered a characteristic of good clinical practice.
The document summarizes the basics of cognitive-behavioral therapy (CBT), including its model and techniques.
CBT is based on a bio-psycho-social model that views psychopathology as stemming from maladaptive cognitions and behaviors learned through "if-then" schemas. Treatment involves identifying distorted thoughts, or "automatic thoughts", in three cognitive categories - self, others/world, future. CBT aims to overcome "cognitive blockades" and replace distortions with evidence-based thinking through collaborative, Socratic questioning between the patient and therapist. Common techniques include activity scheduling, thought monitoring/challenging, and behavioral experiments.
Stress & Burnout Presentation April 2014Emma Hamel
A stress and burnout presentation which gives the signs of both and tools to deal with each. For more information contact Emma on emma@time2beme.co.za.
DBT was developed by Marsha Linehan for those with borderline personality disorder and self-harming behaviors. It combines standard cognitive-behavioral techniques with acceptance-based strategies and mindfulness. DBT therapy includes individual sessions, skills training groups, telephone coaching, and therapist consultation meetings. The goal is to decrease harmful behaviors while increasing functional coping skills through commitment to the treatment and its four stages: pre-therapy commitment, therapy, ending therapy, and post-therapy.
This document provides an overview of Solution Focused Brief Therapy (SFBT). It describes the goals and process of SFBT, how it differs from other treatments, key active ingredients and techniques used, and the nature of the client-therapist relationship in SFBT. Some of the main techniques discussed include focusing on solutions instead of problems, setting measurable goals, using future-oriented questions, scaling progress, and exploring past successes and exceptions to the present issue.
This presentation takes a look at the ethical responsibilities, training, strategic planning and other considerations that should be examined before entering the business of interventions.
Failure to Launch is a subject I recently addressed at the Innovations in Recovery Conference in April 2016.
According to Psychology Today, the term “failure to launch,” is an increasingly popular way to describe the difficulties some young adults face when transitioning into the next phase of development—a stage which involves greater independence and responsibility. Although this is how it is commonly thought of in industry, from my experience the seedling for this phenomena may have been planted in the early teen and young adult years by over-anxious and well-meaning parents (often called helicopter parents) who wanted a life much easier than they experienced for their offspring.
The effects of FTL can be clearly observed in 49-50-60 and, yes, even 70 years-old individuals who are in need of behavioral health care interventions. These individuals often still live at home or are supported by their parents and do not work. Even if they have been married and have children, they still act as if they were a child and take little responsibility for their financial well-being. My hope is that you find this presentation helpful as we work to reach this fascinating population!
OBJECTIVES:
If I were starting an adolescent treatment center what would I want to make sure adolescents and families learn?
Identify and Describe How Families Arrive at your door.
To Demonstrate the Power of Family Mapping and the Art and Science of Portraiture.
Clinical and Reverse Interventions - what are these and how to do?
Share Standard Vocabulary Families need to know Family Change Agreements - What are these - when to use?
This document provides information to help wealth advisors identify and assist clients who may be struggling with substance abuse or other behavioral health issues. It discusses signs to look out for, the importance of legal documentation that allows advisors to communicate with family members, different types of treatment options and specialties, and resources for intervention and treatment referral. Case studies of potential clients with issues are also presented to demonstrate how to assess situations using the ABC (age of first use, big changes, co-existing issues) model.
This document discusses the importance of understanding narratives in non-linear and collaborative conversations. It encourages growth and renewal through self-care like exercise, healthy boundaries, and living consistently with one's values. It advocates living with possibility through being open, passionate, learning from mistakes, engaging with others, creating value, looking for goodness, being of service, and cultivating gratitude while expecting good things.
OBJECTIVES
To Talk about Family, Friends, & Recovery
To Show Ways in Which Family and Friends May Engage In Healthy Communications
To Demonstrate ways in which Families, Friends can take care of themselves
Identify external motivators and collateral processes for the resistant client
Learn alignment strategies using Motivational Interviewing and Solution Focused Therapy
Practice the art of Crucial Conversations
Practice Parallel Processes
Identify Emotional Attunement
Practice Reflective Listening and Speaking
Identify Ways to Integrate these strategies into your practice
Care Advocacy for the client in treatment
Dr. Louise Stanger of All About Interventions describes SFT, motivational interviewing and parallel processes to help addiction professionals integrate these transformational processes into practice.
This presentation was given at CORE in Amelia Island, FL in 2016. Presentation objective:
Identify, Describe & Explain Resistant Clients
Learn alignment strategies using MI, SFT, Daring way & Rising Strong strategies
Practice Crucial Conversations
Identify Role of Shame and the Practice of Empathy and Compassion
Show how these strategies may be integrated into practice using case examples
Newer Drugs emerging
Clinical Practices shifting to recovery management models
DSM V -Basic assumptions being questions
Triple Threat
Evidenced based principles in practice
Technology as a healing helper
Pain management is a critical component to patient care. However, it is leading to opioid addiction at an alarming rate in the United States. For many patients, a paradigm shift is needed to go from pain management to pain recovery.
This presentation "What's Love Got to Do With It? Boundaries and Relationships" describes how developing compassionate discipline and by choosing to abdicate our role as hostages and hostage-takers that we can really begin to not take love’s glorious and transcendent name in vain.
