1. Motivational Interviewing

2. Objectives To understand the concept of motivational interviewing. To understand the concept of motivational interviewing. To be able to discuss some of the general principles. To be able to discuss some of the general principles. To be able to begin to use some of the concepts in practice To be able to begin to use some of the concepts in practice

3. What is Motivational Interviewing?

4. What is Motivational interviewing?

5. What is Motivational Interviewing? Client –centred counselling style for changing behaviour by helping clients explore/resolve ambivalence. Client –centred counselling style for changing behaviour by helping clients explore/resolve ambivalence. A approach to help individuals develop a commitment to changing problematic behaviour. A approach to help individuals develop a commitment to changing problematic behaviour. A motivation to change that comes from the client. A motivation to change that comes from the client.

6. Be aware of………… Assuming that the client wants to change. Assuming that the client wants to change. Assuming the client’s health is the prime motivating factor from them. Assuming the client’s health is the prime motivating factor from them. That if the client does not decide to change then the intervention has failed. That if the client does not decide to change then the intervention has failed.

7. 5 General principles Express sympathy Express sympathy Develop discrepancy Develop discrepancy Avoid arguments Avoid arguments Roll with resistance Roll with resistance support self efficacy (believe one is capable of performing in a certain manner) support self efficacy (believe one is capable of performing in a certain manner)

8. Strategies of MI Elicit - draw out Elicit - draw out Clarify – make clear Clarify – make clear Resolve ambivalence – simultaneous attraction + revulsion towards an object/ action ( I do but I don’t!) Resolve ambivalence – simultaneous attraction + revulsion towards an object/ action ( I do but I don’t!)

9. For a client to change they need to……… Recognise the current behaviour is a problem or concern. Recognise the current behaviour is a problem or concern. Believe that they will be better off if they change. Believe that they will be better off if they change. Believe that they are able to change. Believe that they are able to change.

10. Process of change

11. Worker skills Express empathy through reflective listening. Express empathy through reflective listening. Communicate respect for and acceptance of their feelings. Communicate respect for and acceptance of their feelings. Establish a non judgemental relationship with client. Establish a non judgemental relationship with client. Be complimentary not punitive. Be complimentary not punitive. Listen rather than tell. Listen rather than tell. Gently persuade ( change is up to the client.) Gently persuade ( change is up to the client.) Develop discrepancy between clients goals and values and their current behaviour. Develop discrepancy between clients goals and values and their current behaviour. Focus on clients strengths to support and optimising needed to change. Focus on clients strengths to support and optimising needed to change.

12. Undertaking an interview Examine the good things about the clients behaviour. Examine the good things about the clients behaviour. Examine the less good things and compare the two. Examine the less good things and compare the two. Explore how much of a concern the less good things are. Explore how much of a concern the less good things are.

13. Decisional balance sheet Positives of ……… Less good things about……. Positives of not …….. Less good things about not ………….

14. Tool kit! Be empathic – non judgemental Be empathic – non judgemental Use open Questioning Use open Questioning Reflective listening Reflective listening Summarize Summarize Use decisional balance sheet Use decisional balance sheet

15. Some good phrases to use! Tell me about your …………… Tell me about your …………… What do you like about ……………… What do you like about ……………… What is positive about your……..for you? What is positive about your……..for you? Do you have any concerns about…………… Do you have any concerns about……………

16. Summary Sowing a seed!! Sowing a seed!! Helping people to maintain change Helping people to maintain change Client centred Client centred Non confrontational Non confrontational Opportunist Opportunist Can be delivered by non-specialist Can be delivered by non-specialist