Motivational Interviewing: Helping People Change 3rd Edition Ebook Pdf Epub
A superb, readable guide to theory and practice. MI has fundamentally changed the way we think about working with less motivated clients, especially in todays health care climate, with its emphasis on evidence-based brief treatments. The four-part framework introduced in this edition greatly simplifies the way that MI is delivered. Miller and Rollnick do a superb job of breaking down a complex process. At each step, readers see exactly why the provider is choosing certain questions or statements over others.Scott T. Walters, PhD, Professor and Chair, Department of Health Behavior and Health Systems, University of North Texas Health Science Center member, Motivational Interviewing Network of Trainers
This book builds on the prior editions, but the result is substantially different, because it incorporates so many new concepts, skills, research findings, and practical applications. Written in a user-friendly manner, with many sample dialogues, this is an immensely useful resource. It is a must have for anyone who is learning MI or utilizing the approach in clinical practice, from students to seasoned professionals.Melinda Hohman, PhD, School of Social Work, San Diego State University member, Motivational Interviewing Network of Trainers
The Transtheoretical Model Of Change
The aspect of Motivational Interviewing that most individuals are familiar with is the stages of change model. The original development of the MI model was designed to identify where an individual with a substance abuse issue stood regarding their perception of their need to address the problem. Many times, individuals who enter treatment for substance abuse issues do not readily accept the notion that there is something about their behavior that they need to change. Often, these individuals are forced into treatment by family, their occupation, the legal system, etc. They may not have developed the notion that their behavior is problematic for them and may believe that they are able to control their issues with alcohol or drugs in such a manner that they can continue using their substance of choice and avoid the particular issues that brought them into treatment.
Miller and Rollnick realized that in order for any intervention for any type of substance use issue to be successful, it would be important to understand how the client visualized their substance use. Individuals who demonstrated behavioral issues sufficient to qualify for a diagnosis of a substance use disorder, but who did not see the need for substance abuse treatment, would need to be approached differently than individuals who already agreed with the idea that they must change their behavior .
Seven Principles Of Motivational Interviewing
The following are seven core principles of Motivational Interviewing:
Motivation to change is elicited from the client, and not imposed from without. Emphasis on coercion, persuasion, constructive confrontation and the use of external contingencies go against the spirit of motivational interviewing.
It is the clients task, not the practitioner’s, to articulate and resolve his or her ambivalence. They describe ambivalence as a conflict between two courses of action. The practitioner’s task is to facilitate expression of both sides of the ambivalence impasse, and guide the client toward an acceptable resolution that leads to behavior change.
Direct persuasion is not an effective method for resolving ambivalence. While tempting to be helpful by offering persuasive arguments for change, practitioners usually create resistance to change in their clients.
The motivational interviewing style is generally a quiet and eliciting one. To a practitioner accustomed to confronting and giving advice, motivational interviewing can appear to be a hopelessly slow and passive process.
Readiness to change is not a client trait, but a fluctuating product of interpersonal interaction. Resistance and denial are seen not as client traits, but as feedback regarding therapist behavior. Client resistance is often a signal that the practitioner is assuming greater readiness to change than is the case.
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Lowering Sustain Talk And Discord
In concert with building a sense of collaboration from the beginning and resolving ambivalence by eliciting change talk, MI theory conveys strategies for lowering sustain talk and discord. âSustain talkâ refers to statements that indicate the staffâs reluctance to take on a new behavior in favor of maintaining the status quo whereas âdiscordâ indicates a breakdown in collaboration and alliance between staff and those suggesting change. In the example above, several staff make comments consistent with sustain-talk. Arguing, interrupting, and negating all represent examples of discord. Rather than viewing sustain talk and discord as staff being âresistantâ to change, think of sustain talk and discord as signals that staff view the situation differently than those who are asking that the new practice be implemented.
Adjusting to sustain talk and discord is similar to avoiding argument in that it offers another chance to express empathy by remaining nonjudgmental and respectful, encouraging people to talk and to stay involved, and diverting the energy toward finding shared experiences and goals. MI-informed ways of responding to sustain talk and discord include offering validation to people, listening empathically and reflectively, and affirming the autonomy of personal choice, where possible, as described in Table 3.
The Benefits Of Motivational Interviewing
Motivational interviewing helps clients take the next step in their mental health or substance abuse recovery journey. Benefits of motivational interviewing include:
- Helping clients to take responsibility for themselves and their actions
- Encouraging clients to envision a future free of substance abuse or mental health struggles
- Preparing clients to become more receptive to treatment
- Building the clients self-confidence and trust in themselves
Motivational interviewing is a great adjunct to other therapeutic styles and substance use treatments. Its especially beneficial to patients who are initially resistant to starting a treatment program or who are unprepared to make the necessary life changes.