From identifying ethical decision-making models to the top issues, Dr. Louise Stanger of All About Interventions provides ethical guidelines for addiction and marketing professionals
As a seasoned interventionist, I’ve seen clients from both sides of the mental illness/substance abuse spectrum as well as clients with an avalanche of additional problems that I describe as the TRIPLE THREAT, those who suffer from a tertiary issue either as a result of a prior condition (i.e. disorder or illness) or that one that is exacerbated by additional factors (i.e. physical, legal, traumatic, etc.). These folks and their families present a diagnostic quandary with their kaleidoscope of competing and equally important issues.
This document discusses the Karpman drama triangle model of dysfunctional relationships. The triangle consists of the roles of Victim, Rescuer, and Perpetrator. It explains how people can get stuck in these roles due to core beliefs and coping mechanisms related to shame. The document then outlines ways to move from these roles by recognizing emotions, owning one's story, and writing a new ending through tools like mindfulness, self-compassion, and setting boundaries.
Describe and Define Standard of Care & Ethics
Describe and Define Laws
Identify Top Ethical Issues visa vie Snowball Sample
Recommend Ethical Decision
Making Models
CARE Challenge Providers to Develop Mission, and Ethics Statements for Behavioral Health Care Centers
Motivational Interviewing by Ravi Kolli,MDravikolli
Motivational Interviewing is a client-centered treatment approach that aims to resolve ambivalence and increase intrinsic motivation for change. It seeks to increase the importance a client places on changing and their belief that change is possible. Motivational Interviewing has been shown to be effective in treating substance abuse and increasing compliance with medical treatment plans in as little as 1-4 sessions. Key principles of Motivational Interviewing include expressing empathy, rolling with resistance rather than confronting it, developing discrepancy between a client's goals and behaviors, and supporting a client's self-efficacy for change.
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.
The document discusses motivational interviewing, a counseling technique used to encourage behavior change by exploring an individual's own motivations for change in a non-confrontational manner. It is used in academic settings to help students who are struggling with workload stress, have discrepancies between goals and behaviors, or are ambivalent about abilities or services. The document outlines techniques of motivational interviewing like reflective listening, decisional balancing, affirmations, and summaries.
This document provides guidance on developing a positive mindset and outlook toward life and the future. It discusses the power of optimism, hope, and future-mindedness. Specific tools for success mentioned include positive self-talk, affirmations, visualizing success, and practicing gratitude. Happiness is presented as stemming from internal beliefs, values, and voluntary actions like expressing optimism, kindness, and accomplishing goals rather than external factors. The document encourages developing life priorities and habits for continuous self-improvement.
This document discusses leadership and the seven habits of highly effective people based on Stephen Covey's work. It provides an overview of the seven habits, which include being proactive, beginning with the end in mind, putting first things first, thinking win-win, seeking first to understand then to be understood, synergizing, and sharpening the saw. The habits move from independence to interdependence and developing trust and effective relationships. The document also discusses developing personal leadership through personal strategic planning, mentors, reading, and continuous self-improvement.
This presentation is the crux of a famous book "Seven Habits of Highly Effective People" by Stephen R. Covey. The presentation was originally created by Paul L Gerhardt of South Seattle Community College.
This document discusses the importance of self-management skills. It explains that an individual is the creator, executor, and judge of their own destiny. It outlines some key areas of life that are affected by self-management like career, family, income, and health. The document then discusses developing self-acceptance, accepting personal responsibility, and mastering creator language to take control of outcomes rather than feeling like a victim. It also identifies six components of self-management: motivation, learning style/strategies, time management, physical environment, social environment, and performance.
This document provides guidance on peer-to-peer mentoring. It emphasizes valuing one's own skills and helping others grow through sharing knowledge, building relationships, and empowering mentees to become mentors themselves. Effective mentoring involves knowing your mentee's goals, being patient, celebrating successes, and encouraging accountability and improvement. Mentors should lead by example, avoid being defensive or inflexible, and focus on small, consistent efforts that can lead to big successes over time.
Here are some strategies for handling this situation:
- Initiate feedback conversations yourself. Schedule regular check-ins to discuss your work and get their perspective.
- Ask specific questions to elicit feedback, like "How am I doing on X project?" or "What can I do to improve in area Y?"
- Share examples of your work for their input. Ask "What do you think of how I handled this situation?"
- Express your desire to develop in your role and how feedback will help with that. Say something like "Feedback is really important to me for continuing to grow in this position."
- If they still don't provide feedback, request setting goals and metrics for evaluation. Ask them to commit to
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.
The document provides information about an upcoming presentation on mindfulness and exceptionalities. It will cover:
1) Learning at least three new things that can be applied during presentations.
2) Having fun while covering different exceptionalities important to the audience.
3) Learning how to apply mindfulness strategies to help students and oneself.
The presentation will be led by Sean Murphy, Principal of The Matheny School, and Denise Micheletti, Chief Nursing Officer of Matheny. It will discuss research on emotional intelligence and mindfulness, applications of mindfulness at Matheny, and ideas for application in other settings.
This document summarizes a webinar about using self-awareness and observation to increase inner resilience through understanding motivation and predispositions. It discusses how assessments like the Individual Directions Inventory can reveal deeper motivational drivers and how those drivers can form self-reinforcing patterns. It also explains how greater awareness of reactions, triggers, and life goals can help mitigate reactive cycles and harness motivation for well-being rather than just achievement. The webinar provides strategies for developing observational skills to better understand and regulate one's motivations.
