motivational interviewing
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- what are 8 components of motivational interviewing
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1.giving advice about specific behaviours to change
2. removing barriers (often regarding access to help)
3.providing choice through encouragement
4. decrease desirability to ambivilence
5. practice empathy
6. provide feedback (from variety of perspectives to give client full picture)
7.clarify goals
8.active helping - what are the 5 stages of change
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pre-contemplation
contemplation
planning
action
maintenance - what are the 5 principles of motivational interviewing to create the conditions for change
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1. express empathy
2. avoid argument
3. support self efficacy
4. roll with resistance
5. develop discrepency - how can you express empathy?
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active listening
respond with consise s
statements encapsulating what
the client is trying to convey - how can you avoid argument?
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therapist must actively listen
to the patients reasons why it is difficult to ....so that the patient hears themself say why they want to change - how can you support self efficacy?
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reframe "failure" as
a. the person knows what needs to change
b. motivated to keep going under difficult circumstances
c. willing to accept help to achieve the goal - how can you roll with resistence?
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ask for clarification
elaborate the problem, sometimes to the point of exxageration (to help the patient see incompatable beliefs) - How can we develop discrepency?
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help patient to accept that the arguments for change are based on incompatible beliefs
help client establish reasonable goals
determine the difference between the current and ideal situation - what are the 8 steps related to HOW a counselor does motivational interviewing
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1. establish rapport
2. set the agenda
3. assess readiness for change
4. sharpen the focus
5. identify ambivalence
6. eliciting self-motivating statements
7. handling resistance
8. shifting the focus - how does a counselor assess the radiness for change
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ask simple questions such as..
"on a scale of 1-10 how keen are you to ....?
then gently challenge the response with something like
"you said 4, why not 3 or 7?
this will identify barriers - how does a counselor sharpen the focus
- focus specifically on what the client wants to change. it helps to break down their "pattern of behavior, into its component parts
- how can a counselor identify "ambivelence"
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ambivelence is normal , and can be identified if the client is epressing disagreement,denies or ignores statemnets of reflection, or counselor request for elaboration. It is an idication that there still remains reasons for/against changing
r - what are some causes of ambivelence
- if the therapist is working with the information the client is giving, and not interpreting or hurrying the client to change there should be no reason for disagreement
- how can a counselor elicit self motivating statemnets
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take every opportunity to encourage the client to phrase things in a positive way.
ask "what would be the best outcome from a course of action they might choose"
rather than accept "if i could only do" to " I am keen to..." - how can a counselor handle resistence
- reflecting back to the client what you are hearing and seeing
- how can a counselor shift the focus?
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shift to beliefs underpinning behaviour
repeat the belief, acknowledging the power of the stment
offer to the client the opportunity to talk about it when/if they are ready.