Active Listening and Motivational Interviewing Purpose

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Active Listening and Motivational Interviewing
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Purpose

• Minimize resistance to change
• Elicit change talk
• Explore and resolve ambivalence
• Nurture hope and confidence

Wrestling vs dancing
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Stages of Change
The stages describe a persons motivational
readiness or progress towards modifying the
problem behaviour Precontemplation not
considering behavior change in the next 6 months
may not be aware a problem exists Contemplation
seriously considering behavior change in the next
6 months
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Stages of Change contd
Preparation planning behavior change in the next
30 days Action the first 6 months of behavior
change Maintenance behavior changed for more
than 6 months Relapse transition to an earlier
stage
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Change Talk

• Listen for indications of readiness to change in
  the clients language. Phrases to listen for
  include
• I want to
• I can
• There are good reasons to
• I really need to
• I started
• When you hear change talk
• reflect, reinforce and ask for more!

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Questions that will encourage change talk

• What step could you take immediately that would
  make the greatest difference in your life?
• If nothing changes, what might happen?
• Suppose that you did succeed and are looking
  back on it now What is most likely to have
  worked? How did it happen?
• If you dont feel ready for change, what would
  need to happen for you to think about changing?

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Conversational Barriers

• Confronting
• Persuading
• Nagging
• Interrupting
• Ordering
• Judging

• Pressuring
• Criticizing
• Directing
• Talking down to
• Shaming
• Scolding

Dont try to fix things, set someone right, or
get them to face up to reality!
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Active Listening OARS

• Open-ended questions
• Example?
• Affirms the client
• Positive or complimentary statements
• Reflective listening
• State what you heard the client say
• Summaries
• Summarize the clients conversation

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More on Reflective Listening

• Reflections have the effect of encouraging the
  other person
• to elaborate, amplify, confirm or correct
• Good reflective statement openings
• So you feel
• Youre wondering if
• It sounds like you
• So you
• Types of reflection
• Repeating (repeat part of what the speaker said,
  use synonyms)
• Rephrasing (use new words)
• Paraphrasing (make a guess as to unspoken or
  hidden meaning)
• Reflect feelings (type of paraphrase that speaks
  to emotional meaning)

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The 10 Minute Interview

• Create focus
• What change would give you the greatest return?
• Build motivation
• How important is it for you to make this
  change?
• What will happen if you dont make this change?
• Summarize the big picture
• So you want to X because Y. Z will happen if
  you dont make this change.
• Ask transition questions
• What happens next?