Two mindsets exist - a fixed mindset where ability is believed to be innate and unchanging, and a growth mindset where ability can be developed through effort. People with a growth mindset are more motivated, set learning goals, and persist in the face of challenges. Praising a person's effort rather than their intelligence fosters a growth mindset by encouraging strategies like trying new approaches and increased effort when struggling. The brain is malleable, and adopting a growth mindset through targeted praise can create lasting positive change in a person's beliefs about learning and achievement.
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Learn about Treatment Without Walls.
We help individuals AND families navigate life’s challenges.
We work in home – to provide support in the family’s environment.
We create healthy long-term dynamics.
We tailor programs that work toward results-oriented living.
We are fully bespoke. We are there for you and your family, wherever and whenever.
We collaborate with the best behavioral health specialists and centers across the globe.
This is the guidebook I wish I had when I was first learning about addiction and mental health disorders when I was a young woman.
It’s the book I give to every client who walks through my door. It is Family Focused, Practical, Hopeful and full of real life examples to help you understand and have the courage to change your experience.
At the end of the presentation, you will be able to:
Identify, Describe and Discuss, How Clients and Families Come to your Practice
Identify Describe and Discuss Addiction, Mental Health, Trauma, Chronic Pain and Process Disorders
Identify how Trauma, Shame, Guilt, Humiliation, Embarrassment, Grief and Loss Effect Ones Story about themselves
Identify how Growing Up in An Alcoholic Family can effect one
Review evidence based strategies
Identify and Differentiate trauma as both objective and subjective and how it effects people over the life span
Recognize how trauma can be precipitating factor which leads to a substance use disorder and vice versa the activities one engages in the midst of a substance use disorder can be traumatic
Identify and Describe Addiction per ASAM new definition
Describe and Discuss Qualitative Methods of Inquiry and Family Mapping as a Way into Story
Objectives
Describe and Discuss major
Gen Z issues :
Isolation Bullying, Cutting,
Vaping, Texting ,Self Harm
Teen Suicide
Alcohol, Marijuana and Other
Drug Use
Tips for Parents and Counselors
OBJECTIVES:
To describe and explain Gen Z in COVID 19
To highlight the differences between Gen Z and Millennials
To explore the problems of Anxiety and Depression in this group
Demonstrate, Recognize, Define and Identify what we mean by aging
Describe Substance Use Disorders (Marijuna, Alcohol & Opioids)
Identify Mental Health Issues (Depression & Anxiety, Grief and Loss, Suicide )
OBJECTIVES
Identify, Describe and Discuss Trauma and Collective Trauma Describe and Discuss how Holidays are being altered by Covid 19 Identify and Describe How to deal with Holiday Stress
Identify Describe and Discuss Addiction, Mental Health, Trauma, Chronic Pain and Process Disorders
Identify how Trauma, Shame, Guilt, Humiliation, Embarrassment, Grief and Loss Effect Ones Story about themselves
Identify how Growing Up in An Alcoholic Family can effect one Review evidence based strategies
At the end of this session, participants will be able to:
Identify and define their philosophical orientation
Become Acquainted with Appreciative Inquiry
Identify Intergenerational patterns in their clients
Assess the value of Portraiture as a qualitative mode of inquiry to gain valuable data about an individual and family themes as a nonjudgemental way into story
Demonstrate pictorially family resilience and wounds and use this as broad map for clinical interventions ( in private practice, in interventions and in behavioral health centers
How do you discover joy and gratitude and move forward in life with purpose and hope? We explore these and other issues related to addiction, mental health, chronic pain, and trauma.
OBJECTIVES:
Examine the history of suicide in the medical professional and how that differs from other groups
Look at variables which contribute to physician burn out
Describe and Discuss Depression, Stress and Anxiety in the Medical Community
Describe how Addiction, Depression and Anxiety and Suicide Effect Families
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-Who-s Your Family? Describe and Define using Family Maps
-Learn how to have open ended Conversations through the Art & Science of Portraiture
-Teach the us of Memoir as a way to learn to live with Possibility & Affirm Resilience.
OBJECTIVES
- Identify, Describe How Clients and Families Come to your
Practice
- Identify , Describe and Discuss Addiction, Mental Health ,
Chronic Pain and Process Disorders
-Identify how Trauma, Shame ,Guilt, Humiliation, Embarrassment , Grief and Loss Effect Ones Story about Themselves
-Identify how we as clinicians, behavioral health care professionals identify our clients
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OBJECTIVES:
Identify, Describe How Clients and Families Come to your Practice
Identify , Describe and Discuss Addiction, Mental Heath , Trauma , Chronic Pain and Process Disorders
Identify how Trauma, Shame ,Guilt, Humiliation, Embarrassment , Grief and Loss Effect Ones Story about Themselves
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To describe and explain Gen Z
To highlight the differences between Gen Z and Millennials
To explore the problems of Anxiety and Depression in this group
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Motivational interviewing Training
1. Motivational Interviewing:Motivational Interviewing: Working with TheWorking with The
Resistant ClientResistant Client
Dr Louise A. Stanger Ed. D,Dr Louise A. Stanger Ed. D,
LCSW, BRI II, CIPLCSW, BRI II, CIP
MINT Trainer of TrainersMINT Trainer of Trainers
Faculty SDSUFaculty SDSU
Director All AboutDirector All About
InterventionsInterventions
2. ObjectivesObjectives
To experience and practice the basics of MI
To learn MI Style and Principles
To directly experience the MI approach and
contrast with others
To see how it integrates into everyday practice
3. Getting To Know YouGetting To Know You
Hello, Tell us aboutHello, Tell us about
Yourself ?Yourself ?
