November Motivational Interviewing--The Ruler Exercise
MOTIVATION NEWS
Published by Cathy Cole, MSSW, LCSW Motivational Interviewing Network of Trainers November 2004 http://www.cathycoletrainging.com \"What People Need is a Good Listening To\" Mary Lou Casey
MOTIVATION NEWS MAIN FEATURE The Ruler Exercise as a method of Eliciting Change Talk How this might look with a client.
DISTANCE LEARNING TRAINING
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There are eight one hour sessions for this Basic MI training.
Class begins May 2 and concludes July 25, 2005
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March 21/22-05 with interview review and follow up conference call. ADVANCED MI TRAINING ; prior MI training required. For full course description and registration click Onsite Training on my web site http://www.cathycoletraining.com or write to me at cathy@cathycoletraining.com
April 18, 19, 20-05 INTRODUCTION TO MOTIVATIONAL INTERVIEWING A 2 1/2 day workshop on the basic concepts on MI and beginning practice. For full course description and registration click Onsite Training on my web site http://www.cathycoletraining.com or write to me at cathy@cathycoletraining.com
Both trainings will be held in Chapel Hill, NC at the Friday Center for Continuing Education. This beautiful town is home to the University of NC and is within a short drive to Durham, NC, home of Duke University.
This letter may be forwarded to anyone you feel could benefit as long as it is forwarded in its entirety. Past newsletters available via web site http://www.cathycoletraining.com
Welcome to Motivation News, a newsletter devoted to clinical information on the use of a Motivational Interviewing (MI) approach to change. The authors of this approach, William Miller, PhD and Stephen Rollnick, PhD define MI as a 'client centered, directive method for enhancing an intrinsic motivation for change by exploring and resolving ambivalence\". This collaborative approach to working with clients has wide application in coaching, mental health, addictions, health care and health education. Information in this newsletter is taken from various source material from the Motivational Interviewing Network of Trainers and specifically from the book Motivational Interviewing, Preparing People for Change; Miller and Rollnick, 2nd edition, 2002, Guilford Press.
The Ruler Exercise
The 'ruler' exercise is widely used in Motivational Interviewing to better understand ambivalence and elicit change talk. Essentially, the interviewer asks the client three staging questions and then uses the answers to facilitate a discussion on the topic at hand. Along the way, other MI concepts will be used; watch for them!
I is for interviewer; C is for client.
So let's say you have a client who is 65, lives alone, uses eating out as a way of increasing social contact. You are the nutritionist focusing on overall health, managing blood pressure, diabetes, and heart disease as risk factors for this relatively healthy person. Let's say, for the sake of this exercise that you know the client eats mostly in fast food places and mostly foods high in fat and few vegetables; has milkshakes and frozen desserts that are low in cost; she is on a small, fixed income and uses coupons for discounts. You have summarized what you know and with permission, offered some concern over the high fat, low vegetable diet. The client says she is aware of this information.
You might start the conversation this way: I-- 'Thanks for continuing to look at this with me. You are a pretty healthy person and we want to reinforce that. So, just for us to focus on this in a slightly different way, I'd like to ask you three questions, if that is okay with you. (C says okay). Here are the three questions and they are on this sheet as well for you to look at; read each one and then come back and put a number to each question: On a scale of 1-5, when 1 is not important and 5 is very important, how important is it to you to eat in a way that supports your health? On the same scale, how confident are you that you that you can do this? And finally, on the scale, how ready are you to do this?
C--says 5 on importance, 2 on confidence and 2 on ready.
I--Tell me about the 5 on importance. C--Well, I know all the information and I believe it. I--Okay, so you know this is important; so tell me about the 2 on confidence. C--I don't think I can do any better than I am doing, with my fixed income and not wanting to be home alone. I--So you know it is important but your income and need to be around others is important and you don't think you could do better. Okay, we'll come back to this. Why the 2 on readiness...although that seems kinda strange to ask right now. C--Yes, I'd be more ready if I thought I could do better! I--I get it on that! So, back to this confidence area. What would help move that 2 up to just even a 2.5, if you decided to tackle this at all? C--Maybe I could do better if I had a quideline on how to eat at fast food places which are the only places I can afford. And, I don't want to give up all the stuff that tastes so good! Food is a pleasure for me. I--So if you and I looked a some of the menus from these places and did a plan for you that would involve better eating AND keep some of the fun, you would feel more confident. C--That's right and more ready. I--Great idea and we can start that right now since I keep the menus from lots of places. Would you like to do that now? C--Yes.
Now the two of you are partnered on this, the client has generated her own solution and you are ready to lend your expertise to tailor a plan for her.
A simple example to illustrate this one concept. Try this out with a client of yours and let me know what happens!
For more information on MI training and Cathy Cole visit http://www.cathycoletraining.com
Additional Educational Offerings: Onsite workshops: one to three day training in MI for agencies or educational consortiums
Onsite consultation: Preparing your agency for MI. Combining this with specific training for agency staff increases the effectiveness of implementing MI.
Additinal Advanced MI training: 8 one hour teleclasses for active case supervision and focus on MI skills or on site training for staff groups already trained in MI
MI Coaching: assessment of a taped client session with phone supervisory consultation.
For information on any of these MI trainings, send email to cathy@cathycoletraining.com
Cathy Cole, MSSW, LCSW is an educator and clinician.
She received her Masters of Science in Social Work from
the University of Tennessee and has maintained a varied clinical and
education practice throughout her career. Since her training in
Motivational Interviewing in 1995, she has provided extensive training.
For more information on Cathy visit http://www.cathycoletraining.com
To contact Cathy, use cathy@cathycoletraining.com
cathycoletraining Mission: to provide excellent education and coaching with a specific focus on the use of Motivational Interviewing for exploring and resolving the natural ambivalence for change. Training in the use of Motivational Interviewing is offered on site or via teleconference. Contact Cathy at cathy@cathycoletraining.com for more information or visit http://www.cathycoletraining.com
For more information on Motivational Interviewing, visit the web site http://www.motivationalinterview.org
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