A Plan with Ambivalence MI News 2-08
MOTIVATION NEWS
Published by Cathy Cole, MSSW, LCSW Motivational Interviewing Network of Trainers
February 2008 http://www.cathycoletraining.com (MI training since 1995) We sit together~ My thoughts you reflect And hope springs forth Cole, 2007
NEWSLETTER FEATURE ARTICLE
A STRONG PLAN WITH ONGOING AMBIVALENCE
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:
INTRODUCTION TO MOTIVATIONAL INTERVIEWING: March 4-6, 2008----PLEASE EMAIL ME TO DETERMINE AVAILABILITY! 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.
FEBRUARY MAIN FEATURE A STRONG PLAN WITH ONGOING AMBIVALENCE
The use of MI in psychotherapy settings sets the theme of this month's
newsletter.
MI attends to the change process in two phases: phase one, increasing
motivation for change and phase two, reinforcing commitment to change.
Typically phase one addresses matters of importance and confidence and
phase two strong change plans and clear intent. However, even when a
strong change plan has been outlined, ambivalence in following that plan
needs to be explored. After all, change is indeed a strong challenge for many
reasons.
For clients with long histories of complex emotional difficulties, there can often be a separation between knowing the ways to make and maintain change regarding the goal of more emotional stability and the confidence in doing this. So while there might be a strong change plan, uncertainty remains a needed issue to address.
Here is what a conversation might sound like. I is for interviewer and C is for client.
The setting: A mental health clinic; the scenario: a client well known to the clinician who continues to struggle with emotional disruptions in her life. She has spent a self directed session outlining a plan for determining danger signs and ways to prevent the need for emergency care and then ends the session saying, 'Now, we need to talk about why I can't let myself take care of me by following this plan.' We pick up the conversation in the next session. Rather than get caught in some righting reflex response, the clinician allows the client to explore this dilemma for herself.
I: 'So where should we begin today?' (open question)
C: ‘I can't get beyond believing it is a weakness to have a mental illness.’
I: ‘It seems like a personal flaw to you.' (complex reflection)
C: 'Yes, like I should be able to just get over it, stop being anxious, self conscious; that is what other people seem to think in my life....I should just get over it!'
I: ‘Others downplay how hard this is and you find yourself doing the same thing.' (complex reflection)
C: ‘I get really scared; wondering if I will just completely lose it one day, go into the hospital and never come out.’
I: ‘This fear really rules your life, consumes your thoughts.' (complex reflection)
C: ‘There has to be some answer; I try to just ignore it but the more I try, the more it seems to be on my mind.’
I: ‘Your efforts don't seem to work the way you want them to.' (complex reflection)
C: ‘What else can I do?.’
I: ‘If it is alright with you, maybe we could think about some things you have already learned and have used well for yourself.' (feedback with permission; affirming past successes at change)
C: ‘That sounds like a great idea!’
I: 'You'd like to use what you know has worked in some ways for you already; what are some things that come to mind?' (reflection and open question)
C: ‘It seems like the harder I try to fight it, the stronger the fear and anger at myself for having mental illness gets.’
I: ‘So fighting it doesn't work, just makes it worse; what is another time in our work together that we have talked about fighting what you know to be a reality?' (reflection and open question)
C: .’Hmmm, I guess when my husband was so sick and I was always worrying about when he would die.'
I: 'And what helped then?' (open question)
C: Pauses for a bit in thought and then says 'that radical acceptance thing! I was able to relax some by accepting that he had a terminal illness and would die.'
I: ‘You did not like it as I recall but you were able to relax more.' (reflection)
C: ‘So I should accept that I have mental illness?’
I: ‘Well ultimately you have to decide how you want to approach this thing that has you upset a lot of the time, but if you did accept rather than fight, how would that possibly make a difference?' (personal choice and open question)
And so the conversation would continue.
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.
Use of a structured supervisory feedback form for targeting competence and places for improvement in MI practice.
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.