What brought you hereWhat brought you here
today ?today ?
What do you want to getWhat do you want to get
out of training ?out of training ?
4. What is Motivation?What is Motivation?
Probability ofProbability of
behavior change orbehavior change or
movement toward ormovement toward or
against goalagainst goal
Extrinsic…….Extrinsic…….
Intrinsic ……Intrinsic ……
5. Personal Goal :Personal Goal :
Choose a personal goalChoose a personal goal
Develop an action PlanDevelop an action Plan
Action
Thinking
Idea
6. SO…………………..SO…………………..
How realistic is this plan for you & how soon will youHow realistic is this plan for you & how soon will you
start?start?
How faithful will you be to the plan?.. Be Honest!How faithful will you be to the plan?.. Be Honest!
Will it be easy or hard?Will it be easy or hard?
How long will you do this plan for?How long will you do this plan for?
How will you view yourself if you stop, do it partially ,How will you view yourself if you stop, do it partially ,
stop & start, never start at all?stop & start, never start at all?
Can others help you and how will you respond toCan others help you and how will you respond to
reminders?reminders?
8. AfterthoughtsAfterthoughts
How was this for youHow was this for you
Is the process of changeIs the process of change
simple or complexsimple or complex
Is change linearIs change linear
Is it all or nothing forIs it all or nothing for
you?you?
Motivation >>>Motivation >>>
Confidence >>>>Confidence >>>>
9. When do People ChangeWhen do People Change
Stages of ChangeStages of Change
Readiness to ChangeReadiness to Change
10. In between the cravingsIn between the cravings
Find the Spaces InbetweenFind the Spaces Inbetween
Omar Manejawa MDOmar Manejawa MD
Cravings – MyopicCravings – Myopic
Spaces- ChangeSpaces- Change
Habits -ActionsHabits -Actions
11. Stages Of ChangeStages Of Change
Precontemplation
Contemplation
Preparation
Action
Maintenance
12. PrecontemplationPrecontemplation
Person is not seeing need for lifestyle changePerson is not seeing need for lifestyle change
Client believes there is no problemClient believes there is no problem
May feel forced into treatment.May feel forced into treatment.
Response to resisistanceResponse to resisistance
What does this sound like?What does this sound like?
13. Counselors Task : PrecontemplationCounselors Task : Precontemplation
Raise DoubtRaise Doubt
Increase the person’s perception of risks andIncrease the person’s perception of risks and
problems with current behaviorproblems with current behavior
14. 2. Contemplation2. Contemplation
Person is consideringPerson is considering
making a change and hasmaking a change and has
not decided yetnot decided yet
Response to resistanceResponse to resistance
Estimates put 80% ofEstimates put 80% of
people eitherpeople either
precontemplative orprecontemplative or
contemplativecontemplative
Maybe I willl …………Maybe I willl …………
15. Task : ContemplationTask : Contemplation
Client is considering changeClient is considering change
Client not fully convinced he / she will makeClient not fully convinced he / she will make
change- eovke responses to changechange- eovke responses to change
Tip the Balance –strengthen self efficacyTip the Balance –strengthen self efficacy
Case example :Lisa visits CVSCase example :Lisa visits CVS
16. PreparationPreparation
Person has decided toPerson has decided to
change and ischange and is
considering how to Makeconsidering how to Make
changeschanges
Motivation fluctuates asMotivation fluctuates as
does ambivalencedoes ambivalence
MI used to elicit changeMI used to elicit change
talktalk
17. ActionAction
Person is actively doingPerson is actively doing
something to changesomething to change
May experience setbacksMay experience setbacks
Encourage action, setEncourage action, set
example, give homeworkexample, give homework
18. MaintenanceMaintenance
Person is maintaining activity over timePerson is maintaining activity over time
Some temptation to return to former behaviorSome temptation to return to former behavior
or small lapses ( TRIGGER LANE )or small lapses ( TRIGGER LANE )
Change has existed over 6 months or moreChange has existed over 6 months or more
19. RELAPSE & RECYCLERELAPSE & RECYCLE
Restart, reboot the processesRestart, reboot the processes
Help the person renew the process ofHelp the person renew the process of
contemplation, determination, and action w/ocontemplation, determination, and action w/o
getting stuck in Shameville !getting stuck in Shameville !
20. What is Motivational Interviewing?What is Motivational Interviewing?
A directive client-centered counseling approachA directive client-centered counseling approach
for eliciting behavior change by helping clientsfor eliciting behavior change by helping clients
to explore and resolve ambivalence.to explore and resolve ambivalence.
