MI for Psychotherapy 1-08
MOTIVATION NEWS
Published by Cathy Cole, MSSW, LCSW Motivational Interviewing Network of Trainers
January 2008----HAPPY NEW YEAR!!! http://www.cathycoletraining.com (MI training since 1995) We sit together~ My thoughts you do recapture And bring out the hope Cole, 2007
NEWSLETTER FEATURE ARTICLE
MI TO RESOLVE AMBIVALENCE FOR ENTERING THERAPY
IF YOU DO NOT SEE TRAINING THAT WILL FIT YOUR NEEDS, PLEASE EMAIL ME AT cathy@cathycoletraining.com IN ORDER TO DISCUSS HOW I CAN PROVIDE TRAINING TAILORED TO YOUR NEEDS. I FREQUENTLY TRAVEL TO AGENCIES OR CONFERENCES TO PROVIDE MI TRAINING.
ONSITE TRAINING OPPORTUNITIES
2008 ONSITE TRAINING DATES:
*****NEW WORKSHOP.....REGISTER NOW*********** MOTIVATIONAL INTERVIEWING IN SUPERVISION January 31-February 1, 2008 Century Center, Carrboro, NC Carrboro is adjacent to Chapel Hill, NC Limited to 15 participants
Purpose of workshop: to provide a format for self assessment, supervision or peer consultation for determining level of and improvement of MI consistent skills.
Format: use on the MIA STEP process to rate recorded interviews
Participants should be knowledgeable of Motivational Interviewing with the ability to demonstrate and recognize skills that are consistent with the practice of MI. This is not a workshop to train the use of MI skills but participants already practicing MI can expect an increased awareness of MI consistent practice and be able to compare their level of practice to the standards.
To register: 1. Email Cathy Cole at cathy@cathycoletraining.com to reserve a spot. 2. Send a check to Cathy Cole for $440 POB 17271 Chapel Hill, NC 27516- 7271 3. Pay by credit card at http://www.cathycoletraining.com/paypal_payments.php Using the distance learning fee schedule 4. Indicate payment from what institution:
INTRODUCTION TO MOTIVATIONAL INTERVIEWING: March 4-6, 2008 August 18-20, 2008 November 17-19, 2008 Three day workshops covering the basics with ample opportunity for coached practice Century Center, Carrboro, NC Carrboro is adjacent to Chapel Hill, NC Limited to 15 participants $550, 18 hours CE; ASWB continuing education pending Please email cathy@cathycoletraining.com to reserve a spot Payment accepted beginning January 2008 via check or credit card at http://www.cathycoletraining.com/paypal_payments.php
ADVANCED MI TRAINING April 14-16, 2008 October 13-15, 2008 Three day workshops with an emphasis on coached practice Century Center, Carrboro, NC Carrboro is adjacent to Chapel Hill, NC Limited to 15 participants $550, 15 hours CE; ASWB continuing education pending Please email cathy@cathycoletraining.com to reserve a spot Payment accepted beginning January 2008 credit card at http://www.cathycoletraining.com/paypal_payments.php
MI COACHING--TAKE ADVANTAGE OF ONGOING SUPERVISION OF YOUR MI PROGRESS VIA COACHING For individuals and agencies with previous MI training either with me or another MI trainer, I offer ongoing coaching/supervision in the application of MI. Generally, this coaching takes place by phone. You can arrange for individual or group coaching. Please email me at cathy@cathycoletraining for more information.
ADOPTING THE MI PRINCIPLES ON AN AGENCY LEVEL
The fullest implementation of MI is achieved when staff are trained in the use
of
MI and all of the operation of the agency is consistent with MI principles. I
offer
consultation that will assess all levels of function in the agency, from how the
phones are answered, clients greeted, intake achieved and provide guidance
in making changes to incorporate MI into the full process of work. At a
recent
workshop, a staff member, responding to a crisis, remarked that he was able
to
handle the situation more effectively by using MI as an approach. A
receptionist
remarked that she now would use MI in her client interactions.
Please email me at cathy@cathycoletraining for
more information.
ABOUT MY WORKSHOPS: I have provided MI training since 1995, following my training with Drs. Miller and Rollnick. My teaching approach is very pragmatic, focusing on the core concepts of MI and allowing the learning to progress from direct practice.
I have elected to limit the size of my workshops in order to maximize the opportunity to provide learning that can both address the concepts and practice of Motivational Interviewing while at the same time assist in the application of MI to each participant's work setting.
I offer all participants the opportunity to submit a 15-minute audio-tape of an interview using the MI approach before and after each workshop. This will allow for you to have feedback on your progress in learning.
Onsite training is limited to 15 participants, both in Advanced and Introductory MI; Distance Learning classes are limited to 10.
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 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. Additional source material: Motivational Interviewing in the Treatment of Psychological Problems, ed. Arkowitz, Westra, Miller, and Rollnick, Guilford 2007; Motivational Interviewing In Health Care, Rollnick, Miller, and Butler, Guilford, 2007.
