Transcript BHICCI MI part 1, with presenter notes 2017

Motivational Interviewing:
Part 1
Elizabeth Morrison, LCSW, MAC
Michael Mabanglo, LCSW, PhD
1
Evidence Base
• 70 Clinical Trials (MARMITE)
• 25 years of research on MI skills and their impact
on adherence, outcomes, risk management,
client/patient experience and provider
experience.
2
MI Pyramid
3
Principles
• Express Empathy
• Support Self Efficacy
• Roll with Resistance
• Develop Discrepancy
4
Stages of Change
Pre-Contemplation
Identification
Action
Contemplation
Preparation
5
Principle Techniques of Motivational Interviewing:
EMPATHY- non verbal
• Eye contact
• Sitting
• Handshake
• Smiling
6
Demonstration:
Non-Verbal Empathy
7
Principle Techniques of Motivational Interviewing:
EMPATHY- Verbal
• Affirmation
• Acknowledgement
• Normalizing
• Non-judgement
8
Demonstration and Exercise:
Verbal Empathy
9
Empathy Technique Practice!
• Groups of 3:
• Observer (naming skills)
• Practicer
• Practicee
• Quick time outs and feedback by
your coach
• Switch!
10
Open ended questions?
The gold standard of
communication
11
Closed ended questions
Do you use birth
control ?
No
12
Open ended questions
Can you tell me
more about ‘not
worrying’ about
getting
pregnant?
Sure.
Chat chat chat
Chat chat more
chat
13
Closed ended questions
• Are you taking your medications?
• Are you checking your
blood sugars?
• Do you want to quit
drinking?
14
Open ended questions
• What are your thoughts about
starting this medicine?
• How are you doing with checking your
blood sugars?
• Tell me more about your feelings
about drinking.
15
Demonstration and Exercise:
Open Ended
Questions
16
Open Ended Question Practice!
• Groups of 3:
• Observer (name open or closed)
• Practicee
• Practicer
• Quick time outs and feedback by
your coach
• Switch!
17
Principle Techniques of Motivational Interviewing:
Reflective Listening
Repeating important
words and phrases
18
Principle Techniques of Motivational Interviewing:
Reflective Listening
Demonstrates:
• Listening
• Understanding
• Acknowledgement
• Value
19
Principle Techniques of Motivational Interviewing:
Reflective Listening: Types
1.
Summary
2.
Selected exact words
3.
Double-sided reflection
20
Reflective Listening
It doesn’t matter
how hard I try, I
can’t lose
weight….
It doesn’t matter
how hard you
try….
21
Demonstration and Exercise:
Reflective Listening
22
Reflective Listening Practice!
• Groups of 3:
• Observer (name what type)
• Practicee
• Practicer
• Quick time outs and feedback by
your coach
• Switch
23
Most Common Pitfalls
• Advice Giving: Increases passivity, no
correlation to behavior change
• Righting Reflex: Increases passivity,
no correlation to behavior change
24
More Practice!
• Empathy (verbal/non verbal)
• Open Ended Questions
• Reflective Listening
25
Deliberate Practice is Key
Goals…..
26
Evaluations
Thank you for your time.
27