Increaing Importance and Making a Change Plan July 08 MI News
MOTIVATION NEWS
Published by Cathy Cole, MSSW, LCSW Motivational Interviewing Network of Trainers
July 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
INCREASING IMPORTANCE AND ELICITING A BEGINNING PLAN
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: THE AUGUST WORKSHOP IS FULL; PLEASE CONSIDER REGISTERING FOR THE NOVEMBER WORKSHOP August 18-20, 2008
November 17-19, 2008 http://www.cathycoletraining.com/trainingnovemberintroductiontomi.ph p 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 via check or credit card at http://www.cathycoletraining.com/paypal_payments.php
ADVANCED MI TRAINING October 13-15, 2008 http://www.cathycoletraining.com/trainingoctoberadvancedmi.php 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 via check or credit card at http://www.cathycoletraining.com/paypalpayments.php
PROVIDING SUPERVISION I now offer a 3 day workshop focused on coding of interviews using the MITI and providing supervision via the use of an adaptation of the MIA STEP supervisory format. In this workshop, the principles of providing supervision in an MI consistent format are discussed, interviews are scored from the supervisory and supervisee perspective, as well as the MITI, and practice sessions are conducted in providing supervision.
If you are interested in this workshop, I am able to provide it for agency staff or for up to 15 participants in a workshop sponsored by me in Carrboro, NC (adjacent to Chapel Hill, NC). Please email me at cathy@cathycoletraining.com if you are interested.
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.
THE PATH FOR BECOMING A TRAINER FOR MOTIVATIONAL INTERVIEWING If you are considering becoming a trainer in MI, you will be expected to demonstrate proficiency in MI. Applications are reviewed for indication of both introductory and advanced MI training as well as supervision of MI fidelity. I am able to assist you in all of these areas.
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 and
proposal tailored to your agency.
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.
Onsite training is limited to 15 participants for Supervising MI, Advanced and Introductory MI.
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.
JULY MAIN FEATURE
INCREASING IMPORTANCE AND ELICITING A BEGINNING PLAN
Having a client thoroughly explore the importance of making change is a critical step in resolving ambivalence for change. Particularly in a setting where there might be limited contact or limited time, it can be tempting to bypass a more in depth conversation about importance. However, most of us don’t make any change without knowing why it would be to our benefit so taking this time will only be valued added for the client.
As the client explores importance, we can be in a delicate balance of facilitating this while also picking up on change talk and wanting to solidify a beginning plan. All of this requires careful listening, making certain that we don't leave the client floundering, while we also take care not to get ahead of the client. For sure a balancing act and a reminder why practicing MI is about staying directly tied to what the client has just said….no preset manual to follow here!
Let’s return to the female college student from last month’s MI News who has to attend counseling after being found passed out from drinking in her dorm room. There was an initial brief conversation, then the student was asked to complete some questionnaires related to drinking, both amount and behaviors when drinking. In her second visit, she had recognized that her behavior while drinking was not consistent with her values. We’ll pick up on the conversation for the second appointment: (I) is for interviewer and (C) is for client.
C: I'm wondering what you are going to tell me after I answered all of those questions!
I: You're curious about the feedback. (reflection)
C: Yes, after I left here I started thinking about some of the questions, particularly the ones about things that happen because of drinking.
I: Answering the questions got your attention in some way; tell me about that. (reflection and open question)
C: Well, I felt embarrassed to have to answer things like missing class, doing poorly on tests because I had been drinking and was hungover....but most of all, I realized how many times I had sex drunk....scary!
I: You realized you are acting in ways that are uncomfortable for you. (reflection)
C: Yes, but am I different from other students? Is that what you are going to tell me?
I: Seems like you think you might be. I do want to go over this in as much detail as you want but the short answer is yes; you do drink more than what is average and you show more problems related to drinking that most students do.
C: Am I an alcoholic?
I: Rather than get caught in labels, I'd like us to talk more about what you are thinking about your drinking now, after taking answering all of those questions; sound likes you are shocked. (shifting focus and complex reflection)
C: Well, I did think more about what the hall counselor said....that she had been worried about me and when she saw me passed out with a bottle next to me, she was very upset. She told me she knew all of us drank, her included, but I seem to drink more than anyone else.
I: You are taking this more seriously now. ( complex reflection)
C: Yes! I keep wondering what I must have been like, drunk, having sex with some guy I don't really know, don't even remember. That is so different from how I was raised.
I: The sexual behavior is what has you the most upset. (reflection following what she is saying is the most important right now)
C: For sure, I'm not feeling so good about me right now.
I: The way you are when drinking is not consistent with how you want to see yourself. (complex reflection picking up on change talk)
C: Right! I mean I have to be careful anyway about drinking because I can’t
get in any more trouble or I’ll be on academic probation. That would mean I
would lose my financial support, likely would have to drop out of college.
And….I don’t want to be seen as a drunk slut!
I: The stakes are high for you. (complex reflection) What are you thinking about how to handle this? (open question to determine client’s ideas about a plan)
C: Well, I have not had anything to drink since I got in trouble and I guess I need not to drink, at least for the next 2 months til the semester is over. But I don’t know after that….I am not sure if I have to quit forever. What do you think?
I: I think that really only you can decide about drinking or not for the long term (emphasizing personal choice and control) but I do hear you are motivated not to get in any more trouble with drinking for now. (reinforcing change talk).
C: Yes, and I must say that it was not all that easy these last few weeks since I got in trouble; all of my friends drink, say that I am just the unlucky one who got caught. And, when I look at all of those questions, it seems that I drink not just for fun but drink pretty much whenever I get the chance.
I: So the drinking has a bigger place in your life than you had realized. (complex reflection)
C: Right…..what do I do? I know I should not drink for now, don’t know about the future; I feel confused.
I: Understandable, all of this is such a shock to you. If it is alright with you, I’d like us to have some at least beginning plan here to help you at least get started with your goal of not drinking for the remainder of the semester. (asking permission)
C: That would be great! Where do I start? I feel kind of lonely right now.
I: So some contact with others is really needed. (reflection) What do you know about other college kids who are trying not to drink? (open questions to elicit her ideas)
C: I have heard that some of them meet and talk; I think I have also heard about some way you can do this on the computer but I don’t know the specifics. I sure need to talk to somebody else who is trying this. Can you tell me about these things?
I: You are correct; there is a group of students who meet on Wednesdays at 9pm here at the counseling center; all of them are trying not to drink; you can just show up. There is also a web site I can give you that has an online meeting, some more ways you can answer questions about how drinking fits in your life…and of course, you and I can keep meeting. What do you think? (providing information and then eliciting)
C: That sounds like a place to start. (commitment language but not specific)
I: So tell me what you will do before you and I meet next week? (open question to solidify a plan)
C: Well, today is Tuesday…..I will look at the web site tonight after I get back from the library and I’ll go to the Wednesday meeting at the coffee shop. I’ll see you next week.
I: You are definitely taking this seriously (affirmation). I’ll see you next week.
Keep practicing!
Next month we will look at how to MINDFULLY avoid getting caught in resistance.
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 based on the MIA STEP materials.
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.