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Project ECHOMotivational Interviewing (MI): A
Brief Overview - Part FourAffirmations
Mark Evans, MSW, LCSWMember, Motivational Interviewing Network of Trainers (MINT)
What is Motivational Interviewing?
A CONVERSATION about CHANGE!
The Spirit of Motivational Interviewing
From: Advanced Motivational Training Two Day Seminar facilitated by Drs. Miller and Moyers. April 2012: Albuquerque, New Mexico
OARS - Core Interviewing Skills in MI
Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: The Guildford Press. 2013
OARS - Core Interviewing Skills in MI Continued
Miller, William R. and Stephen Rollnick. Motivational Interviewing: Helping People Change. Third Edition. New York: The Guildford Press. 2013
O ‐ Open‐Ended Questions A ‐ AffirmationsR ‐ ReflectionsS ‐ Summaries
Getting Moving: OARS
OPEN QuestionsAFFIRMATIONSREFLECTIONSSUMMARIES
Affirmations
• Affirms the client by saying things that are positive or reinforcing. Focusing on strengths, abilities, or efforts.
o Affirm behaviors, not ideas.
• “You” statements vs. “I” statements if possible.
Affirmations Continued
• Seek opportunities to affirm, appreciate, and reinforce.
• Strengthens the working relationship.
Affirmations Continued
• Should be genuine.
• Expresses positive regard and caring.
• Don’t overdo.
Affirmations Continued
• Focus on descriptions and not evaluations.
• Think of affirmations as attributing interesting qualities to clients.
• Nurture a competency instead of focusing on a deficit. REFRAME.
Affirmations Continued
• There’s a fine line between affirming and becoming a cheerleader. Don’t want the client to become dependent upon our approval. What happens when the client lapses?
Affirmations Continued
• Comment positively on an attributeo “You’re a strong person, a real survivor.”
• A statement of appreciationo “You’ve been very open and honest
today, and that’s not always easy.”
Affirmations Continued
• Catch the person doing something righto “Even though it’s been difficult, you’re
sticking to your plan.”o “You took a big step in coming here
today.” o “You really handled that situation well.”
Affirmations Continued
• A complimento “You’ve been very thoughtful about
this.”
• An expression of hope, caring, supporto “Good luck with your quit attempt!
You’ve worked so hard to prepare.”o “It’s been great talking with you, and
getting to know you today.”
Affirmations - Examples• “Thank you for listening so carefully today!”
• “You clearly have the insight to recognize the risk here, and the courage to do something before it gets more serious.”
• “You’ve been through a lot together, and the fact you’ve stayed together says a lot about your love and commitment.”
Affirmations - Examples Continued
• You’ve tried to quit smoking before, and you haven’t given up. You keep trying.”
• “You really had some concerns about this appointment, and you kept it!”
• “You don’t give up.”
Affirmations - Examples Continued
Adapted from Berg‐Smith Training & Consultation 2010
• “You have some really good ideas about how you might make this change.”
• “You’ve taken a big step today, and clearly have a lot of determination.”
• “You are a loyal friend, willing to defend others, even when it causes you trouble.”
Affirmations - Examples Continued
Adapted from Berg‐Smith Training & Consultation 2010
• “By the way you handled that, you showed a lot of strength.”
• “You don’t take the easy way out.”
Affirmations - Examples Continued
Adapted from Berg‐Smith Training & Consultation 2010
• “You’re concerned about what is best not only for you, but for the people you care about.”
• “Being a good parent is important to you.”
Affirmations - Examples Continued
• You’re the kind of person who cares a lot about other people.
• Despite your strong reservations, you must have a lot of resolve to come in today.
• What would others say about this step that you took?
Exercise - Time Permitting(or on your own/with a colleague)
• Generate a list of strengths that you have come across in your work with your clients
• Let’s use this list of strengths to generate affirming statements
The OARSOpen‐Ended QuestionsAffirmationsReflectionsSummaries
A Sneak Preview…Where do we go from Here?
ACKNOWLEDGEMENTS/REFERENCES
Unless otherwise noted, the materials in this presentation are from/adapted from the following publications/individuals/organizations:
• Miller, WR and Rollnick, S. Motivational Interviewing. Helping People Change. New York: The Guilford Press. 2013. Third Edition.
• The Motivational Interviewing Network of Trainers (MINT), and Patricia Figueroa, M.Ed., Lorraine Reitzel, Ph.D., Nanette Stephens, Ph.D., Theresa Moyers, Ph.D., and William Miller, Ph.D. for training, mentoring, and sharing of materials.
• Stephen Malcolm Berg‐Smith. Advanced MI Training. Sept. 28‐30, 2011, San Francisco, CA.
• The Motivational Interviewing website: http://www.motivationalinterviewing.org/
Special thanks to:• Paul Cinciripini, Ph.D., Janice Blalock, Ph.D., Maher, Karam‐Hage, MD, David Wetter, Ph.D. and
Diane Beneventi, Ph.D., for training opportunities, encouragement and support for training.