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AN INTRODUCTION TO AN INTRODUCTION TO MOTIVATIONAL INTERVIEWINGMOTIVATIONAL INTERVIEWING
Derek McLaughlinDerek McLaughlin
OVERVIEWOVERVIEW
Welcome introduction and warm upWelcome introduction and warm up What are your learning needsWhat are your learning needs Exercise oneExercise one Theory of Motivational InterviewingTheory of Motivational Interviewing Exercise twoExercise two The actual process of Motivational Interviewing The actual process of Motivational Interviewing Exercise threeExercise three Review and evaluationReview and evaluation
WHAT ARE YOUR LEARNING WHAT ARE YOUR LEARNING NEEDS?NEEDS?
PASCAL’S PENSEESPASCAL’S PENSEES
““People are generally better persuaded People are generally better persuaded by the reasons which they have by the reasons which they have themselves discovered, than by those themselves discovered, than by those which have come into the minds of which have come into the minds of others.” (17th Century)others.” (17th Century)
OR ANOTHER VIEWOR ANOTHER VIEW
“…“…still the man hears what he wants to still the man hears what he wants to hear and disregards the rest” (The Boxer, hear and disregards the rest” (The Boxer, Simon and Garfunkel, 1970).Simon and Garfunkel, 1970).
EXERCISE ONEEXERCISE ONE Break into pairsBreak into pairs One person plays role of occupational health nurse of a One person plays role of occupational health nurse of a
large company the other person plays the role of an large company the other person plays the role of an employee of the company who smokes employee of the company who smokes
The scenario-the company has decided to ‘help’ The scenario-the company has decided to ‘help’ smokers to stop smoking via the occupational health smokers to stop smoking via the occupational health nurse nurse
The employee who smokes does not want to stopThe employee who smokes does not want to stop The nurse must stop this person from smokingThe nurse must stop this person from smoking Rollnick, SRollnick, S
MOTIVATIONMOTIVATION
Motivation should not be thought of as a Motivation should not be thought of as a personality trait rather as a personality trait rather as a statestate of readiness or of readiness or eagerness to change, which may fluctuate from eagerness to change, which may fluctuate from one time or situation to anotherone time or situation to another
This This statestate is one that can be influenced is one that can be influenced
Miller & Rollnick (1991)Miller & Rollnick (1991)
STAGES OF CHANGESTAGES OF CHANGE
Pre-contemplationPre-contemplation ContemplationContemplation DeterminationDetermination ActionAction MaintenanceMaintenance RelapseRelapse Changed lifestyleChanged lifestyle Prochaska & DiClemente (1983)Prochaska & DiClemente (1983)
CYCLE OF CHANGECYCLE OF CHANGE
Ti
me
X
X
X
EXERCISE TWOEXERCISE TWO
Favourite Teacher – What made them an Favourite Teacher – What made them an effective educator?effective educator?
Least Favourite Teacher – What was it Least Favourite Teacher – What was it about this person that left this impression about this person that left this impression with you?with you?
DEFINITIONDEFINITION
Motivational Interviewing is a Motivational Interviewing is a directive, client-centred counselling directive, client-centred counselling style for eliciting behaviour change style for eliciting behaviour change
by helping clients to explore and by helping clients to explore and resolve ambivalence.resolve ambivalence.
From Rollnick S. & Miller, W.R. (1995) What is From Rollnick S. & Miller, W.R. (1995) What is Motivational Interviewing? Motivational Interviewing? Behavioural and Behavioural and Cognitive Psychotherapy, 23,325-334Cognitive Psychotherapy, 23,325-334
Good PracticeGood PracticeThe principlesThe principles -- Express EmpathyExpress Empathy
Develop DiscrepancyDevelop Discrepancy
Roll with ResistanceRoll with Resistance
Support Self-efficacySupport Self-efficacy
TWO VITAL ELEMENTSTWO VITAL ELEMENTS
Behavioural changeBehavioural change AmbivalenceAmbivalence
EXERCISE THREEEXERCISE THREE
Break into pairsBreak into pairs One person in the role of the nurse the One person in the role of the nurse the
other person attending about their use of other person attending about their use of cigarettes cigarettes
This time using a motivational interviewing This time using a motivational interviewing approach the nurse will discuss with the approach the nurse will discuss with the person their use of cigarettesperson their use of cigarettes
EARLY STRATEGIESEARLY STRATEGIES
Agenda SettingAgenda Setting
medication
pain
poor housing
family
stress
EARLY STRATEGIESEARLY STRATEGIES
Readiness RulerReadiness Ruler Scaling questions 1 - Scaling questions 1 -
10 to assess10 to assess
ImportanceImportance andand ConfidenceConfidence
11 22 33 44 55 66 77 88 99 1010
IS MOTIVATIONAL IS MOTIVATIONAL INTERVIEWING FOR YOU?INTERVIEWING FOR YOU?
People have the right to live their lives in their People have the right to live their lives in their own way, providing they do not infringe the own way, providing they do not infringe the rights of others.rights of others.
It is rarely clear cut what someone ought or It is rarely clear cut what someone ought or ought not to do.ought not to do.
Responsibility for changes lies with the Responsibility for changes lies with the person.person.
Health is not everyone’s top priority.Health is not everyone’s top priority. People often do know what would be best for People often do know what would be best for
them. them.
IS MOTIVATIONAL IS MOTIVATIONAL INTERVIEWING FOR YOU?INTERVIEWING FOR YOU?
Professional are not failures just because they Professional are not failures just because they can not persuade people to change.can not persuade people to change.
Motivation is not an all or nothing concept, it is Motivation is not an all or nothing concept, it is on a continuum and is subject to change.on a continuum and is subject to change.
Change is a process not an event.Change is a process not an event. Successful change occurs only when a person Successful change occurs only when a person
has made up their mind that it is what they has made up their mind that it is what they really want. really want.
Mason (2006) Dual Diagnosis Nursing p 254. Mason (2006) Dual Diagnosis Nursing p 254.
AN INTRODUCTION TO AN INTRODUCTION TO MOTIVATIONAL INTERVIEWINGMOTIVATIONAL INTERVIEWING
Derek McLaughlinDerek McLaughlin
[email protected]@ulster.ac.uk
