The Spirit of MI
"______ _______ is a collaborative, person-centered form of guiding to elicit and strengthen motivation for change."
~Miller and Rollnick
Motivational Interviewing
What does O.A.R.S. stand for?
List two strategies for evoking Change Talk
Ask Evocative Questions, Pro & Cons, ask for more details, ask for an example, looking back, looking forward, querying extremes, change ruler, explore goals & values, come alongside, not ready for change
Nancy lives with her parents and receives SSI. She does not want to work and is comfortable with life. She enjoys volunteering at the SPCA.
Pre-Contemplation
Client: "" I want to to start taking my medication again."
Counselor: "You want start taking your medication again."
Simple Reflection
_____ Refers to the patient's experience of conflicting thoughts and feelings about a particular behavior or change.
Ambivalence
"So far you've expressed concern about your diabetes, getting your weight down and finding a medication that works."
What strategy is being used?
Summaries
"What are some of the advantages for keeping things just the way they are? On the other hand, what are some of the reason for making a change?"
Pro & Cons
Client's in this stage are aware of the consequences of their behavior and they spend time thinking about the problem and consider the possibility of change.
Comtemplation
Client: " I really want to stop smoking, but I'm not ready yet."
Counselor: Stopping is really important to you. You'll stop when you're ready."
Emphasizing Personal Choice
What are the four fundamental processes of MI?
Planning, Evoking, Focusing and Engaging
What are the 4 levels of Reflection?
Repeat, Rephrase, Paraphrase and Summarize
Three ways to reinforce change talk
Open-ended questions, affirmations, reflections, and summaries.
After successfully quitting smoking, Sue was sober for 8 months and was hired at Target as a cashier. One day she sees an old boyfriend at her job and becomes depressed. Sue starts calling in sick to work and is in danger of losing her job.
Relapse
Counselor: "You are persistent, even in the face of discouragement. This change must be really important to you."
Reframing
The practitioner elicits and coveys respects for the patient's ideas, opinions and autonomy. ____ is non-authoritarian, ever present, supportive and exploratory.
Collaboration
___ ___ ___ facilitate a patient's response to questions from his or her own perspective and from the area(s) that are deemed important or relevant.
Open-Ended Questions
What does D.A.R.N C.A.T. stand for?
Desire, Ability, Reason, Need, Commitment, Activation, Taking Steps
Client's in this stage continue to acquire new skills and continue to benefit from support from others but are now les reliant on others to maintain the change behavior.
Maintenance
Client: "What do you know about being in recovery? You probably never had a drug problem."
Counselor: "It's hard to imagine how I could possibly understand."
Shifting Focus
The practitioner works to evoke the ideas, opinions, reason to change, and patient confidence that change is possible. The practitioner is invested in facilitating intrinsic change pursued with the patient's own reasons and motivation.
Evocation
List four types of Reflections
Repeating, Rephrasing, Amplified, Double-Sided, Coming Alongside, Metaphor, Shifting Focus, Reframing, Emphasize Personal Choice and Siding with the Negative,
"Perhaps ____ is so important to you that you won't give it up, no matter what the cost."
Coming Alongside
During this stage the client is willing to admit there is a problem and prepares to do something about it.
Client: "My drinking isn't that bad."
Counselor: "There's no reason for you to be concerned about your drinking."