Rollnick and Miller 1995Rollnick and Miller 1995
21. MI StyleMI Style
Process not TechniqueProcess not Technique
CollaborativeCollaborative
Evocation- elicit clientsEvocation- elicit clients
internal viewpointinternal viewpoint
AutonomyAutonomy
Roll With ResistanceRoll With Resistance
22. MI SpiritMI Spirit
Rogerian approachRogerian approach
Coupled with a directionCoupled with a direction
EqualitarianEqualitarian
Warm, Empathetic, Affirming & RespectfulWarm, Empathetic, Affirming & Respectful
Guiding & eliciting vs. instructing & persuadingGuiding & eliciting vs. instructing & persuading
Video- Join Up (Horse Whisper)Video- Join Up (Horse Whisper)
23. Characteristics of MICharacteristics of MI
Counselor is active and directiveCounselor is active and directive
Counselor helps shape behaviorCounselor helps shape behavior
MI strategy is specific and systematicMI strategy is specific and systematic
Consistent with principles of client choice andConsistent with principles of client choice and
empowermentempowerment
Consistent with cultural sensitivity in that clientConsistent with cultural sensitivity in that client
leads and counselors agenda is not imposedleads and counselors agenda is not imposed
24. Traps to AvoidTraps to Avoid
Question-AnswerQuestion-Answer
Labeling Trap – dx codesLabeling Trap – dx codes
Premature Focus Trap-start withPremature Focus Trap-start with
clients concern not yoursclients concern not yours
ExpertExpert
Taking sidesTaking sides
Blaming Others _ who is toBlaming Others _ who is to
blame is not as important asblame is not as important as
to what your concerns areto what your concerns are
25. MI PrinciplesMI Principles
EE-DD-RR-SSEE-DD-RR-SS
Express EmpathyExpress Empathy
Develop Discrepancy- help one get unstuck fromDevelop Discrepancy- help one get unstuck from
ambivalent feelingsambivalent feelings
Roll with Resistance ( get out of the way )Roll with Resistance ( get out of the way )
Support Self Efficacy ( Bandura) The capacity of aSupport Self Efficacy ( Bandura) The capacity of a
person to believe they can carryspecific act or behaviorperson to believe they can carryspecific act or behavior
26. Guiding StrategiesGuiding Strategies
How to Express EmpathyHow to Express Empathy
How to Develop DiscrepancyHow to Develop Discrepancy
How to Roll With ResistanceHow to Roll With Resistance
How to Elicit Self-MotivationHow to Elicit Self-Motivation
Brief NegotiationBrief Negotiation
27. How to Express EmpathyHow to Express Empathy
Use your OarsUse your Oars
Open Ended QuestionsOpen Ended Questions
AffirmationsAffirmations
ReflectionsReflections
SummariesSummaries
28. Open and Closed EndedOpen and Closed Ended
What types of things do youWhat types of things do you
want to talk aboutwant to talk about
Tell me about…Tell me about…
How do you think smokingHow do you think smoking
pot is related to the problemspot is related to the problems
you talk about in youryou talk about in your
marriagemarriage
What brings you hereWhat brings you here
today?/today?/
Don’t yuu think your wifeDon’t yuu think your wife
and kids are hurt enough byand kids are hurt enough by
your drinking ?your drinking ?
Isn’t your friends idea thatIsn’t your friends idea that
you quit ?you quit ?
Are there good things aboutAre there good things about
your drug use?your drug use?
How long have you beenHow long have you been
concerned about x ?concerned about x ?
29. Mining for AffirmationsMining for Affirmations
Group ExerciseGroup Exercise
20 Strengths20 Strengths
Groups of 5-with 5Groups of 5-with 5
strengthsstrengths
Identify open endedIdentify open ended
question to elicit strengthquestion to elicit strength
and an affirmation youand an affirmation you
might offer in responsemight offer in response
to a strengthto a strength
30. Affirm your clientAffirm your client
I appreciate your honestyI appreciate your honesty
I can see that caring forI can see that caring for
your children isyour children is
important to youimportant to you
It shows courage andIt shows courage and
commitment to comecommitment to come
back to meetingsback to meetings
You have good ideasYou have good ideas
31. Listening ExerciseListening Exercise
Break up in dyadsBreak up in dyads
Practice Listening – 3Practice Listening – 3
minutesminutes
DebriefDebrief
32. 12 Roadblocks to Listening12 Roadblocks to Listening
1. Ordering, directing,1. Ordering, directing,
commandingcommanding
2. Warning or threatening2. Warning or threatening
3. Giving advice, suggestions,3. Giving advice, suggestions,
solutionssolutions
4. Persuading with logic,4. Persuading with logic,
arguing,arguing,
5. Moralizing, preaching5. Moralizing, preaching
6.Disagreening, judging,6.Disagreening, judging,
criticizing , blamingcriticizing , blaming
33. 12 Roadblocks to Listening12 Roadblocks to Listening
7.Agreeing, approving,7.Agreeing, approving,
praisingpraising
8. Shaming, ridiculing or8. Shaming, ridiculing or
labelinglabeling
9. Interpreting or analyzing9. Interpreting or analyzing
10. Reassuring, sympathizing10. Reassuring, sympathizing
11. Questioning or probing11. Questioning or probing
12.Withdrawing, distracting12.Withdrawing, distracting
34. Assumptions To AvoidAssumptions To Avoid
Person OUGHT to changePerson OUGHT to change
Person WANTS to changePerson WANTS to change
Persons health is primePersons health is prime
motivation factormotivation factor
If she/he decides not toIf she/he decides not to
change consultation is achange consultation is a
failurefailure
Individuals are eitherIndividuals are either
motivated to change or theymotivated to change or they
are notare not
Now is the right time toNow is the right time to
consider changeconsider change
A tough approach isA tough approach is
always the best approachalways the best approach
