Motivational Interviewing

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Motivational Interviewing

• Presentation by
• Lorell Thoms BA, BSW
• MRC Instructor / Program facilitator

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Todays Talk

• This session will define motivation, change, and
  ambivalence in accordance with Motivational
  Interviewing provide an overview of the
  Transtheoretical Model the Stages of Change
  describe the key principles underlying the MI
  approach and conclude examination of MI in
  corrections will conclude the presentation. I
  hope you will leave with a with a sense of hope
  and confidence to help others Tip the scale
  towards change and to address even the most
  resistant offender.

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How do you feel about the attending the ACEA
conference?
Motivational Interviewing (MI) would say that
your initial motivation does not predict the
outcome and long-term motivation for learning at
the conference.
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What is Motivational Interviewing

• Motivational Interviewing, developed by Miller
  and Rollnick (1991), is a way to help people
  recognize and do something about their present or
  potential problems. It is especially useful with
  people who are either reluctant to change or
  ambivalent about changing. It is intended to
  help resolve ambivalence and get a person moving
  along the path to change. The strategies of MI
  are persuasive and supportive rather than
  coercive or argumentative. The goal is to
  encourage internal change rather than impose
  external change onto clients.

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Spirit of MI

• When the tires begin to slide off the road to the
  right, there is a natural tendency to turn the
  steering wheel to the left, because that is where
  you want to go. Doing so, however, simply
  decreases control and increases skidding toward
  the right. Wrong as it feels in the beginning,
  you must turn in the direction of the skid turn
  the wheel to right when the vehicle is skidding
  to the right. This provides traction that allows
  you to redirect momentum back onto the road.
• This righting principle is the essence of MI
  moving with people to help them find traction for
  change. The spirit of MI gives autonomy and asks
  for collaboration. When done effectively, it
  leaves people with feelings of hope and
  confidence.

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Definitions of Motivation

• Motivation state of readiness or eagerness for
  change.
• Motivation is the set of reasons that determines
  one to engage in a particular behavior. According
  to various theories, motivation may be rooted in
  the basic need to minimize physical pain and
  maximize pleasure.

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Motivation

• Assumptions about the nature of motivation
• Motivation is a key to change
• Motivation is multidimensional
• Motivation is dynamic fluctuating
• Motivation is influenced by social interactions
• Motivation can be modified

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Definitions of Change

• Change is to make different to transform to
  continue on ones journey from one station.

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Ambivalence

• AMBIVALENCE COEXISTING BUT CONFLICTING FEELINGS
  ABOUT SOMETHING.
• It is an important part of the process of change
  and resolving ambivalence is the purpose of MI.
  Ambivalence makes change possible it is the
  precursor to positive behavior change.

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Stages of Change
Precontemplation
Maintenance
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Stages of ChangeProchaska and Diclemente, 1994

• PRECONTEMPLATION
• CONTEMPLATION
• DETERMINATION
• ACTION
• MAINTENANCE
• RELAPSE
• People move from being unaware or unwilling to do
  anything about their situation, to considering
  the possibility of change, to preparing to make
  the change, and finally taking action, and then
  sustaining change over time.

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Principles of MI

• Express empathy
• Develop discrepancy
• Avoid argumentation
• Roll with resistance
• Support Self-efficacy

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Engaging Motivation

• Video scenario
• MANDY An addictions counselor talks with Mandy
  about her struggle to give up smoking. Mandy is
  keen to give up but has tried unsuccessfully and
  in the scenario the counselor aims to re-build
  her self-efficacy after relapse.
• 13 minutes in duration

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MI in Corrections

• MI aligns with evidence based practice and
  enhances intrinsic motivation.

Evidence Based NIAAA MI performed significantly
better than other approaches in 3 out of 4
published research studies MI outperformed
traditional advice-giving approaches 80 of the
time. In 64 of MI single sessions (lt15 minutes),
effects were long lasting. Good Correctional
Interventions address offenders RISK NEEDS RE
SPONSIVITY MI helps address needs and
responsivity.
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MI and corrections

• It can help an officer get back into the game
  of behavior change
• Offers tools for handling resistance and for
  stopping difficult situation from worsening.
• MI lets offenders do the talking.
• Helps prepare for change by leading offender to
  ask the questions.
• MI elicits change talk.
• Allows officers to enforce rules and deliver
  sanctions without having to leave a motivational
  style.

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Signs of Readiness for Change

• Decreased resistance
• less arguing interrupting.
• Decreased questions about the problem
• Information has been gathered solution is new
  focus
• Resolve a resolution is reached
• More peaceful, calm or settled.
• Self-motivational statements
• Statements of concern, openness to change,
  optimism.
• Increased questions about change
• Asking the HOW of change
• Envisioning
• Futuristic talk talks about advantages of
  change
• Experimenting
• Trying new approaches forms of communication

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Final remarks . . .

• Thank you if this presentation has got you
  thinking about motivation and change, please
  pick-up a copy of Miller and Rollnicks
  Motivational Interviewing Preparing people to
  Change Addictive Behavior 1st or 2nd editions.
  It is a great read.
• Enjoy the rest of the conference!