Miller and ollnick Motivational Interviewing REAL Flashcards
Who are involved in the history of motivational interviewing?
Developed in the the 1980s by: William Miller, PhD (professor of psychology & psychiatry)
Steven Rollnick, PhD (Professor of General Medicine, clincial pyschologist)
What is motivational interviewing history and how did it begin
Began as a frame work for counseling clients with alcolhol problems
Adapted as a broader framework for changing behavior:
- Social Work
- Corrections
- Relationship Counseling
- General Medicine
What is it, MI?
A reaction to the more confrontational counseling methods (“Tough love”) of the 1970s and 1980s
A recognition that classic psychological concepts (e.g. avoidance of pain/punishment) don’t always work the way we predict
Definition of Motivational Interviewing.
Motivational interviewing is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence
What is motivation?
Readiness
Willing
Able
What is ready?
Client perceives change to be a relatively high priority
What is willing?
Client perceives discrepancy between status quo and desired goals
What is able?
Client perceives high self-efficacy (confidence to actualize one’s intentions)
This is where we talked about self efficacy
Self efficacy is the confidence to actualize one’s intentsion
What is involved in the general spirit of MI?
Collaboration
Evocation
Autonomy
What is collaboration?
counselor should not enact an authoritarian, one-up stance
What is evocation?
Counselor should work to draw wisdom out of the client, not impose it
What is autonomy?
Counselor should openly respect the client’s freedom to accept or reject ideas
What is “Change Talk”?
The client needs to voice the arguments for change (counselor works to bring this out): Disadvantages of the status quo Advantages of change optimism about change Intention to change
What is involved in the counseling practices?
- Express empathy
- Develop discrepancy
- Roll with resistance
- Support of self-efficacy
What is involved in expressing empathy?
- Being accepting of the client’s circumstances (acceptance is not agreement or approval)
- Treat the client’s choices as understandable
- “Ironic process” - acceptance encourages change; lack of acceptance limits change
- -Unraveling of tough love
- acceptance encourages change, now the personal feels they could change
- irony - oppositie of expectations
MI asks you to check your own morality at the door. It’s the patients morality. You must set your own aside and focus on the patient. You will fail at this as much as you will succeed.
A quote
Expressing Empathy employ reflective listening techniques which include:
- Paraphrasing ( “It sounds like..”
- Invites clarification - Summarizing ambivalence (“On one hand… and on the other hand…)
- Moderate understatement (intentionally misunderstand)
- “It sounds like you’re a bit annoyed about that”
- – “I get completely furious
- Moderate overstatement
- you feel your drinking is totally under control
- – well there are some times when i wonder…”
Develop discrepancy
See where the status Quo is and the desired goal and how far they are from one another and how much motivation will be used.
What is involved in developing discrepancy?
Open-ended questions:
- Disadvantages of status quo
- Advantages of change
Inclining to patient motivation and patient care. These are used to motivate patients and those people around you to influence you within your goals
What is roll with resistance?
Resistance (“No change talk”) is a natural manifestation of ambivalence
Arguments for change invite client resistance
Boxing versus Aikido
– Aikido: MI takes this approach (the way of unifying)
What are reactions to avoid as a counselor?
- — Arguing for change
- — Assuming the expert role
- — Criticizing, shaming or blaming
- — Labeling the client
- — Acting in a hurry
What are reactions to rely on as a counselor?
- — Reflective listening
- — Discussing the positive of not changing
- — Shifting focus
- — agreeing with a twist
- — Emphasizing client choice and control
What is Support Self efficacy?
Even when motivation is high, a client with low self-efficacy will struggle to change
Enhancing the patients self-efficacy
What kind of questions to evoke change talk?
Open-ended questions
a) Optimism about change
b) Intention to change