Intro to motivational interviewing lecture 2 Flashcards
What are the consequences of advice that isnt being followed?
- Tune you out
- increase the sense that change is difficult
- less likely to be honest if you think youll not approve
- Lack of response leading to frustration
What we know about change?
- we make resolutions to change
- Often fail
- Know how difficult it is to change
- Relapse is common
What are 3 ways we can illicit change? examples of each?
- Direct ( Teach, lead)
- Guide ( coach and motivate)
- Follow (Listen and go along)
What type of change iliciting methods is MI (motivational Interviewing)?
- a refined form of follow
What is MI?
Person centered, goal oriented approach for facilitating change by exploring and resulting ambivalence.
What are the advantages of MI?
- Enhances relationship w/ patient
- Less frustration
- better response
- increase motivation
- better prognosis
What are the stages of change? which stage most patients are found?
- Pre contemplation
- contemplation
- preparation
- Action
- maintenance
Relapse can happen at any stage.
Most patients are in the contemplation stage
Where can you apply stages of change?
- Smoking
- substance abuse
- HIV risk reduction
- Cancer prevention
What does MI assumes of change?
- Change happens in small steps
- Relapse is normal
- motivation is a continuum
- PATIENT VALUE BASED CHANGE NOT YOURS
What is the spirit of MI?
- Express empathy
- develop discrepancy
- -Watch for change talk
- Roll with resistance and dont let the righting reflex affects you
- Support self efficacy
What are the MI technique OARS?
- Open ended questions
- Affirmation
- Reflective listening
- Summerization
What is Affirmation in Oars?
Must include direct reference to patient not just “Great”, “Good shit” and “Nice”
- reinforce patients strengths
- convey support
What are the benifets of reflective listening>
Deepens conversation, helps patients understand themselves better.
-Simple amplified and double sided reflection.
What is the readiness rule?
How important is it to make change? How confident are you?
Why didnt you say (1-2 points lower)?
What are the overall goals of MI?
Reduce resistance
- avoid arguing
- acknlowedge patients POV
- Help patients discover their own motivation
