Motivational interviewing in health care resource book. Reflective listening is like holding a mirror up as people speak. Reflections motivational interviewing for smoking cessation. Glossary of motivational interviewing terms ability a form of client preparatory change talk that relects perceived personal capability of making a change. Motivational interviewing skills manual christopher bolling, md 1 motivational interviewing in a brief encounter skills handbook. Jun 03, 2015 motivational interviewing also uses various types of reflectionsrepeating statements by patients and families so that they can hear what was said. Aug 28, 2017 3 welcome to mi clubwith john russell member of the motivational interviewing network of trainers. Affirmations are statements and gestures that recognize client strengths and acknowledge behaviors that lead in the direction of positive change, no matter how. A brief guide to motivational interviewing the hrb. Reflective listening reflective listening challenges the provider to listen so carefully to the patient that they are able to reflect the. Rather than blaming the client for lack of change, this book takes seriously. Precontemplation inactive and no intention to change.
Effectiveness of motivational interviewing in a wic clinic. Motivational interviewing is a type of motivational therapy that helps clients recognize a problem and build motivation to pursue a solution. Reflective listening is a way of checking rather than assuming that. Resolving ambivalence in motivational interviewing with cathy cole, lcsw table of contents tips for making the best use of the dvd 4 summary of motivational interviewing approach 6 discussion questions 12 reaction paper guide for classrooms and training 17 roleplays 18 related websites, videos and further readings 21 video transcript 23. This approach has built up a solid evidence base for effectiveness, and has been applied to a variety of people with different problems, including adherence. They are created to keep the conversation going in the right direction, and their purpose is to create a space in which client can address all of his problems and see all the possible solutions to find the right motivation and gain. Reflective listening is a key motivational interviewing skill. Hypotheses not questions further explanations demonstrate i am listening acknowledge the speakers position whats between the lines. The basics of motivational interviewing educateria. The primary mission of mint is to promote the quality of training and practice of motivational interviewing. When providing an affirmation, therapists should avoid statements that sound overly ingratiating e. Communicate interest and understanding of an individuals. Passmore 20 motivational interviewing reflecting on. Motivational interviewing arizona state university.
Reflecting in motivational interviewing mi involves listening to the patient and then making statements not asking the patient questions rosengren, 2009. Retrieved from lecture notes at people incorporated training on july 10, 20. Motivational interviewing, when used as a technique to increase selfefficacy, is more than merely planting a seed that change is possible. Motivational interviewing is an empathic, personcentered counseling approach that prepares people for change by helping them resolve ambivalence, enhance intrinsic motivation, and build confidence to change. A randomised control trial found out that drink driving offenders that received mi had lower rates of drink driving in the future as compared to those that received other counselling approaches stein et al. Skillful reflective listening is the essence of motivational interviewing the concept and practice the clinician can return to over and over again. The provider does this by asking openended questions, providing affirmation, using reflective listening and summarizing for the patients oars. Chapter 6 on the reflective researcher is excellent, although the only section that explicitly addresses reflexivity, although the book is title reflective interviewing. Offering a theoreticallyinformed guide for researchers learning how to interview in the social sciences. I can see how it would be hard to keep all that straight. Many tens of thousands of mental health and health care professionals have used this essential booknow significantly revised with 70% new content reflecting important advances in the fieldto develop and sharpen their skills in motivational interviewing mi. There is hope in the range of alternative approaches available. Motivational interviewing mi is a therapeutic strategy for facilitating behaviour change. Which of the following statements reflects the spirit of motivational interviewing.
It is a way to interact with substanceusing clients, not merely as an adjunct to other therapeutic approaches. Motivational interviewing network of trainers mint webpage. Motivational interviewing reduces substance use in adolescents with one or more psychiatric disorder. Mi coaching session 5 reflective listening different types of. Take time to conduct a thorough inquiry about the topic, stories that provide the foundation of the focus area, and any outside influences. Motivational interviewing in the treatment of anxiety. Given the emphasis on reflective listening in mi, fidelity measures include two types of therapist reflections. For example, sometimes i end a reflective statement with a higher tone of voice, almost like im asking a question.
