welcome welcome the use of motivational interviewing working with women clients’
TRANSCRIPT
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WELCOME
The Use of Motivational Interviewing working with
Women Clients’
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COMMON FACTORS
40%--CLIENT TRAITS– Strengths, Resources, Client Perceptions
30%--THERAPEUTIC RELATIONSHIP– Empathy, Acceptance, Mutual Affirmation,
Encouragement, Respect & Warmth 15%--HOPE-EXPECTANCY
– Belief in possibility of change 15%--TECHNIQUES/ORIENTATION
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Women’s Treatment
Elements for Engagement/RetentionAvailable Child Care &
TransportationRelationship-BasedFamily/Couples CounselingDomestic Violence ServicesEmployment Services
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TerminationTermination
MaintenanceMaintenanceActioActionn
PreparationPreparationContemplatiContemplationon
PrecontemplationPrecontemplationStages of ChangeProchaska et al, 1991
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Why Enhance Motivation?
Inspire Motivation Assist Individuals
Readiness for Change
Keep People in Treatment
Improve Individuals Experiences in Treatment
Improve Outcomes Increase Return Rate
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KEY TO CHANGE
MULTIDIMENSIONAL
CAN BE MODIFIED
DYNAMIC & FLUCTUATES
INFLUENCED BY OTHERS
STYLE OF CLINICIAN INFLUENCES
IS ELICITED & ENHANCED
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Directive Client-centered Counseling style Elicits behavior
change
Client ambivalence
Communication style
Autonomy respected
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Express Empathy
Develop Discrepancy
Roll with Resistance
Support Self-efficacy
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Motivational Interviewing
PHASE I: BUILDING
MOTIVATION
PHASE II: STRENGTHENING
COMMITMENT TO CHANGE
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Phase One StrategiesBuilding Motivation
Open-ended Questions
Affirmation
Reflective Listening
Summary
Eliciting Change Talk
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Open-– Requires more than a yes or no response– Eliciting – more person centered– Aides individual cognitions
Closed-– Quick, easier, & efficient– Less person centered– Less engaging
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Affirmations
Client Focused Build on Client StrengthsHighlight Client SuccessExpress Empathy
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What is Reflective Listening?
•Hearing meaning behind the client’s words•Building Hypothesis vs. Making Assumptions•Creating a non-judgmental, accepting environment•Genuineness
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REFLECTIVE LISTENING
Levels of depth --Level One: RepeatLevel Two:
RephraseLevel Three:
Paraphrase
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Reflections Options
Some Starting Points It sounds like you . . . .
You’re feeling . . . .
It seems to you that . . . .
So you . . . .
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Summarizing
Special form of reflection Provider chooses what to include and
emphasize Includes: concerns about change, problem
recognition, optimism about change, ambivalence about change
Client knows you are listening Invite client to respond to your summary
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Change Talk CategoriesSelf-Motivational Statement
Problem Recognition
Statements of Concern
Intention to Change
Optimistic about Change
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Phase TwoStrengthening Commitment
Recognizing ReadinessTransitional SummaryKey Questions Information & AdviseNegotiating a Plan
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Motivation Exercise
•Listener –
Ask – What is something you are motivated to change?
Use active listening, open-ended statements or questions
• Speaker- respond
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Maintenance
Termination
Action
Preparation
Contemplation
Precontemplation
MI-SOC ROADMAP TOMLIN/RICHARDSON-2000
SPIRAL OF CHANGE DEVELOPED BY PROCHASKA, et al, ‘94OARS IS A TERM DEVELOPED BY MILLER et al, ‘00
OARS
OARS OARS
CHANGE CHANGE TALKTALK
Summary & Key Questions
OARS
SS
RRAA
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