AN INTRODUCTION TO MOTIVATIONAL INTERVIEWING Derek

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AN INTRODUCTION TO MOTIVATIONAL INTERVIEWING

• Derek McLaughlin

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OVERVIEW

• Welcome introduction and warm up
• What are your learning needs
• Exercise one
• Theory of Motivational Interviewing
• Exercise two
• The actual process of Motivational Interviewing
• Exercise three
• Review and evaluation

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WHAT ARE YOUR LEARNING NEEDS?
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PASCALS PENSEES

• People are generally better persuaded by the
  reasons which they have themselves discovered,
  than by those which have come into the minds of
  others. (17th Century)

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OR ANOTHER VIEW

• still the man hears what he wants to hear and
  disregards the rest (The Boxer, Simon and
  Garfunkel, 1970).

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EXERCISE ONE

• Break into pairs
• One person plays role of occupational health
  nurse of a large company the other person plays
  the role of an employee of the company who smokes
  
• The scenario-the company has decided to help
  smokers to stop smoking via the occupational
  health nurse
• The employee who smokes does not want to stop
• The nurse must stop this person from smoking
• Rollnick, S

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MOTIVATION

• Motivation should not be thought of as a
  personality trait rather as a state of readiness
  or eagerness to change, which may fluctuate from
  one time or situation to another
• This state is one that can be influenced
• Miller Rollnick (1991)

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STAGES OF CHANGE

• Pre-contemplation
• Contemplation
• Determination
• Action
• Maintenance
• Relapse
• Changed lifestyle
• Prochaska DiClemente (1983)

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CYCLE OF CHANGE
T i m e
X
X
X
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EXERCISE TWO

• Favourite Teacher What made them an effective
  educator?
• Least Favourite Teacher What was it about this
  person that left this impression with you?

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DEFINITION

• Motivational Interviewing is a directive,
  client-centred counselling style for eliciting
  behaviour change by helping clients to explore
  and resolve ambivalence.
• From Rollnick S. Miller, W.R. (1995) What is
  Motivational Interviewing? Behavioural and
  Cognitive Psychotherapy, 23,325-334

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Good Practice

• The principles - Express Empathy
• Develop Discrepancy
• Roll with Resistance
• Support Self-efficacy

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TWO VITAL ELEMENTS

• Behavioural change
• Ambivalence

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EXERCISE THREE

• Break into pairs
• One person in the role of the nurse the other
  person attending about their use of cigarettes
• This time using a motivational interviewing
  approach the nurse will discuss with the person
  their use of cigarettes

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EARLY STRATEGIES

• Agenda Setting

medication
poor housing
stress
pain
family
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EARLY STRATEGIES

• Readiness Ruler
  Scaling questions
  1 - 10 to assess
• Importance and Confidence

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IS MOTIVATIONAL INTERVIEWING FOR YOU?

• People have the right to live their lives in
  their own way, providing they do not infringe the
  rights of others.
• It is rarely clear cut what someone ought or
  ought not to do.
• Responsibility for changes lies with the person.
• Health is not everyones top priority.
• People often do know what would be best for them.
  

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IS MOTIVATIONAL INTERVIEWING FOR YOU?

• Professional are not failures just because they
  can not persuade people to change.
• Motivation is not an all or nothing concept, it
  is on a continuum and is subject to change.
• Change is a process not an event.
• Successful change occurs only when a person has
  made up their mind that it is what they really
  want.
• Mason (2006) Dual Diagnosis Nursing p 254.

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AN INTRODUCTION TO MOTIVATIONAL INTERVIEWING

• Derek McLaughlin
• DF.McLaughlin_at_ulster.ac.uk