Motivational
Interviewing
24seven
Tobias Sandberg
MI-trainer
Member of: Motivational Interviewing Network of Trainers
Motivational Interviewing
• Developed by William R. Miller
and Stephen Rollnick
• Evidence-based method
• Focus on motivation and change
• Person-centered
• Humanistic psychology
Motivational Interviewing
• Motivational interviewing is a
collaborative conversational style for
strengthening a person’s own
motivation and commitment to change.
A way of being
Structured conversation
Influencing time
(24seven)
A Continuum of
Communication styles
Directing
Command
Decide
Lead
Rule
Take charge
Tell
Guiding
Elicit
Collaborate
Motivate
Support
Assist
Inspire
Following
Allow
Go along with
Permit
Listen
Attend
Stick to
A Continuum of styles
7
6
5
4
Informing
Asking
Listening
3
2
1
0
Directing
Guiding
Following
MI is like dancing
Spirit of MI
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Collaborativ
Evoking
Autonomy support
Empathy
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Rule
Listen to me!
I decide
Antipathy
X
What we know
We have to avoid…
”Roadblocks”/Righting reflex
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Ordering, or commanding
Warning, or threatening
Giving advice
Telling people what to do
Shaming, ridiculing
Judging
How to do…
• Active listening
• Try to understand the person’s dilemma
Show Empathy
Empathy
Treatment provider who shows a high degree
of empathy in meeting with clients
increases the likelihood that:
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"Resistance" is reduced.
Reduces relapse.
Reduction of interruptions in treatment.
Increases the change tendency.
Does not damage or worse treatment.
MI’s
Communication skills
Open questions
Affirmations
Reflections
Summaries
When Worlds Collide
Resistance/Discord
You are always nagging and complaining!
I hate this place!
I don’t know if I want to!
I will always smoke weed!
Increases Resistance
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Argue
Ignore
Raise our voice
Warn
Reduce
Feelings
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Anger
Sadnes
Powerlessness
Frustration
Loneliness
Misunderstood
Reduce Resistance
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Listen
Give choices
Confirm
Show empathy
Be present
We can choose to try to reduce the resistance
or cause it to increase
Some examples that can reduce
resistance
- You are always nagging and complaining!
- You think I demand too much of you…
- I will always smoke weed!
- You think you’re going to smoke weed when you are forty…
- I don’t know if I want to!
- You feel unsure about what you want…
- I hate this place!
- How do you think I can help you to feel a little better?
We try
Consistent and inconsistent with MI
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What do you think you need to do?
You have really exerted yourself.
You are the one who know yourself best.
If I'm able to help you, you must do as I say.
I'm warning you!
I really appreciate you taking the time for this.
Now you listen to me!
How do you see it?
We use the MI-spirit and
MI’s
Communication skills to
show Empathy and elicit the
Clients dilemma.
Change Talk
Desire
Ability
Reasons
Need
“I want”, “I wish”
Commitment
Activation
Taking Steps
“I've decided to ...”,
“I could do it”, “I am able to”
“I want to live with my parents”
“I must”, “I need to”
“I am ready to…”
“I went to the meeting this week”
Change Talk
………but………
It would feel good to practice, but I love to watch TV
Change Talk and Sustain Talk
“Other Side of the Coin”
It would be good for me to take my
medicine, but I ignore it.
I want to stop drinking, but not
now!
I need help, but this is no help.
We try
I actually have time to exercise
If I work out, I will be more alert
It's no fun to run in the rain
I'm too old to go to the gym.
I'll take the bike to work.
On Thursday I'll go out and run.
I will never find the strength to work
out.
• I know I can.
• I've decided to start training
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The first meeting
Perhaps one of the most important encounter at the
institution.
We have to:
• Remind us of the MI spirit
• Be active listeners and show empathy
by using the OARS.
• Make use of an MI strategy,
Meny/Agenda
Meny/Agenda
Call home
4.
1.
Most important for you
3.
2.
What happens next
Smoke
5.
Råby
Spirit of MI
• Collaborativ
• Evoking
• Autonomy support
• Empathy
The essens of MI
The MI-Spirit
Avoid confrontation
and
The righting reflex
Elicit and respond
Change talk
MI is simpel but not easy
We need to train and assist each other in MI
Summary of ”how to do”
• The importance of MI-Spirit:
- Collaborative, Evoking, Autonomy support, Empathy
- MI is like dancing, you need to be controlling and following at
the same time.
• Most of the time use a guiding style
• When we listen, we use active listening and try to show
empathy
• The first meeting is important
• We can reduce resistance by our way of being
• We listen and respond to change talk
• We know that the more a person expresses change talk
the more likely it is that she makes a change
Thank you very much!
Tobias Sandberg
MI-trainer
Member of: Motivational Interviewing Network of Trainers
Tobias.Sandberg@stat-inst.se