1. Evidence – Based Practices
Motivational Interviewing (MI)

2. History
Developed by Drs. Miller & Rollnick in the early 1980s and developed into a curriculum in 1991
Evolved from experiences with treating “problem drinkers”
From U.K., and implementation has slowly made it’s way to the U.S. and to the criminal justice field

3. A directive, client-centered counseling style for helping clients explore and resolve ambivalence about behavior change
Goal directed
Focused
An evidence–based practice that is an alternative that staff in corrections can use to decrease resistance to change
Definition

4. Client resistance typically is a behavior evoked by environmental conditions.
The client/counselor relationship should be collaborative and friendly.
Motivational Interviewing gives priority to resolving ambivalence.
The counselor does not prescribe specific methods or techniques.
Philosophy

5. Philosophy cont. Clients are responsible for their progress.
MI focuses on clients' sense of self-efficacy.
Philosophy cont.

6. 8 Guiding Principles for Reducing Recidivism/Risk
Risk/need – assess risk
Enhance intrinsic motivation
Target intervention
Skill train w/directed practice
Increase positive reinforcement
Engage ongoing support
Measure feedback
Measure relevant practices

7. The Big 6 in Criminogenic Needs
Substance abuse
Criminal personality
Anti-social values
Dysfunctional family ties
Low self-control
Criminal peers

8. Effective Casework Model
Mapping – review case file, administer assessment
Finding the hook – motivation, prioritizing
Moving forward – interventions, case planning
Reviewing and supporting – monitoring, successes & obstacles

9. Benefits of MI Provides a model for the process of change
Reframes “denial” as ambivalence
Shows the counselors how to manage ambivalence about change
Identifies client motivational structure
Correlates with compliance

10. General Principles: DEARS
Develop discrepancy
Express empathy
Amplify ambivalence
Roll with resistance
Support self–efficacy (the client is responsible for choosing and carrying out personal change)
General Principles: DEARS

11. Open-ended questions – “tell me…, explain…, describe when…”
Affirmations – “good job,” “I am proud of you”
Reflective listening – “So…, “You mean…”
Summarization – “What I hear you saying is…,” “Let me see if I understand…,” … “did I get that right?”
Major Strategies

12. Traps to Avoid Question/Answer
Premature Focus – you need to meet the client where they are
Confrontation – “you HAVE to do this”
Blaming
“expert” role – “I have been a PO for 10 yrs and…”
Labeling – you are just an addict
Traps to Avoid

13. Taking sides – we need to phrase what we say as neutrally as possible
Big hammer – “I’m the PO, and if you don’t do what I tell you then you are going to prison”
The righting reflex – when someone comes to you with a problem, you feel the need to immediately fix it
Traps to Avoid cont.

14. What is Change Talk?? The Desire Ability Reason Need and
Commitment to change
What is Change Talk??

15. Once you hear Change Talk, you need to …
Reflect
Elaborate
Summarize
Affirm
Utilize skills like the importance/confidence scale, querying extremes, and looking back/looking forward to develop this change talk.

16. Resistance Talk Desire for status quo Inability to change
Reason for the status quo
Need for the status quo
Commitment for the status quo
Resistance Talk

17. Clinical Factors Encourage the client to be a self-investigator
Encourage the client to see choices in situations and consequences of those choices
Help the client define goals
Promote increased hope, confidence, and positive attitude
Clinical Factors

18. Handling Resistance Simple reflection
Amplified reflection – never, will always
Double-sided reflection – on the one hand… on the other hand
Shifting focus – “We’ve talked about what other people say about your drinking. What do you think?”
Handling Resistance

19. Handling Resistance cont.
Coming alongside – “It sounds like the pros of smoking outweigh the cons of quitting. So maybe you will decide to never stop smoking.”
Agreement with a twist – a reflection with reframing
A new meaning, interpretation, perspective
“My husband is always nagging me.” “It sounds like your husband really cares about you.”
Handling Resistance cont.

20. Handling Resistance cont.
Emphasizing personal choice / control – “No one can make you do this. This decision is yours.”
Disclosing feelings – “I’m getting a stuck feeling as we are sitting here, and I’m wondering if you are feeling the same way?”
Handling Resistance cont.

21. Examples http://www.youtube.com/watch?v=cj1BDPBE6W k
rJJPCuTE HE
GRk (Great intro video)
Examples

22. Rationalizing
Reluctant
Rebellious
Resigned
Types of Resistance

23. Stages of Change Pre-contemplation Contemplation
Determination (Preparation)
Action
Maintenance
Relapse
Stages of Change