This resources provides basic information about the principles on communicating using motivational interviewing. It results in a delay in time to first use of any substance after discharge from the hospital. The spirit of motivational interviewing mi the dance collaboration not confrontation evocation not educationadvice acceptanceautonomy not authority. Motivational interviewing mi is a counseling style that helps practitioners guide patients through ambivalence about a potentially beneficial behavior change by using specific conversational. It was during this training that i first learned of the term microaffirmations. These theories are relatively recent modi fications of the humanistic approach to. The book shows how to navigate each session using microskills that many. The menu of strategies was devised by rollnick, heather and bell 1992 as a brief intervention method for people at different stages of readiness for change. Motivational interviewing mi integrated behavioral. In a recent workshop i presented on motivational interviewing originated by dr.
Instead, they are trained to direct the clients cognition towards modifying the target behavior. Goals for todays seminar 2 participants will be able to identify 3 key elements of motivational interviewing. Exploring ambivalence in motivational interviewing with obese. Building motivational interviewing skills, second edition.
Fader will guide participants in informative journey through the theories and spirit of mi. In this focused introduction to motivational interviewing, dr. Adds little or no meaning or emphasis to what the client said. The key component to expressing empathy is reflective listening. Building skills in motivational interviewing all home king county. It requires sharp attention to each new client statement, and the continual generation of. Participants will learn about the use of the motivational interviewing oars skills openended questions, affirmations, reflective statements and summaries. Jul 02, 2014 motivational interviewing is a form of collaborative conversation for strengthening a persons own motivation and commitment to change. The delivery of mibased interventions in diverse areas of. Motivational interviewing center for health training 2010 1 the oars model1 essential communication skills o. Shift the direction of conversations that have become stuck. In the world of motivational interviewing mi we talk a lot about intentional affirmations as statements highlighting a persons characteristics, values, and hard work. This book was recommended to me by a psychiatrist who teaches motivational interviewing. More reflective statements 30 double sided reflection.
Stephen rollnick, the audience of interprofessional clinical practitioners came with varying degrees of familiarity with. Content in this educational module was provided by the substance abuse and mental health services administration samhsa under grant to the university of iowa with permission to adapt and use in training. Chapter 3motivational interviewing as a counseling style. I like to use the analogy of an iceberg to illustrate the difference between simple and complex reflections link to article. Motivational interviewing and the stages of change theory sage.
Elements of mi can make a difference in practice quite quickly, while gaining competence in the approach requires the clinician to be highly selfreflective on their intention, use of skills and attention to the client. It is designed to help people explore their ambivalence to change and to move towards behavioural change at an appropriate pace. Motivational interviewing and related techniques for. These skillbased techniques include verbal and nonverbal responses and behaviors.
He has authored numerous book chapters and journal articles on mirelated topics. Reflections are an important aspect of reflective listening. The book elucidates the four processes of mi engaging, focusing, evoking, and planning and vividly demonstrates what they look like in action. Reflective listening is using one or more reflections in each statement you make. Reflective listening can be used by a clinician to determine if the clinician is moving ahead of the member which can create resistance. Mi seeks to identify and resolve ambivalence, and is centered on various motivational processes that make it easier for an individual to change. Psychological interviewing can be difficult for the counselor and client.