When used to treat patients struggling with a mental health disorder, motivational interviewing can help them better manage their symptoms. Patients living with an anxiety disorder or depression may feel more inclined to seek additional therapy, continue current therapy, or work more openly with their therapist to find an effective solution.
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Motivational Interviewing: Helping People Change 3rd Edition Pdf Free Download:
March 12, 2022 by dramjad
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This bestselling work for professionals and students is the authoritative presentation of motivational interviewing , the powerful approach to facilitating change. The book elucidates the four processes of MIengaging, focusing, evoking, and planningand vividly demonstrates what they look like in action. A wealth of vignettes and interview examples illustrate the dos and donts of successful implementation in diverse contexts. Highly accessible, the book is infused with respect and compassion for clients. The companion Web page provides additional helpful resources, including reflection questions, an extended bibliography, and annotated case material.
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What Is Motivational Interviewing A Scientific Theory
Motivational Interviewing is an evidence-based treatment used by providers all around the world to explore clientsâ ambivalence, enhance motivation and commitment for change, and support the clientâs autonomy to change.
The approach allows clients to identify their reasons for change based on their own values and interests. Providers can decrease the clientâs resistance or defensiveness by taking a seat alongside their clients, as both are considered experts in this approach.
A laypersonâs definition of MI would be âa collaborative conversation style for strengthening a personâs own motivation and commitment to changeâ . This collaborative conversation includes the spirit of MI: partnership, acceptance, compassion, and evocation. The spirit of MI is based on the principles of Carl Rogersâs client-centered counseling .
For change to occur in the conversation, unconditional positive regard is essential.
An acceptance of this other individual as a separate person, a respect for the other as having worth in his or her own right. It is a basic trust â a belief that this other person is somehow fundamentally trustworthy.
The spirit of MI, combined with the four processes and core skills, has been used worldwide in various settings to assist with changing behavior.
The development of MI includes the combination of Client-Centered Therapy, the Self-Determination Theory, and the Transtheoretical Model of behavior change.
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Why Motivational Interviewing Questions Matter
So why is motivational interviewing an effective technique?
Because it doesnt focus on asking if the interviewee is motivated to make significant changes in their life. This would be ineffective, as a person who is resistant to change would say, No.
Instead, the coach or counselor helps their client explore their own belief systems. This allows them to uncover their intrinsic motivations. When people arrive at these conclusions using their own words, they are more likely to follow through on making the necessary changes.
Organizations can use motivational interviewing to help employees overcome resistance to change. For example, they may be resistant to learning new skills in the face of organizational changes.
Its also a way to deal with difficult employees by encouraging change before resorting to disciplinary action.
Adopting An Mi Approach To Facilitate Organizational Change
Those leading quality improvement initiatives are often faced with staff who may express reluctance, reservations, and concerns about change, or exhibit ambivalence about change by appearing disengaged or even hostile. Clinical administrators and others charged with facilitating the implementation of new practices often are in the position of having to implement new initiatives in response to âtop downâ mandates. While quality improvement theory offers a strategy for tackling the change process through iterative small steps , it is silent on the following common concerns: What are effective ways to engage the group as collaborators in the implementation process? What are effective ways to manage the various types of ambivalence to change so often encountered in the change process?
In implementation science, there is an emerging consensus around the importance of working with staff collaboratively to implement a change. A recent compilation of implementation strategies includes four that are directly related to this collaboration: assessing for readiness and identifying barriers and facilitators to change, building a coalition, conducting local consensus discussions, and facilitation .7 MI may be one route to implementing these strategies.
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If Prepared To Begin Planning Change:
It sounds like youve thought a lot about this issue, and you are ready to make a change.
Can I help you make a change/quit plan today?
You will always be the one who decides if and when you make this change, but Im happy to help you create a plan that will maximize your chances of success, if you want.
I have a simple set of questions I ask to help make a change plan is it OK if I go through them with you?
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What Is The Theory Behind Motivational Interviewing
Motivational interviewing is a collaborative, goal- oriented method of communication with particular attention to the language of change. It is intended to strengthen personal motivation for and com- mitment to a target behavior change by eliciting and exploring an individual’s own arguments for change.
How To Do Motivational Interviewing
Written by Steve Rose
On the go? Listen to the audio version of the article here:
Here is a recording of a live training I conducted on Motivational Interviewing. If you or your organization are interested in setting up a private workshop or one-on-one coaching, you can contact me here.
