1. Motivational Interviewing Groups as a Positive Psychology Intervention Christopher C. Wagner, Ph.D. Karen S. Ingersoll, Ph.D. Virginia Commonwealth University University of Virginia Overview: Motivational interviewing (MI) is an evidence-based, client- centered, goal-oriented therapeutic approach for a range of mental health, behavioral health, relational and substance abuse issues. The authors have developed an MI group therapy model that draws significantly from positive psychology. Their four-phase model of MI groups specifically incorporates Frederickson´s work on positive emotions as a basis for the third phase of the group model. The MI group approach is positively-focused and future-oriented, and fosters supportive group dynamics to build motivation to help group members make changes that promote greater well-being and fulfillment. The positive environment of MI groups can help members escape downward spirals of negativity and become more creative in fashioning better long-term solutions to life challenges, in part by connecting members to the wisdom and resources of the larger group. Leaders aim to shape group conversations toward greater depth (while tending to safety), toward greater breadth (helping members move from addressing one specific habit or behavior toward broader lifestyle change), and toward momentum toward positive change. Shaping conversational depth, breadth and momentum enhances the power of the group to promote positive change while minimizing time spent on detailed exploration of problems or past events. Engaging the Group: The first task of MI groups is not pursuing therapeutic change, but developing a safe, supportive, and empowering environment in which members can thrive. MI groups begin by engaging members holistically - not as individuals who are identified by their referral problems and related deficits, but as individuals who are creative and successful in their own ways, with experience, knowledge and skills that can benefit the whole group once engaged. Group rules are not provided, but members generate their own guidelines pertaining to issues such as respect, mutual support and confidentiality. Members are invited to explore positive aspects of their lives before discussing problems. Members are invited to begin brainstorming potential initiation goals – things they want to achieve, gain or develop through group participation. Exploring Perspectives: As members engage with one another rather than talking primarily to the group leader(s), attention turns to exploring members’ perspectives on their current situations, lifestyles and habits. Leaders guide members to focus on the positives – what members hope for, the positive choices they are considering, their past successes, and their strengths. Leaders engage members as a group rather than as a collection of individuals, finding areas of overlapping interest, experiences and values, and promoting mutual involvement and support among members. Ambivalence about change is not pathologized, but normalized and approached as an internal guiding resource. Negative or destructive habits are explored as examples of imperfectly seeking a desired state, and provide an important source of self- learning. Members are encouraged to explore their values, including non- traditional process values such as peacefulness or excitement, and how their values can guide them toward a more fulfilling and satisfying life. Leaders shape conversations deeper exploration, and elicit important information that is useful later in helping members broaden their perspectives and brainstorm new possibilities. Broadening Perspectives: The first two phases intentionally engage members outside of their problem areas, in positive and empowering ways, in order to provide a foundation for reconceptualizing the clinical problems that have brought them into contact with the helping system from a place of open non-defensiveness and expanded perspective. Members come to value one another’s perspectives, and draw upon one another’s wisdom. Consistent with Frederickson’s broaden and build model, leaders focus on eliciting positive emotions such as hope, joy, curiosity, and peacefulness in order to help members be more creative in solving problems and developing new possibilities. Members learn to use the group to build resources upon which to draw while pursuing challenging and often frightening change. Members are guided to develop a positive vision of the future that helps pull them forward. Focusing on discrepancies in a positive manner motivates them to close the gap by pursuing a better future rather than downsizing their dreams. Eliciting change success stories can broaden members’ perspectives by connecting them to their past successes, boosting their confidence about current change possibilities and inspiring new change attempts Exploring members’ perceived strengths and the strengths they see in one another can increase confidence and willingness to attempt change, while also increasing group cohesion, trust, and hope With positive perspectives and internal resources engage, members are guided to further clarify their vision of the lives they are moving toward. Moving into Action: With an increased sense of freedom that comes from broadening perspectives outward from current problems to future possibilities, the focus now narrows toward brainstorming more near-term goals, plans, and actions. The group is kept cohesive as members progress at different rates by inviting members who have made quicker progress to share the challenges they are experiencing, and inviting members who have made slower progress to share the steps they have taken and the hope they have about moving forward. Leaders review members’ sense of importance and confidence about achieving their goals as defined so far, and help members use this information to help shape the best plans for moving forward. Leaders help members develop change plans in a way that increases group cohesion and identity while emphasizing autonomy and individualized planning. Members are invited to make a verbal commitment to the group to take specific action (no matter how small) as a means of helping can help bolster members’ motivation. Success is accomplished not by developing a perfect plan, but by persevering through challenges and creatively adapting to new developments. Members support one another during initial and ongoing attempt to change, functioning as a community of individuals helping one another “go through it together.” As the group nears its ending, members focus on what they have gained and how they plan to continue to pursue important goals. Leaders also share what they have gained from being part of the group. Research to date suggests that MI groups can increase treatment engagement, self-efficacy, behavioral intentions and readiness to change, reduce drug use and smoking, and increase risk management and disease coping. EngagingExploringBroadening Moving into Action