Motivational interviewing mi is a form of counselling designed to examine and resolve ambivalence around changes relevant for health using the patients own motivation for change. The goal is to help the client identify and resolve ambivalence so he or she can move forward. Motivational interviewing is a way of being with a client, not just a set of techniques for doing counseling. Additionally, motivational interviewing incorporates selfdetermination, which is one of the tenets of traumainformed care. This bestselling work has introduced hundreds of thousands of professionals and students to motivational interviewing mi, a proven approach to helping people. Change talk and sustain talk reflect two sides of a persons ambivalence about changing. Counselors met first with adolescents alone, then with caregivers alone and ended with both together. For each of your clients statements below, select the best reflective listening response. Apr 30, 20 motivational interviewing is a technique that uses a dialogue between a counselor and a client who needs to change behaviors in his or her life. Sessions were conducted by three mi counselors who were members of the motivational interviewing network of trainers 1 phd psychologist, 1 phd dietician, and 1 masters level psychologist. Motivational interviewing in the treatment of anxiety applications of motivational interviewing. Ambivalence is normal and a critical element for all human growth. Motivational interviewing california state university. This is the authoritative, bestselling guide that professionals and students turn to for a complete introduction to motivational interviewing mi, the powerful approach to facilitating change.
The skillful counsellor understands that difference and guides the client away from sustain talk and toward change talk, listening especially for statements. Affirmative responses or supportive statements by therapists verify and acknowledge clients behavior changes and attempts to change. It is especially helpful in the mi processes of evoking, focusing and planning. In 2015, the motivational interviewing implementation and practice. Helping people change, 3rd edition applications of motivational interviewing.
Similarly, it reduces a frequency of any substance use and of marijuana use reported during the first sixmonth post discharge from hospital. Absolute worth one of four aspects of acceptance as a component of mi spirit, prizing the inherent value and potential of every human being. Motivational interviewing mi is a therapeutic strategy for. Motivational interviewing is a collaborative, goal. The relationship between a therapist and client is. Motivational interviewing module 2 1 screening, brief intervention, and referral totreatment motivational interviewing steps and core skills screening, brief intervention, and referral totreatment learning objectives at the end of the session, you will be able to 1. Advanced motivational interviewing annie fahy rn, lcsw. Openended questions, affirmations, reflective listening statements, and. Motivational interviewing resources for supervisors.
Reflective responses summary statements motivational interviewing basic structure. Motivation is elicited, not imposed, and it is the task of the patientclient to identify and address ambivalence. Although some clients may recognize they need help and are willing to talk about their issues, they may have a hard time finding the words to express themselves. Policy on commercial activityresources for sale this resources page is used to disseminate information regarding motivational interviewing and promote proficiency in the use of motivational interviewing. Motivational interviewing is based on four assumptions. Nov 30, 20 the latte factor in motivational interviewing reflective listening, as its used in motivational interviewing, can include both simple contentfocused and complex beneaththesurface reflections. Choose the best answer for each of the following questions. Which of the following is not consistent with the mi approach to counseling. Motivational interviewing in a brief encounter skills handbook. Motivational interviewing provides a foundation for assisting individuals with developing the rationale for beginning change in their lives. Thirty days to a noregrets life by kerry shook, zen and the art of motorcycle m. In motivational interviewing, oars or openended questions, affirmations, reflections, and summarizing are employed toward eliciting change talk.
This demonstrates the health care providers understanding of what the patient and family said, building trust and allowing the patient or family to clarify points. Reflective listening is a fundamental skill to motivational interviewing. Mi seeks to identify and resolve ambivalence, and is centered on various motivational processes that make it easier for an individual to. Rollnick has written books on motivational interviewing and health be. Mi techniques reflective listening jonathan passmore. Motivational interviewing training new trainers manual. Feb 11, 2010 offering a theoreticallyinformed guide for researchers learning how to interview in the social sciences, this book provides a practical approach to interviewing, helping researchers to learn about themselves as interviewers in ways that will inform the design, conduct, analysis, and representation of interview data. There are a few techniques that are common for a motivational interview process. Open questions invite others to tell their story in their own words without leading themin a specific direction. Motivational interviewing a personcentered counseling method for addressing the common problem of ambivalence about behavior change ambivalence the central aspect of behavior change. The purpose of this technique is to be nonconfrontational, nonadversarial and nonjudgmental, and uses openended questions and reflective listening to forge a relationship between counselor. Listen for the reflective listening statements the counselor in the video. Motivational interviewing strategies and techniques.
