Motivational Interviewing: A Refresher on the Basics--the MI Newsletter
MOTIVATION NEWS
Published by Cathy Cole, MSSW, LCSW Motivational Interviewing Network of Trainers August 2004 http://www.cathycoletrainging.com \"What People Need is a Good Listening To\" Mary Lou Casey
MOTIVATION NEWS TOPICS Motivational Interviewing---A Refresher on the Basics
UPCOMING TRAINING Fall Teleclass Schedule Join me and fellow classmates for the ease and convenience of learning via telephone brigde line...no special equipment needed Class begins September 13, 2004
For full course description and registration, click on Distance Learning on my web site: http://www.cathycoletraining.com
FALL TWO DAY ONSITE WORKSHOP I am pleased to announce dates for my Fall two day training to be held in beautiful Chapel Hill, NC. Workshop dates: Thursday and Friday, September 23 and 24, 2004. For more information, please click on Onsite Training on my web site: http://www.cathycoletraining.com
This letter may be forwarded to anyone you feel could benefit as long as it is forwarded in its entirety.
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 NATURE OF CHANGE ëUntil one is committed there is hesitancy, the chance to draw back, always ineffectiveness, concerning all acts of initiative and creation. There is one elementary truth, the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then Providence moves too. All sorts of things occur to help one that would never otherwise have occurred. A whole stream of events issues from the decision.í -Johann Wolfgang von Goethe
Before you stop and think about why others change, think about why you have made changes at times in your life. Perhaps you pondered moving to a small town from a large city for several years and suddenly put that plan into action.
What happened to move this pondering from contemplation to action? Did you finally get fed up one day with sitting in traffic, breathing in bad air while you spent an hour in commute home? Or maybe your children moved out to pursue adult lives and you and your spouse decided that the timing was right for new scenery, a slower pace, an early retirement?
Or on the other side, how many times have you thought something like this? Youíd think heíd stop smoking after he had that heart attack! If I was that much in debt, Iíd tear up my credit cards!
Go back the Goethe quote and look at the essential componentÖ ëthe moment one definitely commits oneselfíÖ So we could spend all kinds of time thinking about why people do or do not change, but the essential ingredient in a treatment or coaching relationship is determining the degree of motivation/commitment for change and assisting our clients in moving forward in making change.
ëAre you ready, willing and able?íÖthose three elements are the essential parts to a high level of motivation for change. First willingnessÖ.how much does a person want change? How is the current situation in discrepancy with how the person wants it to be?
Able: Does the person feel like he/she has what it takes to make change? Is self confidence low?
Ready: Is it the time now for change?
A brief example: John wants to lose weight; his current weight is outside of what he considers healthy----he is willing to lose weight.
John is not certain about how able he is to lose weight as he has never attempted this before and isnít quite certain how to approach this problem.
When it comes to readiness, John knows he will not be ready Until he and his wife take their second honeymoon cruise. He doesnít want to have to fret about what to eat/not to eat on such an important occasion.
A Motivational Interviewing approach in client work addresses these questions and other questions in the context of exploring, clarifying and resolving ambivalence for change. Pacing and the use of reflective listening are two keys to this process that emphasizes partnering with the client and eliciting change statements and eliciting/not imposing solutions for change.
THE FOUR PRINCIPLES OF MOTIVATIONAL INTERVIEWING Four general principles provide the foundation for MI: expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy.
Expressing empathy: this involves true understanding of the client's situation achieved through reflective listening; it involves no blaming, judging, or criticizing; ' acceptance' of the client's perspective does not equate with approval or endorsement; it just means trying to understand. There is a recognition that ambivalence about change is normal.
Developing discrepancy: client motivation for change is heightened through the process of exploring and amplifying the discrepancy in the current situation and important client goals and values.
Rolling with resistance: \"resistance\" is recognized as an interpersonal process that can be influenced by clinician style; the clinician avoids arguing for change and uses reflective listening primarily to help the client identify reasons for change.
Supporting self-efficacy: the client's belief in the ability to change is a very important ingredient for progress; exploring confidence in the ability to change is critical.
THE FIVE OPENING STRATEGIES OF MOTIVATIONAL INTERVIEWING An acronym is available for the first four methods: OARS O---Ask open ended questions: provides the greatest opportunity for eliciting and understand client concerns; asking questions in this fashion alleviates the temptation of just completing a check list of your desires and provides the chance for the client to define a range of concerns that may be different that your original ideas R---Use reflective listening: the cornerstone of MI; the skillful response to client material shared; allows for expansion of the information and checking for accuracy; truly listening enhances the relationship and sets the stage for 'partnering' in change A---Use of Affirmation: a way to reinforce client strengths and supports; an important method for developing and reinforcing self-efficacy S---Summarize: a method to link and reinforce information shared; a basic reflective listening method. Eliciting and reinforcing client change statements completes the full list. Skillful use of MI means selectively reinforcing client generated motivation for change.
For more information on MI training and Cathy Cole visit http://www.cathycoletraining.com
Additional Educational Offerings: Onsite workshops: one or two 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.
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 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.
For more information on Motivational Interviewing, visit the web site http://www.motivationalinterview.org
(919) 967-9653 — 
cathy@cathycoletraining.com© 2009 Cathy Cole Training, Inc.