Motivational Interviewing

Session 2: Elicit and Strengthen Change Talk

Stephen R. Andrew, LCSW LADC CCS

An MI Conversation

Target/purpose

Express empathy

OARS

Develop discrepancy/Amplify

ambivalence

Change talk/ “Change Theory”

Change plan

Commitment language

Goal-Oriented Interventions

Empathic reflection

Elicit, options, elicit...

Importance, confidence and ruler

Remember: We are responsible for the intervention, not the outcome

Find Out Where the Patient isMeet them where they are

Continuum of ambivalence

Explore importance and confidence

Readiness Ruler

Importance. How important is it for you right now to prevent illness? On a scale of 1-10, how important is it?

1-------------------------------10

How come you are a ___ and not a ___? What would it take to go from __ to __?

Confidence Ruler

Confidence. How confident are you that you could complete a colon cancer screening test?

How come you are a ___ and not a ___? What would it take to go from __ to __?

Strategies to Increase Importance and

ConfidenceELicit & reflect change talk

Explore goals & values

Highlight personal strengths & supports

Brainstorm solutions

Hypothetical change (“I wonder if...”)

Resistance or Change Talk?

“I want to lose weight.”

“I’d like to spend less money.”

“I could if I wanted to, but I don’t really want to.”

Resistance or Change Talk?

“I wish people understood me better.”

“I want to get along with my wife.”

“I wish my parents would stop nagging me.”

Resistance or Change Talk?

“I don’t want the colonoscopy but I need to do it for my family.”

“I don’t want to go looking for trouble with those tests. I feel fine.”

“I’m scared. But if you tell me I need it, I will do it.”

Thank You!Stephen Andrew, LCSW LADC

CCSheti@gwi.net

www.hetimaine.org