JANUARY MAIN FEATURE MI TO RESOLVE AMBIVALENCE FOR ENTERING THERAPY
Often a client will be aware of problems that create difficulty in life but is not willing for whatever reasons to pursue additional help. These clients are often seen in clinic settings where psychotherapy is offered and can be labeled as ‘resistant’ or not ready. From the MI perspective, we would be interested in understanding the nature of the ambivalence. The use of MI is such settings is addressed in Motivational Interviewing in the Treatment of Psychological Problems.
Here is what a conversation might sound like. I is for interviewer and C is for client.
The setting: You are doing a follow up interview after an intake assessment with a young woman who was evaluated for problems related to a sexual assault. She has symptoms of Post Traumatic Stress Disorder.
I: ‘Hello, Ms. Owens; my name is Cathy Cole, the social worker for our clinic; thanks for coming in today.’
C: ‘Sure, but I don’t really know why I am here.’
I: ‘My understanding is that we are meeting to talk about difficulties you are having following your rape and how we might be of help here. However, I want to know how you want to spend the time; something else may feel more important to you today.’ (agenda setting)
C: ‘No, that’s okay but I don’t really think anything is going to help.’
I: ‘You are feeling discouraged.’ (following by reflecting)
C: ‘Yes, it just seems to get worse and I can’t stop thinking about it; I figure this is how I will be forever.’
I: ‘It’s with you all the time; what is the worse part for you?’ (reflection and open question)
C: ‘I am a prisoner now; I don’t leave my house much at all…just to work and back; I am scared all the time, don’t trust people much anymore; I have bad dreams…it’s just a mess.’
I: ‘You’re paralyzed by this and don’t think you will ever be any different.’ (following by reflecting)
C: ‘I don’t want to be this way but it seems that nothing helps make the memories go away.’
I: ‘You would like it to be different but you can’t seem to find anything that has helped. What have you tried?’ (reflecting and open question)
C: ‘Mostly I thought that if I just tried not to think about it, it would go away; then I thought if I just stayed away from things that make me nervous, I’d feel better…but none of that has helped at all!’
I: ‘So you have tried lots of things to avoid and still you are haunted by this.’ (following by reflecting)
C: ‘Yes, maybe I will just have to live with this.’
I: ‘I hear you are discouraged but I would like to talk with you about what is going on and what might help, if you would be okay with that.’ (following and directing by offering information)
C: ‘That’s fine.’
I: (Provides some information on PTSD, how avoidance makes it worse and some possible treatment options. The conversation picks up after this.)
I: ‘That my be a lot to hear at once, I know.’
C: ‘So you are saying that, based on what you know, some of the expectations I have about not remembering and some of the ways I try to avoid things, could actually make this worse!’
I: ‘You are surprised about that.’ (following by reflecting)
C: ‘It just seemed to make sense; I’m just lost.’
I: ‘You had no idea about all of this, felt kind of in the dark.’ (following by reflecting)
C: ‘I don’t know if I can do anything different; even though I am miserable, it is at least familiar.’
I: ‘You don’t like how it is but there are some advantages; tell me more about the advantages.’ (reflecting and open question)
C: ‘Well, my co-workers just leave me alone now; they have figured out I have a short fuse and they just don’t hassle me, actually make my load lighter. My friends leave me alone also; they finally just got tired of asking me to do things when I would just say no.’
I: ‘You have managed to construct a world that keeps others away.’ (following by reflecting)
C: ‘But that is lonely also.’
I: ‘So while the avoidance has some function, it also has a down side.’ (following by reflecting and picking up on change talk)
C: ‘Yes; before the rape I was a naturally social person and for sure wanted to be good at work, do my share and find more challenges. I miss that person.’
I: ‘The rape took your life away in many ways and you want to regain your old self.’ (following by reflecting and picking up on change talk)
C: (Begins to have tears in her eyes) ‘I don’t want it to control me and yet it seems so scary.’
I: ‘Sad and scared all at the same time.’ (following by reflecting)
And so the conversation would continue to allow this client to look at what, if anything, she would like to do to target the problems that have developed due to the rape. We might continue to look at advantages, or have her reflect more on the time before the rape, or to gently speculate on where she might start if she wanted to tackle this in any way. The overall goal would be for the client to further develop discrepancy and make choices that are hers regarding treatment about the rape. This conversation might continue for 45 minutes with some decision at the end or with a plan to talk more at a future appointment. Some important points would be to: hold the tension of the discrepancy (avoid being overly reassuring), not prescribe treatment while at the same time making certain the client has sufficient information to decide on treatment options, and to explore issues of self efficacy.
Keep practicing!
For more information on MI training and Cathy Cole visit http://www.cathycoletraining.com
Additional Educational/Coaching Offerings: Use of the MITI (Motivational Interviewing Treatment Integrity Code) for feedback on taped interviews.
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.
Additional Advanced MI training: Telephone conferencing for active case supervision and focus on MI skills or on site training for staff groups already trained in MI; feedback on tapes using the MITI.
MI Coaching: assessment of a taped client session with phone supervisory consultation; feedback on tapes using the MITI.
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, inc Cathy Cole, President 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 919-382-8102
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.