Applying Motivational Interviewing Sarah M. Ellis, AFC® Family And Consumer Sciences Agent I Taylor Spangler, M.S., AFC® FCS Extension Program Coordinator Heidi Radunovich, Ph.D. Associate Professor and Extension Specialist

Objectives: Introduction to Motivational Interviewing (MI) Why use MI? MI skills How to use MI

What is MI? “a collaborative, person-centered form of guiding to elicit and strengthen motivation for change.”

Who can use MI? Doctors Nurses Peer mentors Volunteers And YOU!

Does it work? Evidence supports the use of MI in treating alcohol and drug addiction MI has also been successful in facilitating change related to other issues: weight loss diabetes management smoking cessation

Theories that contribute to MI Transtheoretical model (Stages of Change) Carl Rogers’ Humanistic approach (client-centered therapy)

Motivational Interviewing is A technique that increases the likelihood that a client will want to make a positive change A partnership, the argument for change comes from the client, not you. Unfamiliar way to communicate that can be difficult or feel strange. Focuses on resolving the ambivalence of change

Essence of Motivational Interviewing Collaboration vs. confrontation Evocation Autonomy vs. authority

Why MI? Change is hard! It is normal to feel unsure about changing Takes time to make changes Techniques reduce burnout and stress on practitioners

How does MI work? Techniques increase the internal motivation of a participant Develop their own logic Determination to engage in the desired behavior

4 Principles of MI Convey empathy Encourage self-efficacy Roll with resistance Develop discrepancy

4 processes of MI 1. Engaging 2. Focusing 3. Evoking 4. Planning

Engaging How do you build a relationship with a client?

OARS Open-ended Questions Affirmations Reflections Summaries

Focusing How can we help clients identify what needs to change and why?

Determine readiness to change Clarify goals

Evoking Client says what they want to change We reinforce the talk

How to create change talk Ask evoking questions Explore decisional balance Positives vs negatives Elaboration/Examples Look back

How to create change talk cont. Look forward Query extremes Use Change rulers Explore Goals and values Come alongside

How to respond to change talk: EARS: Explore Affirm Reflect Summary

DARN-CAT Preparatory change talk: Desire (want, wish, like) Ability (can, could) Reason (If I do X then) Need (have to, need) Mobilizing change talk: Commitment (intent, decision) Activation (ready, prepared, willing) Taking steps (specific actions)

Planning Conduit to change Reinforce commitment language

What not to do Act as an authority figure Label Ask lots of questions Give advice

Examples of strategies: Ask permission Do you mind if we talk about your shopping?

Evoking What would you like to see different about your current situation?

Open-ended questions Tell me what you like about spending money.

Columbo approach On one hand you are not able to pay your bills, and on the other hand you are saying shopping is not causing you any issues. What do you think is causing your inability to pay your bills?

Discussion Anyone currently using MI? Questions about the technique? Do you think you might want to use MI?

Any Questions or Comments?

Contact Information: Sarah M. Ellis: ellissm@ufl.edu Taylor Spangler: tspangler@ufl.edu