Coming Alongside MI News 4-09

MOTIVATION NEWS

Published by Cathy Cole, MSSW, LCSW Motivational Interviewing Network of Trainers

April 2009
http://www.cathycoletraining.com (MI training since 1995) We sit together~ My thoughts you reflect And hope springs forth Cole, 2007

NEWSLETTER FEATURE ARTICLE

COMING ALONGSIDE: BOTH FOR RESISTANCE BUT DIFFERENT

MOTIVATIONAL INTERVIEWING DEMONSTRATIONS I am pleased to announce the availability of the three MI dvds that I created and am marketing. All clients are actors but the interviews are not scripted or edited. Each dvd has three scenarios and sells for $27.50. Here is the basic information: DVD one: Increasing Importance Sarah is a college student of mixed ethnicity required to complete counseling after an infraction of the college alcohol policy; in this two part interview she completes some self measures about her alcohol use and discusses her thoughts on the use of alcohol. 31:42 minutes Holly is reactive to the news that her daughter is overweight and considers what she might do to make some changes. 13:50 minutes Fred, an African American, is a rising senior in high school and is considering dropping out; he is engaged in a discussion of future goals. 21:28 minutes

DVD two: Resolving Ambivalence Jim is uncertain about making a job change; the use of MI in a directive manner with no preferred outcome is demonstrated. 27:02 minutes Holly, from dvd one, is trying to decide about stopping breastfeeding; information helps her move to a decision that will work for her. 18:06 minutes Kathy, a senior citizen, does not want to stop smoking but comes to the conclusion that she should. 17:39 minutes

DVD three: Increasing Confidence Janet, an African living in the States, focuses on her confidence to start an exercise program. 17:30 minutes Julie wants to make a plan for healthier eating. 34:30 minutes Vance needs to make a plan for a budget. 28:59 minutes

All dvds are available via lulu.com, a self publishing site. My storefront address is http://stores.lulu.com/store.php?fStoreID=1883218&fIsFirstTime=1 or you can go to http://www.lulu.com and search Motivational Interviewing. Lulu handles all payment and shipping. I do not sell these directly.

I hope you enjoy if you order and please provide feedback to me at cathy@cathycoletraining.com

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

CathyColeTraining, inc. provider * 1177, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) program. CathyColeTraining ,inc maintains responsibility for the program.

Social workers participating in this course will receive clinical social work continuing education clock hours. Other professionals need to check with appropriate boards to determine acceptance of ASWB approved CE. For more information on trainings, please email me at cathy@cathycoletraining.com or go to www.cathycoletraining.com

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.

2009 Training Dates:

INTRODUCTION TO MOTIVATIONAL INTERVIEWING July 20-22, 2009 http://www.cathycoletraining.com/2009-introduction- july.php November 10-12, 2009 http://www.cathycoletraining.com/2009- introduction-november.php Century Center, Carrboro, NC Carrboro is adjacent to Chapel Hill, NC Limited to 15 participants $595, 15.5 hours CE; ASWB approved provider Please email cathy@cathycoletraining.com to reserve a spot

ADVANCED MI TRAINING September 14-16, 2009 http://www.cathycoletraining.com/2009-advanced- september.php Century Center, Carrboro, NC Carrboro is adjacent to Chapel Hill, NC Limited to 6 participants $595, 15.5 hours CE; ASWB approved provider Please email cathy@cathycoletraining.com to reserve a spot

DISTANCE LEARNING

SOLIDIFY YOUR SKILLS The research shows that without ongoing consultation, skills learned in an introductory MI training return to baseline after 4 months. This hourly consultation time will take place via bridge line for 8 hours of consultation.
Each week will focus on an area of MI beginning with The Spirit of MI.
Participants will be given assignments that will focus on application in their work settings.
TO BE DETERMINED BASED ON CLASS ENROLLMENT OF AT LEAST 4 Time: 7pm-8pm, Eastern Time Cost: $440, plus cost of accessing the bridge line (participant paid) Size: limited to 6 8 hours CE: ASWB approved provider For more information or to register contact cathy@cathycoletraining.com or access information at www.cathycoletraining.com under distance learning disregarding current dates

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.

THREE LEVELS OF DEVELOPING MI SKILLS IN AN AGENCY in order for your agency staff to learn MI and then continue in developing proficiency, I offer a 3 level training package: Level one: 3 day introductory training for up to 30 staff Level two: 3 day advanced training for up to 10 staff Level three: 3 day training for up to 10 staff who will provide leadership for ongoing training and development of peer consultation teams. For more information, please contact me at cathy@cathycoletraining.com

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.

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.

APRIL MAIN FEATURE

COMING ALONGSIDE: BOTH FOR RESISTANCE BUT DIFFERENT

The concept of Coming Alongside is discussed in Motivational Interviewing as a way of rolling with resistance: pages 107-108. There is one way of using coming alongside that is fairly straightforward. The person desires to make change, is confident in ability and method but is saying the time is not right. An interaction might sound like this: Client: 'I am all set to stop smoking but the time is not right.' Interviewer: 'You are committed to the plan but not the time; when will the time be right? What are your thoughts?' Client: 'Well, it is the NCAA basketball tournament through Monday and I smoke with my friends while we watch the finals. When that is over I'll start on my plan.' The point is to not challenge the first point and still respond with reinforcing change talk.

The second way of coming alongside has been more difficult for me to the extent that I was ready to stop teaching it because I had not found a time to use it that felt genuine to me. As you read about coming alongside in the text, the concerns over this as paradoxical, possibly being viewed as manipulative, fraught with the danger of sounding sarcastic as all valid concerns. Those concerns stated, I found myself in a discussion with a client where it just presented itself as the most reasonable response.

In short, client with long term difficulty with making a decision for herself and her health, caught up in a conflict of values....care for self and care for others. I had exhausted all methods of eliciting change talk, had emphasized personal choice and control, really everything I could think of.

I was feeling helpless myself and knew this would not be helpful. I settled in, fully committing myself to the belief in client autonomy and yet not wanting to hide behind this. After listening carefully to try to understand fully the ambivalence, I was able to say with absolute sincerity and concern: 'Perhaps this choice really is too difficult, would violate some values of yours to the extent that sacrificing yourself and your health/wellbeing has to be your choice.'

She looked confused so I added for clarification: 'it's like a person who knows that drinking is not working, is creating huge life threatening problems, but somehow the value of drinking is so strong that he/she is willing to risk dire outcomes.'

There was a long pause as she sat thoughtfully; suddenly she looked at me with resolve and said 'I know what I have to do, I have the answer'. I truly did not know what her choice would be and asked, 'what?' She said, 'I have to make the choice for my life; this will be hard but I have to do it.'

Next session; she reports on taking action, feeling a weight lifted, realizing the ongoing challenges but with a new confidence in herself.

My thoughts on coming alongside; a great way to work with resistance in the right circumstance and only with great care.

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 919-360-3071

For more information on Motivational Interviewing, visit the web site http://www.motivationalinterview.org