Microskills Bootcamp Motivational Interviewing

(but not there yet) Getting to “Change Talk” OARS

Plus (+): What do you like about behavior? Delta (∆): What would you change to improve? Plus Delta Feedback

Writing Assignment 1)Think of an adult patient with ‘manageable’ behavior change issues, with whom you can identify enough to remember or make up details. Write a one sentence patient summary of the sort that you might receive about a new patient on the outside of the envelope. Feel free to make up a name for your patient. 2)Answer questions 3 to 7 on piece of paper. 3)What is the explicit reason for their physician visit today? 4)What is the implicit reason for the visit? 5)AMBIVALENCE: Why is there tension about change? 6)What are the patient’s strengths? 7)What is a useful visit agenda for this patient? 8)Fold the paper and put it in the envelope.

Physician (Be curious, collect data about what is difficult.) Patient (Don’t make it TOO easy.) Observer (Keep track of interview. Prepare to give feedback.) Groups of 3: Coaching

What’s happened since we last met? What would you like to see different about your current situation? Why do you think others are concerned about your …? Open Ended

By the way you handled that situation, you showed a lot of courage, insight, willpower… Sounds like you’ve given this a lot of thought… Affirmation

Checks understanding. I get the sense that…. It sounds like…. Reflective Listening

Ideally emphasizes ambivalence. It sounds like you are concerned about your cocaine use because it is costing you a lot of money and there is a chance you could end up in jail. You also said quitting will probably mean not associating with your friends any more. That doesn’t sound like an easy choice. Summary

Are we there yet? Write about the patient you interviewed based on the responses to open ended questions. What was the implicit reason for the visit? What ambivalence did you identify with your open ended questions? What patient strengths did you identify? What is you agenda for this patient visit? What does OARS stand for?

There is a summary of Motivational Interviewing Rationale and Techniques derived from Sobell & Sobell, 2008 (on P:Conferences Handouts\ ) Stay tuned for MI Change Talk Challenge coming in Spring of 2015 Please open the envelope. How did you do?