We feel that mi may offer some useful resources for busy cf clinicians. Books motivational interviewing network of trainers mint. Motivational interviewing techniques can improve patient self. Motivational interviewing and related techniques for engaging adolescents and families in behavior change david g.
Careful eliciting of the values, assumptions, fears, expectations and hopes of the patient. Kraybill and morrison, 2007 open questions, affirmation, reflective listening, and summary reflections oars are the basic. In 1993, he completed miller and rollnicks initial training for mi trainers and has provided training in mi since, including serving as a member of the motivational interviewing network of trainers mint. Highlight both sides of an individuals ambivalence about change. Motivational interviewing reflection premium assignment help. I chose to do motivational interviewing mi on my client who has been referred to me because of driving under the influence of alcohol. Introduction to stages of change and change talk in. Miller and stephen rollnick wrote a book titled motivational. Utilizing reflections and reflective listening involves the practitioner listening to the.
Open questions, affirmation, reflective listening, and summary reflections oars are the basic interaction techniques and skills that are used early and often in the motivational interviewing approach. Motivational interviewing is a technique in which you become a helper in the change process and express acceptance of your client. Motivational interviewing treatment integrity scale moyers, martin, manual. Its common to get into a rhythm of 1 or 2 reflections followed by an open question at the end of some volleys a single set of back and forth statements during the conversation. Utilize your discoveries to pullout the positive and functioning themes. Tnt manual 2014 d10 20150205 motivational interviewing. Evoking commitment to change in this video clip, the physician works together with the patient to develop a specific focus. Mint is providing the resources on this page as a benefit and service in furtherance of mints mission and its nonprofit and tax exempt status. The belief that one can perform a behavior or accomplish a particular task belief in the possibility of change is an important motivator. The patient had recently been discharged for chf, and the community paramedic was visiting as part of a program to reduce the likelihood of a.
Use of motivational interviewing one of the key methods associated with brief interventions is motivational interviewing, which is an empathic, respectful philosophy and set of techniques for promoting behavior change. A good reflective listening response is a statement and the inflection should turn down at the end. Apr 24, 2017 motivational interviewing mi is a wellknown scientifically tested method of affecting behavior change in humans. Chapter 3motivational interviewing as a counseling style motivational interviewing is a way of being with a client, not just a set of techniques for doing counseling. Empathy genuineness egalitarianism acceptance unconditional positive regard warmth mi spirit collaboration evocation autonomy its your choice. Introduction to stages of change and change talk in motivational interviewing lisa kugler, psyd. Child welfare practice also tends to embrace some of the same tenets present in motivational interviewing, such as engaging clients in decisions and focusing on their strengths. Motivational interviewing skills manual christopher bolling, md 2 definitions. Psychological interviewing techniques career trend. It doesnt necessarily show patients which actions to take or teach them how to change behaviors. Tollison sj1, lee cm, neighbors c, neil ta, olson nd, larimer me.
I read this mostly to help me improve my motivational interviewing skills at work. In practice dialogues include the actual statements made by the therapist and client, as well as a commentary on each statement. Miller and rollnick, 1991 motivational interviewing is a technique in which you become a helper in the change process and express acceptance of your client. Motivational interviewing reflective listening demo from paul burke training. Learning motivational interviewing summary motivational interviewing mi is a set of principles and skills that take time, practice and discipline to learn. It is very much a collaborative process of careful cultivation of the clients belief in his or her ability to achieve their goals. Ambivalence toward alcohol and drug abuse is a normal obstacle on the path to recovery. Evoking selfmotivational statements is a primary goal of mi approach and unlike oars, is more directive. Resources for program directors, supervisors and staff about mi tip sheets books, manuals dvds, video clips bibliography recent news. Motivational interviewing strategies increase what is known as change talk. Chapter 3motivational interviewing as a counseling style ncbi. In mi, interventionists are instructed not to directly provide clients with advice to change as it is often ineffective. Forming and offering thoughtful reflective statements. Motivational interviewing summaries summaries can be used for multiple purposes.
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