I am the expert andI am the expert and
know bestknow best
A egotiation approach isA egotiation approach is
always bestalways best
35. Persuasion ExercisePersuasion Exercise
Grps of 2Grps of 2
Identify change you are consideringIdentify change you are considering
Counselors roleCounselors role
1. Explain why perosn should make this change1. Explain why perosn should make this change
2. Give three specific benefits that result from change2. Give three specific benefits that result from change
3. Tell the person how they can change3. Tell the person how they can change
4. Emphasize its important for them to make change/include4. Emphasize its important for them to make change/include
negative consequencesnegative consequences
5. Tell persuade the person to do it5. Tell persuade the person to do it
And if you encounter resitance try harderAnd if you encounter resitance try harder
36. Listen ReflectivelyListen Reflectively
Being quiet and activelyBeing quiet and actively
listeninglistening
Responding with aResponding with a
statement that accuratelystatement that accurately
reflects the essence ofreflects the essence of
what the client meantwhat the client meant
Listen carefully thinkListen carefully think
ReflectionsReflections
37. ReflectionsReflections
Think in terms of forming anThink in terms of forming an
hypotheses or best guess athypotheses or best guess at
what client is sayingwhat client is saying
Take a guess –Do youTake a guess –Do you
mean…mean…
You have to differentiateYou have to differentiate
between a question and abetween a question and a
statementstatement
Voice goes down at end ofVoice goes down at end of
statement rather then up withstatement rather then up with
a questiona question
““You're angry with yourYou're angry with your
mother …mother …
A statement does not requireA statement does not require
an answer .an answer .
Used strategically emaphsize,Used strategically emaphsize,
clients view , feelings,clients view , feelings,
ambivalence, emotion changeambivalence, emotion change
talktalk
38. Level of ReflectionLevel of Reflection
Repeating repeat what someone has just saidRepeating repeat what someone has just said
Rephrase – substitute a few different wordsRephrase – substitute a few different words
Paraphrasing-make a fairly major restatementParaphrasing-make a fairly major restatement
inferring what you think a person has saidinferring what you think a person has said
Reflecting feeling – special kind of paraphraseReflecting feeling – special kind of paraphrase
where you are not necessarily relecting contentwhere you are not necessarily relecting content
rather feelingrather feeling
39. Simple ReflectionSimple Reflection
Client: She is driving meClient: She is driving me
crazy trying to get me tocrazy trying to get me to
do quitdo quit
Counselor; Her methodsCounselor; Her methods
are really bothering youare really bothering you
Client: I don’t haveClient: I don’t have
anything to sayanything to say
Counselor- You are notCounselor- You are not
feeling talkative todayfeeling talkative today
40. Amplified ReflectionsAmplified Reflections
Exaggerate what clientExaggerate what client
says be careful not to besays be careful not to be
sarcasticsarcastic
All my friends smokeAll my friends smoke
weed and I don’t seeweed and I don’t see
giving it upgiving it up
So you are likely to keepSo you are likely to keep
smoking foreversmoking forever
41. Doubled Sided ReflectionDoubled Sided Reflection
((meant to capture both sides of ambivalencemeant to capture both sides of ambivalence ))
C- It would stink to lose my job over a dumb policyC- It would stink to lose my job over a dumb policy
because I have been using,because I have been using, butbut do way do I want to quitdo way do I want to quit
partying just because of thatpartying just because of that
Co-Co- On the one handOn the one hand you value your job because it allowsyou value your job because it allows
you to live comfortably and on the other hand you alsoyou to live comfortably and on the other hand you also
enjoy using drugs with your friendsenjoy using drugs with your friends
C -It would be hard to stick to a plan (workout)……….C -It would be hard to stick to a plan (workout)……….
CO--------CO--------
42. Other strategies for HandingOther strategies for Handing
ResistanceResistance
ClarificationClarification
Shift focus away fromShift focus away from
stumbling blockstumbling block
Emphasize PersonalEmphasize Personal
Choice and ControlChoice and Control
43. Provide SummariesProvide Summaries
Communicate what you have tracked what theCommunicate what you have tracked what the
client has said so that you have understanding ofclient has said so that you have understanding of
what is being saidwhat is being said
Helps structure session so you do not getHelps structure session so you do not get
sidetrackedsidetracked
Provide opportunity to emphasize statements aProvide opportunity to emphasize statements a
client has made about change talk gives clientclient has made about change talk gives client
another opportunity to hear what she has saidanother opportunity to hear what she has said
in context provided by the counselorin context provided by the counselor
44. ExampleExample
So Sally , let me know if I heard you correctly.So Sally , let me know if I heard you correctly.
You care about your children and you areYou care about your children and you are
hoping social services does not intervene. Youhoping social services does not intervene. You
believe you need to change your realtionshipsbelieve you need to change your realtionships
that involve using and aren’t quite sure how tothat involve using and aren’t quite sure how to
do that?do that?
Or what else would you add ?......Or what else would you add ?......
