THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING
description
Transcript of THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING
![Page 1: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/1.jpg)
THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING
An Introduction to Patient – Provider Communication Enhancement
Kate Speck, PhD, MAC, LADCUniv. of Nebraska Public Policy Center
Paula Pillen, MPA, NHAHealth Center Association of Nebraska
CIMRO CONFERENCE 2012
![Page 2: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/2.jpg)
OBJECTIVES Engage in Effective Behaviors of Health Have Tools in Your “Backpack” for
Patients Learn About Cultural Sensitivity
Triggers Discuss the application of Motivational
Interviewing to enhance the Behavior Change process.
![Page 3: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/3.jpg)
LET’S HAVE A CONVERSATION…
And, Let’s Reduce The Frustration! What Common Issues or
barriers that Face You or Other Staff When Communicating With
Patients?
![Page 4: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/4.jpg)
YOUR TOP TRIGGERS Cultural Differences? Ageism? Thought Processes? +/+, +/-, +/+-, +/-+
Understanding Patients’ First Reactions Helps With
Change.
![Page 5: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/5.jpg)
TRADITIONAL APPROACH TO HEALTH BEHAVIOR CHANGE
Client/Patient Education
Client/Patient
![Page 6: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/6.jpg)
MOTIVATIONAL INTERVIEWING (MI):
THE BASICS Focus on Behavior Change Motivational Interviewing Style
or “Spirit” Asking Open Ended Questions Affirmation of Strengths and
Change Efforts Making Reflective Statements Fostering a Collaborative
Atmosphere (autonomy and personal choice)
![Page 7: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/7.jpg)
MI: WHAT’S IT FOR?Motivational
interviewing is a collaborative
conversation to strengthen a person’s own motivation for
and commitment to change.
![Page 8: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/8.jpg)
MI: WHY WOULD I USE IT ?Motivational
interviewing is a person-centered communication
method for addressing the
common problem of ambivalenceabout change.
![Page 9: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/9.jpg)
WHAT IS MI GOOD FOR?Two Elements of Motivational
Interviewing are Evidence Based for Client
Engagement ~ Retention
Motivational Interviewing ties in with the NIDA “Principles of
Effective Treatment”; engaging and retaining clients in the
process enhances their experience of change and leads
to successful outcomes.
![Page 10: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/10.jpg)
Managing important in-session behaviors of client,
using MI Spirit and Skills
M.I.: HOW IT WORKS
10
Interaction ofPractitioner and Client
Leads to
Increase Change Talk And
Decrease Sustain Talk
![Page 11: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/11.jpg)
Looking for Change Talk:
Discomfort/disadvantages of status quo Consequences, personal concerns, others’
concerns Advantages of change
Good things (or reduction in negatives) of change Optimism/ability to change
Personal resources, skills, confidence Intention/commitment to change
What change would look like, concrete or hypothetical plans
![Page 12: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/12.jpg)
Ambivalence CONFUSION
DENIAL PROCRASTINATION
DILEMMA
BARRIERS TO CHANGE
![Page 13: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/13.jpg)
PACING: READINESS TO CHANGE
Combinations of Issues, Chronic Conditions,
Practices, and Mindfulness.
Not at all Important Extremely Important5 6 7 8 92 101 3 40
![Page 14: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/14.jpg)
STAGES OF CHANGE
![Page 15: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/15.jpg)
STAGES OF READINESS TO CHANGE
Kate Speck, PhD, LADC
![Page 16: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/16.jpg)
Kate Speck, PhD, LADC
FOUR FOUNDATIONAL PROCESSES
Planning
Evoking
Focusing
Engaging
![Page 17: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/17.jpg)
Preparatory Change T
alk Mobilizing Change Talk
Contemplation Preparation Action(Pre-)
The M.I. HillYet another metaphor
![Page 18: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/18.jpg)
SAMPLE BEHAVIORAL CONSULTATION
Assess
Assess Importance & Confidence
Arrange Follow-Up or ReferralBuild
Confidence
Explore Importance
10-30 minutes
Advise & Provide Options
![Page 19: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/19.jpg)
MOTIVATIONNow, For Those Frustrating
Situations !
![Page 20: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/20.jpg)
MOTIVATIONAL SKILLS O.A.R.S.
Open -Ended Questions Affirmative Statements Reflective Listening Summarizing
![Page 21: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/21.jpg)
SAMPLE BEHAVIORAL CONSULTATION
Assess
Assess Importance & Confidence
Arrange Follow-Up or ReferralBuild
Confidence
Explore Importance
10-30 minutes
Advise & Provide Options
![Page 22: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/22.jpg)
Simplified Motivational Categories
Importance of ChangeConfidence in
Ability Low High
Low
Group 1 – Little interest in change; don’t think they could even if they wanted to.
Group 2 – Want to change, but don’t think they are able.
High
Group 3 – Believe they could change, but not interested right now.
Group 4 – Want to change and believe they have the ability.
![Page 23: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/23.jpg)
MOTIVATIONAL INTERVIEWING SKILLS
O.A.R.S. Open -Ended Questions• Would you tell me more about . . . ? • Would you help me understand . . . ? • How would you like things to be different?
![Page 24: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/24.jpg)
MOTIVATIONAL SKILLS O.A.R.S.
Affirmative Statements• I am really impressed with the way you . . . • That’s great how you’ve reached your goal of cutting back on your drug use. • Using protection shows that you have real respect for yourself and your partners.
![Page 25: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/25.jpg)
MOTIVATIONAL SKILLS O.A.R.S.
Reflective Listening• “So you feel . . .” • “It sounds like you . . .” • “You’re wondering if . . .”
![Page 26: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/26.jpg)
MOTIVATIONAL SKILLS O.A.R.S.
Summarizing• “Let’s see if I understand so far . . .” • “Here is what I’ve heard. • “Did I miss anything?” • “If that’s accurate, what other points are there to consider?”
![Page 27: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/27.jpg)
MOTIVATIONIt is Responsible to Change !
When asked “would you rather
work for change, or just complain?”
81% of the respondents
replied, “Do I have to pick? This is
hard!”
![Page 28: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/28.jpg)
Motivation and Change Motivation is malleable, rather than
fixed. Provider, client, and the interaction
between them all influence desire to change.
Motivation includes components of estimated importance of change and confidence in ability.
How you talk to a client about changing behavior makes a difference.
![Page 29: THE LANGUAGE OF CHANGE: MOTIVATIONAL INTERVIEWING](https://reader036.fdocuments.us/reader036/viewer/2022062323/5681610f550346895dd067fd/html5/thumbnails/29.jpg)
QUESTIONS