Commitment and Ambivalence MI News Sept 08
MOTIVATION NEWS
Published by Cathy Cole, MSSW, LCSW Motivational Interviewing Network of Trainers
September 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
COMMITMENT AND 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:
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
November 17-19, 2008 INTRODUCTION TO MOTIVATIONAL INTERVIEWING 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
2009 Training Dates: INTRODUCTION TO MOTIVATIONAL INTERVIEWING February 17-19, 2009 July 20-22, 2009 November 10-12, 2009 Century Center, Carrboro, NC Carrboro is adjacent to Chapel Hill, NC Limited to 15 participants $595, 18 hours CE; ASWB continuing education pending Please email cathy@cathycoletraining.com to reserve a spot
ADVANCED MI TRAINING May 11-13,2009 September 14-16, 2009 Century Center, Carrboro, NC Carrboro is adjacent to Chapel Hill, NC Limited to 15 participants $595, 18 hours CE; ASWB continuing education pending Please email cathy@cathycoletraining.com to reserve a spot
PROVIDING SUPERVISION March 30-April 1, 2009 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. Century Center, Carrboro, NC Carrboro is adjacent to Chapel Hill, NC Limited to 15 participants $595, 18 hours CE; ASWB continuing education pending Please email cathy@cathycoletraining.com to reserve a spot
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, the justice system, 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.
SEPTEMBER MAIN FEATURE
COMMITMENT AND AMBIVALENCE
Let's return to our college student from June and July; we'll call her Betty. As you recall, she had to complete counseling for an infraction of the college alcohol policy, first answering measures/outcomes of alcohol use and having a feedback session. The following is the last part of the interview in the July MI News.
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.
Betty is now returning and we will look at the mix of commitment to make change but ongoing ambivalence that is mostly focused on the exactly how that change will look for her. Consequently we will be focusing on Stage 2 of MI, Increasing Commitment to Change, while carefully attending to ambivalence that often still remains. C is for Client and I is for Interviewer.
It remains important for Betty to explore the ambivalence and make a plan
that works for her. It would be tempting to move into trying to convince her.
As you read, you may want to read what the client says and then think of
what you might be inclined to say before reading my response.
I: Hi Betty, it's good to see you. Where should we start today? (open question that allows Betty to set the agenda)
C: Well, I did what I said I would do....looked at that web site and went to the meeting. I also managed to not drink since I was here.....not much of a weekend. (all said with a somewhat disgusted look on her face)
I: You don't sound very excited (complex reflection)
C: I mean.....I keep thinking about those questions I answered, particularly about the sex stuff and I know I need to do something, but I just don't know what I should do. The people at the coffee shop were really nice to me, offered that I could hang out with them any time, gave me their cell numbers, wanted me to come to a NON DRINKING party last weekend! I almost went but then I just stayed in the dorm and studied.....bummer all around.
I: You are really torn about this, wanting something different, but unclear at the same time. (complex reflection)
C: Yes.....I mean, it has felt kinda good not to drink; I didn't have a hangover Sunday morning and did some things that day that I want to do on Sundays but was too bummed from drinking before. But it was not fun to be alone in my room, just studying.
I: So the downside was being alone while on the other hand there was the advantage of your Sunday. (double sided reflection)
C: Yes, I think not drinking is okay at least for the rest of the year in order not to get in trouble, but I don't know if I will not ever drink again. And, I don't want to be by myself all the time on the weekend.
I: You are trying to figure out just how this will look for you. (reinforcing change talk)
C: I thought about going to the non drinking party....almost went...maybe I should have gone.
I: What got in the way? (open question to determine barrier)
C: It just seemed so weird that I would not be drinking.....I wondered if I would be fun to be around.
I: You are not certain if you would be accepted in the same way. (complex reflection)
C: They really seemed to like me when I was with them at the coffee shop and they were way cooler than I thought they would be......cute, funny, not sitting talking about not drinking all the time.
I: You felt included and weren't horrified at being with a bunch of NON DRINKERS (amplified reflection, said with a smile)
C: Yes, my roomie said maybe she would like them, even though she does not drink all that much. She said maybe it would be interesting to see what a party where people don't make fools of themselves and throw up might be fun.
I: She was encouraging to you. (complex reflection)
C: Well, tonight is coffee shop night; I think I will go again; they said something about shooting pool at the student union also....I always wanted to learn. Maybe I'll ask my roomie to go to the party Saturday. I figure if I am not going to drink, I should at least have some fun!
I: You are willing to try this out and have a plan. How likely is it that you will do tonight's plan and go to the party? (checking the degree of commitment)
C: Oh, I will definitely do all of it.....it was way too boring just sitting in my room studying!
I: I'll look forward to hearing how it went next week.
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 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. 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.