45. Exploring AmbivalenceExploring Ambivalence
The Existence ofThe Existence of
conflicting emotions orconflicting emotions or
thoughts about a personthoughts about a person
object or ideaobject or idea
Protagonist ExerciseProtagonist Exercise
46. Decisional Balance WorksheetDecisional Balance Worksheet
((Fill in what you are considering as change )Fill in what you are considering as change )
Good things aboutGood things about
Changing behaviorChanging behavior
Good things about changingGood things about changing
behaviorbehavior
Not so good things aboutNot so good things about
behaviorbehavior
Not so good things aboutNot so good things about
changing behaviorchanging behavior
47. Protagonists' ExerciseProtagonists' Exercise
Explore Roles forExplore Roles for
resolving ambivalenceresolving ambivalence
Break up in groups of 6Break up in groups of 6
Client is to discuss anClient is to discuss an
issue on which he/she isissue on which he/she is
ambivalentambivalent
Four counselors areFour counselors are
assigned a role & eachassigned a role & each
has 3 minuteshas 3 minutes
1 observer1 observer
48. Protagonists' ExerciseProtagonists' Exercise
#1- argues for one side#1- argues for one side
of ambivalenceof ambivalence
#2 argues other side of#2 argues other side of
ambivalenceambivalence
#3 communicates#3 communicates
disinterest- “I really don’tdisinterest- “I really don’t
care what you to”care what you to”
#4 show interest in how#4 show interest in how
the person is doingthe person is doing
49. Eliciting Change TalkEliciting Change Talk
Desire StatementsDesire Statements
I’d like toI’d like to quit drinking ifquit drinking if
I couldI could
I wish I couldI wish I could make mymake my
life betterlife better
I want toI want to ……….……….
Getting in shape wouldGetting in shape would
make me feel…….make me feel…….
Ability StatementsAbility Statements
II thinkthink I can do thatI can do that
ThatThat mightmight be possiblebe possible
I’m thinkingI’m thinking I might beI might be
able to……..able to……..
If I had someone to helpIf I had someone to help
me ,me , I probablyI probably couldcould
…..…..
50. Eliciting Change TalkEliciting Change Talk
REASON StatementsREASON Statements
I have to quit smokingI have to quit smoking
becausebecause of my asthmaof my asthma
To keep my truck license ITo keep my truck license I
probably shouldprobably should cut down oncut down on
my meth and drinkingmy meth and drinking
My kids may be taken fromMy kids may be taken from
me if I keep usingme if I keep using
I don’t like my kids to see meI don’t like my kids to see me
this waythis way
NEEDNEED StatementsStatements
It’s really important to myIt’s really important to my
health to change my diethealth to change my diet
Something has to change orSomething has to change or
my marriage will breakmy marriage will break
I will die if I keep using likeI will die if I keep using like
thisthis
51. Do You Swear????Do You Swear????
Person 1: “I want to”Person 1: “I want to”
Person 2: “ I could”Person 2: “ I could”
Person 3: “ I have goodPerson 3: “ I have good
reasons to”reasons to”
Person 4 : “ I need to”Person 4 : “ I need to”
Person 5: I willPerson 5: I will
52. DARN (DARN (Desire, Ability , Reason, Need)Desire, Ability , Reason, Need)
What do you think you willWhat do you think you will
do ?do ?
What does this mean aboutWhat does this mean about
your habit ?your habit ?
What are your options?What are your options?
What's the next step for you?What's the next step for you?
What are some good thingsWhat are some good things
about making a change ?about making a change ?
Where does this leave you?Where does this leave you?
53.
54. On A Scale of 1-10On A Scale of 1-10
Not at all ImportantNot at all Important Very ImportantVery Important
Not at all ConfidentNot at all Confident
You picked a 7 , why wasn’tYou picked a 7 , why wasn’t
a lower scorea lower score
Very ConfidentVery Confident
You picked a seven whyYou picked a seven why
wasn’t a higher scorewasn’t a higher score
56. Signs of ResistanceSigns of Resistance
ArguingArguing
ChallengingChallenging
DiscountingDiscounting
HostilityHostility
IgnoringIgnoring
-Inattention-Inattention
-Non-answer-Non-answer
-No response-No response
-Sidetracking-Sidetracking
DenyingDenying
BlamingBlaming
DisagreeingDisagreeing
ExcusesExcuses
Claiming impunityClaiming impunity
MinimizingMinimizing
PessimismPessimism
ReluctanceReluctance
Unwilling to changeUnwilling to change
•InterruptingInterrupting
Taking OverTaking Over
Cutting OffCutting Off
57. Ten Strategies for Evoking ChangeTen Strategies for Evoking Change
1.1. Ask Evocative questionsAsk Evocative questions
Why would you want to make this change? (Desire)Why would you want to make this change? (Desire)
How might you go about that ? (Ability)How might you go about that ? (Ability)
What are the three best reasons for doing that ?What are the three best reasons for doing that ?
(Reasons)(Reasons)
How important is it for you to make this change?How important is it for you to make this change?
(Need)(Need)
So what do you think you will do? (Commitment)So what do you think you will do? (Commitment)
58. Ten Strategies for Evoking ChangeTen Strategies for Evoking Change
2.2. Ask for ElaborationAsk for Elaboration
When change talk emerges ask for more detail. InWhen change talk emerges ask for more detail. In
what ways?what ways?
3. Ask For Examples3. Ask For Examples
Ask for specific examples, when was the last time thatAsk for specific examples, when was the last time that
happened ? give me an examplehappened ? give me an example
4. Look Back4. Look Back
Ask about a time before current concern emerged.Ask about a time before current concern emerged.
