MOTIVATIONAL INTERVIEWING: Strategies and

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MOTIVATIONALINTERVIEWINGStrategies and
Techniques
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COUNSELLING TRAPS
1. Premature focus trap Start broad, not with
the problem
2. Confrontation-denial trap Creates
counterarguments
B 01.40 04.45
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COUNSELLING TRAPS
3. Question-answer trap Implies the counsellor
is in control whilst the client is a
passive recipient
B 06.45 08.00
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COUNSELLING TRAPS
4. The expert trap Implies the counsellor has
all the answers Intervention should be viewed
as a partnership
B 08.00 10.45
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OPENING STRATEGIES

• Ask open questions
• Let the client set the agenda
• Build a picture of the clients context

B 10.50 12.20
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OPENING STRATEGIES
2. Reflective listening
B 12.20 26.00
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OPENING STRATEGIES
3. Summarising Begins to be directive The
counsellor chooses what to summarise
B26.00 30.20
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OPENING STRATEGIES
4. Affirming Convey respect for the
client Reframe apparent weaknesses as
strengths
B 30.20 32.30
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OPENING STRATEGIES
5. Elicit self-motivating statements Change
talk Encourage the client to make the case for
change
B 32.30 33.10
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SELF-MOTIVATING STATEMENTS
B 33.10 36.40
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SELF-MOTIVATING STATEMENTS
B 36.40 39.00
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SELF-MOTIVATING STATEMENTS
Cognitive, affective and behaviouraldimensions
of motivation to change
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ASK EVOCATIVE QUESTIONS
Not Do you have concerns about
your problem?But What concerns you about the
problem?
C 00.50 04.40
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ASK EVOCATIVE QUESTIONS
1 Problem recognition
Does (your current behaviour)cause you any
problems?
2 Concern for present condition
In what ways does this worry you?
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ASK EVOCATIVE QUESTIONS
3 Intention to change
What is going to have to change tomake things
different?
4 Optimism for change
What do you think would help you tochange?
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EXPLORE IMPORTANCE AND CONFIDENCE
Importance How important is it to you
to change right now? 1 10 Confidence How
confident are you that you could change? 1 - 10
HBC S9. 39.40 48.46
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EXPLORE IMPORTANCE AND CONFIDENCE
Why (3) and not zero? What would it take you
move youup to (5)?
HBC S9. 39.40 48.46
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EXPLORING THE PROS AND CONS
Discuss the positive and negativeconsequences of
changing Develop a discrepancy betweennow and
the ideal state
C 04.40 12.00
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Decisional balance
PROS SHORT-TERM
CONS SHORT-TERM
PROS LONG-TERM
CONS LONG-TERM
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Decisional balance
PROS SHORT-TERM
CONS SHORT-TERM
Feel better about myselfSleep betterFamily
would approve
Hard workPainful musclesFeel tiredCosts
moneyEat more and put on weightHard to find
timeLess time for other things
PROS LONG-TERM
CONS LONG-TERM
Get fitHave better healthLose weightLess
likely to get heart diseaseHave more energyFeel
Ive accomplished somethingFeel less
stressedFamily would be proud of me
Have to fit it in to my daily life
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SEEK ELABORATION
Reinforces the theme and elicits
furtherself-motivational statements Ask for
specific examples When you say youd feel
better about yourself, what exactly do you mean?
C 12.00 13.35
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Imagining Extremes What is the worst/best that
could happen if you did/did not change? Looking
Forward What would things be like? How would
that be different to now? Looking back What was
it like before?
C 13.35 21.45
J 21.45 49.20 (27)
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DEALING WITH RESISTANCE
Recognising resistance Argument and
disagreement Ignoring/tuning out Passive
agreement Denial or minimisation Interrupting
D 00.00 07.40
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DEALING WITH RESISTANCE
Confrontation merely increases resistance Resista
nce is an interpersonal event A reduction in
resistance is a sign thatchange is occurring
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ELABORATIONS ON REFLECTION
1 Amplified Increase the intensity 2 Double-si
ded Reflect ambivalence 3 Shift the
focus Avoid going round in circles
D 08.00 (12.55) 19.45
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ELABORATIONS ON REFLECTION
4 Reframe See things in a different way 5
Agreement with a twist Reflect then
reframe 6 Emphasise personal control and
choice Diffuses resistance
D 19.45 27.30
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ELABORATIONS ON REFLECTION
6. Side with the negative Places the client in
the position that resistance results in
self-motivational statements Needs careful
handling
D 27.30 31.30
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Counsellor Well, weve explored a number
of options today but it seems that you feel
that none of them will work for you. You seem
happy to carry on not worrying about the
serious consequences youll face if you dont
lose some weight. Perhaps we should leave it at
that and accept that youll never change.
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Client OK. Bye-eee!
J 31.30 47.36 P 47.40 59.45
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MOVING TO ACTION
BRAINSTORMING SOLUTIONS - PRINCIPLES
There are usually lots of ways of implementing
change As the exercise expert, you can explain
what has workedfor others The client is the
expert on themselves and can best judgewhat is
likely to work for them
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BRAINSTORMING SOLUTIONS
Explore a range of options for change Offer
suggestions where appropriate Encourage the
client to make suggestions Rule nothing out to
begin with Let the client decide which option to
take Emphasise flexibility if this doesnt
workyou can try something else Set appropriate
(SMART) goals