1. Liz Burns e.j.burns@salford.ac.uk 0161 295 5277
PCPA Annual Conference Motivational interviewing workshop for clinical pharmacists working in primary care
Liz Burns
#PCPA16

2. Session aims
Increase understanding of motivational interviewing in relation to person-centred pharmacist reviews
Enable collaborative conversations about change, with a particular focus on intentional non-adherence or over-adherance

3. Session objectives
Discuss the ethical principles and underpinning spirit of motivational interviewing.
Apply the four overlapping processes of motivational interviewing to clinical scenarios.
Identify at least four core communication skills to practice within motivational interviewing.
Explain the importance of ‘change talk’ and how to recognise it.

4. Conversations about change: a continuum of styles
“I know what you should do, and here’s how to do it”
“I trust your own wisdom to work this out in your own way”
Directing Guiding Following
“Righting Reflex”
Miller and Rollnick (2013)

5. Four key elements underpinning the spirit of Motivational Interviewing
Unlearning the righting reflex can be a challenge for us
A ‘directing’ style is often reinforced by our professional training
In conversations about ‘change’ - lifestyle, self-care, medication adherance – the spirit of motivational interviewing can increase our awareness of the righting reflex
Reflective practice can help us to resist acting on it.
Miller and Rollnick (2013)

6. Collaboration MI Spirit Evocation
Spirit of motivational interviewing
Collaboration
Acceptance
Compassion
MI Spirit
Evocation
Miller and Rollnick (2013)

7. Accepting ambivalence as a normal human experience
People often want to change and don’t want to change, all at the same time
For others who see little or no reason to change, developing ambivalence would be a step forward
How does this fit with a typical day in practice?
Miller and Rollnick (2013)

8. Practicing a guiding method: Four overlapping processes
Miller and Rollnick, 2013; Rollnick, Gobat & Baston, 2014
Planning – “How to change?”
Evoking – “Why change?”
Focussing
Focusing – “What to change?”
Engaging – “Shall we work together?”

9. 5 key communication skills
Asking open questions
Affirming
Forming reflections
Summarising
Seeking permission

10. The significance of ‘Change Talk’
When people hear themselves speak about change, motivation increases – we hear ‘change talk’ e.g. existing desires, abilities, reasons, needs (+ activation, taking steps..)
A growing area of research tracks the language that people use when talking about behaviour change(s)
Research is showing that ‘change talk’ predicts better outcomes
Recognising ‘change talk’ and responding using core communications skills can be practised

11. Summary Where does this leave you now?
How important is it to use motivational interviewing in your professional practice?
If you did decide to have a go, how might you go about it?

12. References and useful resources
Lundahl B, Moleni T, Burke B, Butters R, Tollefson D, Butler C, Rollnick S. (2013). Motivational Interviewing in medical care settings: a systematic review and meta-analysis of RCTs. Patient Education & Counselling. 93(2), Miller, W. and Rollnick, S. (2009). Ten Things That Motivational Interviewing Is Not. Behavioural and Cognitive Psychotherapy, 37, Miller, W. and Rollnick, S. (2013). Motivational Interviewing: Helping People Change (Third Edition). Moyers, T.B., Martin, T., Houck, J.M., Christopher, P.J., Tonigan, J.S. (2009). From in-session beahviors to drinking outcomes: A causal chain for motivational interviewing. Journal of Consulting and Clinical Psychology, 77, Rollnick S, Gobat N, Batson J. (2014). Motivational Interviewing in brief consultations. FREE e-learning module Rubak S, Sandbaek A, Lauritzen T, Christensen B. (2005). Motivational Interviewing: a systematic review and meta-analysis. British Journal of General Practice. 55 (513),