How were things better? different?How were things better? different?
59. Ten Strategies for Evoking ChangeTen Strategies for Evoking Change
5. Looking Forward-5. Looking Forward-
What would happen if thingsWhat would happen if things
stay the same/ If you arestay the same/ If you are
100% successful in making100% successful in making
changes you want whatchanges you want what
would life look like ?would life look like ?
6. Extremes6. Extremes
What is the worst thing thatWhat is the worst thing that
could happen? What is thecould happen? What is the
best thing that could happenbest thing that could happen
60. Ten Strategies for Evoking ChangeTen Strategies for Evoking Change
7.7. Use Change RulersUse Change Rulers
On a scale ofOn a scale of
1-------------------101-------------------10
8.8. Explore Goals andExplore Goals and
ValuesValues
What are the personsWhat are the persons
values and goalsvalues and goals
9.9. Join upJoin up –Come along–Come along
sideside
61. Ten Strategies for Evoking ChangeTen Strategies for Evoking Change
10. Responding to10. Responding to
Change Talk (Change Talk (EARSEARS))
EXPLOREEXPLORE
AFFIRMAFFIRM
SUMMARIZESUMMARIZE
62. Closing Skills –Closing Skills –
55 44 33 22 11
I guaranteeI guarantee
I willI will
I promiseI promise
I vowI vow
I shallI shall
I give myI give my
wordword
I assumeI assume
I dedicateI dedicate
myselfmyself
I knowI know
I am devotedI am devoted
toto
I pledge toI pledge to
I agree toI agree to
I intend toI intend to
I am ready toI am ready to
I look forwardI look forward
toto
I consent toI consent to
I plan toI plan to
I resolve toI resolve to
I expect toI expect to
I concede toI concede to
I declare myI declare my
intention tointention to
I favorI favor
I endorseI endorse
I believeI believe
I acceptI accept
I volunteerI volunteer
I aimI aim
I aspireI aspire
I proposeI propose
I amI am
predisposedpredisposed
I anticipateI anticipate
I predictI predict
I presumeI presume
I mean toI mean to
I forseeI forsee
I envisageI envisage
I assumeI assume
I betI bet
I hop esoI hop eso
I will tryI will try
I think I willI think I will
I suppose II suppose I
willwill
I imagine II imagine I
willwill
I guessI guess
63. Setting a Course of ActionSetting a Course of Action
Set Specific Short term goalsSet Specific Short term goals
Consider Your optionsConsider Your options
Establish a PlanEstablish a Plan
Establish Monitoring ( CBT)Establish Monitoring ( CBT)
64. 10 Things MI is not10 Things MI is not
Based on transtheoreticalBased on transtheoretical
modelmodel
TrickeryTrickery
A specific techniqueA specific technique
Decisional balanceDecisional balance
(equally exploring pros(equally exploring pros
and consand cons
Assessment feedbackAssessment feedback
CBTCBT
Just clinet centeredJust clinet centered
Easy tpo learnEasy tpo learn
What yu are alreadyWhat yu are already
doingdoing
Panacea for every clinicalPanacea for every clinical
challengechallenge
65. Traditional Assumptions ofTraditional Assumptions of
Motivation & ChangeMotivation & Change
Symptoms are weaknesses that need to be fixed.Symptoms are weaknesses that need to be fixed.
Client is damaged, Counselor fixes clientClient is damaged, Counselor fixes client
Doctor knows bestDoctor knows best
Only client has control over motivationOnly client has control over motivation
Client must hit “Rock Bottom”Client must hit “Rock Bottom”
Change is linear and static, “on-off switch”Change is linear and static, “on-off switch”
No motivation=No treatment. ( Ping-Pong for DuallyNo motivation=No treatment. ( Ping-Pong for Dually
Diagnosed clients)Diagnosed clients)
Double Standard of Efficacy.Double Standard of Efficacy.
66. Non-Directive Counseling vs. MINon-Directive Counseling vs. MI
Non-Directive CounselingNon-Directive Counseling
Client determines content 7Client determines content 7
directiondirection
Counselor avoids adviceCounselor avoids advice
giving 7 feedbackgiving 7 feedback
High use of empathicHigh use of empathic
reflectionreflection
Explores clients conflictsExplores clients conflicts
and emotionsand emotions
Motivational InterviewingMotivational Interviewing
Systematically directs clientSystematically directs client
towards motivation fortowards motivation for
changechange
Counselor offers advice &Counselor offers advice &
feedback when appropriatefeedback when appropriate
& solicited& solicited
Empathic reflection usedEmpathic reflection used
selectively to reinforceselectively to reinforce
processprocess
Seeks to create & amplifySeeks to create & amplify
clients discrepancy in orderclients discrepancy in order
to enhance motivation.to enhance motivation.
67. Skills Training/ CBT vs. MISkills Training/ CBT vs. MI
CBT/ Skills TrainingCBT/ Skills Training
Assumes Client is motivatedAssumes Client is motivated
Seeks to modify maladaptive cognitionsSeeks to modify maladaptive cognitions
Treatment provides specific copingTreatment provides specific coping
strategiesstrategies
Teaches through instruction, modelingTeaches through instruction, modeling
practice & feedbackpractice & feedback
Specific problem solving strategies areSpecific problem solving strategies are
taught.taught.