2. Mentor Meeting: March 2, 2007 TOPIC: Helping people stay motivated as they work on personal life issues

3. Motivational Interviewing is a person-centred, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence (Moyers & Rollnick 2002)

4. Motivational Interviewing Preparing People For Change

5. Motivational Interviewing is a model to describe how people change is an effective, innovative method to help people with problems identifies a person’s own fears and difficulties and helps to resolve the issues

6. Six Stages of Change 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance 6. Relapse

7. (Engender Health 2003)

8. Four key principals of Motivational Interviewing Express empathy Develop discrepancy Roll with resistance and avoid argumentation Support self-efficacy (Moyers and Rollnick 2002)

9. And …. highlight any discrepancies Get the person to rate both their motivation and confidence on a scale of 1 to 10 Summarize

10. Motivational Interviewing Skills: Building Self-Efficacy The belief that one can perform a behavior or accomplish a particular task Belief in the possibility of change is an important motivator. The person is responsible for choosing and carrying out personal change. There is hope in the range of alternative approaches available.

11. Motivational Interviewing Skills: Simple reflection The simplest approach to responding to resistance is with nonresistance, by repeating the person's statement in a neutral form. This acknowledges and validates what the person has said and can elicit an opposite response.

12. Motivational Interviewing Skills: Shifting Focus You can defuse resistance by helping the person shift focus away from obstacles and barriers. This method offers an opportunity to affirm your person's personal choice regarding the conduct of his or her own life.

13. Motivational Interviewing Skills: Reframing A good strategy to use when a person denies personal problems is reframing--offering a new and positive interpretation of negative information provided by the person. Reframing acknowledges the validity of the person's raw observations, but offers a new meaning.

14. Motivational Interviewing Skills: Rolling With Resistance Momentum can be used to good advantage. Perceptions can be shifted. New perspectives are invited but not imposed. The person is a valuable resource in finding solutions to problems.

15. Motivational Interviewing Skills: Expressing Empathy Empathy communicates acceptance, while supporting the process of change. Acceptance facilitates change. Clinician seeks to build up rather than tear down. Skillful reflective listening is fundamental to expressing empathy.

16. Motivational Interviewing Skills: Affirm When it is done sincerely, affirming your person supports and promotes self- efficacy.

17. Motivational Interviewing: Putting Responsibility for Change on the person. Simple Reflection Shifting Focus Reframing Rolling with Resistance Siding with the Negative Self-Efficacy Avoiding Arguments Open-ended Questions Listen Reflectively Expressing Empathy Develop Discrepancy Affirm