Motivational interviewing brief negotiation

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Motivational interviewing brief negotiation

• What is it and how can it help me in working with
  my families?

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Motivational interviewing (MI)

• MI is client centered, directive model for
  practitioners to assist clients in their own
  recognition of ambivalence and resolution of that
  ambivalence thus creating stronger working
  relationships

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Motivational Interviewing (MI)

• Always assume ambivalence
• clients must feel their feelings of ambivalence,
  discrepancy, frustration while talking about
  their behavior.
• Your goal is to have the client say out loud his
  or her reasons for change. (or his reasons not to
  change)

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Motivational interviewing

• Through careful balance of inquiry and reflective
  listening, interviewers elicit and selectively
  reinforce pro-change talk responding to
  resistance in a way that is intended to diminish
  it.

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Prochaska and DiClementes Stages of Change Model

• Pre-contemplation Ignorance is bliss"
• Contemplation Sitting on the fence"
• Preparation "Testing the waters"
• Action lets do it
• Maintenance lets keep doing it
• Relapse fall from grace
• We spend time trying to convince people in
  early stages to change when all we might need to
  do is point out the ambivalence.

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Practical tools used in Motivational Interviewing

• Open ended questions
• Reflective listening
• Summarizing statements.

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Open ended questions

• Demand more than one word responses which elicit
  further talk
• The difference between
• Are you worried about this/tell me about your
  concerns about this
• Tell me more about this
• Help me understand your feelings/thoughts
• Why is this a concern for you?
• How do you see this affecting you?
• What is this like for you?

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Reflective listening

• Verbally mirrors back to your clients what you
  understood them to say
• The more you can effectively use reflective
  listening, the more you see increased in client
  participation
• So what I am hearing is..
• I am right in saying..
• You were thinking .
• Sometimes it is more important to reflect
  negative responses (such as anger or
  frustration) as clients might not even know that
  is what they are projecting.
• Am I hearing anger (frustration) in your voice
• I am getting the sense of being overwhelmed with
  the information I am giving you

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Summarizing statements

• Allows you to maintain control and direction of
  the interview
• Weve talked about quite a bit today (state each
  piece discussed) Where do we go from here?
• I am hearing you are not interested in our
  services right now? Help me understand how you
  would know when our services might be helpful to
  you?
• When all else fails summarize

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Brief negotiation in a nutshell

• Open the encounter
• hi my name is Deb and I am calling from your
  doctors office.
• State/negotiate the agenda
• your doctor wanting me to discuss____ with you
  is that ok?
• Explore ambivalence/assess readiness
• Provide intervention
• Using motivational interviewing techniques
• Close the encounter
• I appreciate this time to talk to you,

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Self awareness

• Check your own responses to clients ambivalence
  and ask
• Am I ok with his/her decision?
• Will his/her decision affect my work?
• When uncertain, ask a supervisor or trusted
  co-worker

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• Questions/comments
• Role play