Motivational interviewing is a powerful counseling style, focused on helping someone gain motivation toward a valued direction in their life. The technique was first developed in the addiction field and is now being used broadly within healthcare settings.
As an addiction counselor, I have attended several workshops on motivational interviewing and noticed a wide range in the quality of instruction. Ive witnessed persons leaving these workshops with a shallow understanding of the approach, feeling confused, or deciding to give up on the approach altogether.
Since I am passionate about motivational interviewing and love sharing complex ideas in accessible language, I was inspired to create a practical in-depth summary of this powerful approach.
These are the four processes of Motivational Interviewing , a scientifically validated approach to helping someone change:
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Support And Develop Discrepancy
Supporting and developing discrepancy helps the interviewee see the difference between possible outcomes. It also shows them how their behavior affects those outcomes.
Cognitive dissonance occurs when a person holds two or more conflicting beliefs or behaviors. An example might be continuing to smoke cigarettes even though you know smoking is bad for you.
Developing discrepancy helps the interviewee build awareness of the gap between their goal and their current behavior.
Evocation Rather Than Education
The notion of the counselor drawing out a client’s ideas rather than imposing their own opinions is based on the belief that motivation to change comes from within. As such, it cannot come from the counselor.
No matter how much the counselor might want a person to change their behavior, it will only happen if the individual also wants to change. So, it is the counselor’s job to “draw out” their client’s true motivations for this change. Once these motivators are identified, the client can use them to make the recovery process easier or to help them keep going when they want to give up.
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What Is Motivational Interviewing And How Does It Work
Motivational Interviewing is a style of counseling used to help patients resolve ambivalent feelings and make positive changes in their lives. It was developed by two clinical psychologists, William R. Miller and Stephen Rollnick, and first practiced in the 1980s.
Motivational interviewing is commonly used to help treat addiction, but its use has been expanded to include mental health treatment, parenting, and even in the management of physical health disorders like heart disease and diabetes.
Oars: A Structure For Putting Motivational Interviewing Into Practice
You may be ready to embrace the spirit of motivational interviewing, but some structure can help. The OARS acronym offers four simple reminders.3
1. Open-ended questions. Avoid asking questions that can be answered with a yes or no. Broad questions allow patients maximum freedom to respond without fear of a right or wrong answer. It can be as simple as, What’s been going on with you since we last met? Another question, appropriate for almost anyone, would be, If you had one habit that you wanted to change in order to improve your health, what would that be?
2. Affirmations. Never underestimate the power of expressing empathy during tough spots or in celebrating patients’ accomplishments. When you review patients’ goals, take joy in their success and show your joy. One of the authors even gives patients gold stars the same ones distributed in elementary school. Patients love getting them and wear them proudly.
3. Reflective listening. Patients often have the answers the physician’s role is to help guide them. Reflective listening involves letting patients express their thoughts and then, instead of telling them what to do, capturing the essence of what they have said, with the purpose of eliciting conversation and helping them arrive at an idea for change. Here’s an example:
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The Four Aspects Of The Mi Spirit
The MI spirit consists of partnership, acceptance, compassion, and evocation.
Figure 1. The spirit of MI
Partnership emphasizes how MI is used with and for someone to engage in an active conversation between two experts.
In MI, there is a collaboration between the provider and the client. Providers must sit with the reality that they donât have all the answers and need their clientâs expertise on how change would look in their lives.
The provider is not trying to convince, trick, or argue why a client should change. Instead, providers are guiding, listening, and trying to understand the clientâs circumstances.
The Four Aspects Of Acceptance
Acceptance highlights the importance of respecting what a client contributes to the partnership.
There are four aspects of Acceptance:
Collectively, these four client-centered conditions make up the MI spirit of acceptance.
âOne honors each personâs absolute worth and potential as a human being, recognizes and supports the personâs irrevocable autonomy to choose his or her own way, seeks through accurate empathy to understand the otherâs perspective, and affirms the personâs strengths and efforts.â
William Miller
Figure 2. The four aspects of acceptance
Absolute Worth and Accurate Empathy highlight the work of Carl Rogers and the conditions critical for change.
Absolute Worth emphasizes Rogersâs concept of unconditional positive regard, such that when people are accepted without judgment, they are free to make changes.
Accurate Empathy emphasizes efforts to understand a clientâs perspective without feeling pity or identifying with them.
Autonomy Support highlights the importance of respecting a clientâs autonomy to choose, not to control, persuade, or coerce. This can facilitate change by decreasing a clientâs defensiveness and emphasizes the clientâs freedom of choice.
Affirmation emphasizes recognition of the clientâs strengths and efforts.
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