Lack of Information Laziness Oppositional Personality Denial Resistance MISCONCEPTIONS
AMBIVALENCE IS OFTEN MISTAKEN FOR RESISTANCE MOTIVATIONAL INTERVIEWING CAN ELICIT A A PERSON’S MOTIVATION TO CHANGE
CORE SKILLS FOR MOTIVATIONAL INTERVIEWING Open Questions Affirmations Reflections Summaries
CLOSED VS. OPEN QUESTIONS CLOSED OPEN How much alcohol do you drink a day? What role does alcohol play in your life? Don’t you want to move to a safer place? What are the advantages that you see in moving? Are you in pain? How do you feel?
AFFIRMATIONS “You really care a lot about your family” “This is hard work your doing”
REFLECTIONS Patient - “I have been this way for so long, I think it’s just my personality” Provider Response - “So all of this seems normal to You”
SUMMARIES “If I understood you correctly, you’ve been Thinking about moving. There is a downside In that you have to find a new doctor”
SPIRIT OF MOTIVATIONAL INTERVIEWING CORE PRINCIPALS ACCEPTANCE COMPASSION EVOCATION
THE FOUR PROCESS OF MOTIVATIONAL INTERVIEWING Engaging Focusing EvokingPlanning
ENGAGING Helps to establish a trusting and mutually respectful relationship Avoid bombarding patient with questions in the initial encounter Avoid telling patients how to fix their problem Avoid labeling patients ie. stubborn, resistant
FOCUSING An ongoing process of seeking and maintaining direction Agree on an agenda based on client’s and counselor’s goals & priorities Practice listening skills
EVOKING Elicit a client’s own motivation to change “change talk” Asking questions that favors a movement in the direction of change “I want”, “I can”, “I wish”
PLANNING Developing a specific change plan Plan should be -Specific -Measurable -Achievable -Relevant -Timed
REFERENCES Miller, W. & Rollnick, S. (2002). Motivational Interviewing: Preparing people for change (2 nd ed.). New York, NY: Guilford Press Rochon, D., Ross, M.W. Looney, C., Nepal, V.P., Price, A.J. & Giordano, T.P. (2011). Communications strategies to improve HIV treatment adherence. Health Communication, 26, 461-467
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