Motivational Interviewing: Methodology Overview

Four Processes of Motivational Interviewing

1. Engaging

   • Establish a helpful connection and working relationship.
   • Create a therapeutic relationship.

2. Focusing

   • Develop a focused agenda and clarify the direction of behavior change.
   • Collaboration between both parties' perspectives.

3. Evoking

   • Elicit the client's own motivation for change by having them voice arguments for change.
   • Evoke self-belief and self-efficacy.

4. Planning

   • Formulate a specific plan of action and commitment to change.

Engagement Factors

• Desires or Goals: Understand motivations and importance to client.
• Positivity: Build positive views and realistic expectations with hope.
• Ambivalence: Engage ambivalence to elicit change.
• Collaborative Style: Guiding style between directing and following, emphasizing teamwork and listening.

Evoking Change

• Underlying Premise: Clients have necessary elements within them for change.
• Change Talk: Encourage clients to articulate reasons for change.
• D.A.R.N. Framework
  • Desire: Wanting change.
  • Ability: Capability to change.
  • Reasons: Justifications for change.
  • Need: Importance of change.
• Techniques: Use open-ended questions to evoke change talk.

Mobilizing Change Talk: C.A.T.S Framework

• Commitment: Client expresses intent to act.
• Activation: Movement toward change, not full commitment.
• Taking Steps: Client takes action towards change.

Responding to Change Talk: O.A.R.S Framework

• Open-ended Questions: Elicit more information and examples.
• Affirmations: Positive reinforcement.
• Reflections: Encourage clients to reflect on change talk.
• Summaries: Summarize change talk content and encourage further discussion.

Handling Sustained Talk

• Sustained Talk: Resistance to change due to ambivalence.
• Reflection Techniques:
  • Simple Reflection: Reflecting back content and feelings.
  • Amplified Reflection: Intensifying sustained talk to encourage reconsideration.
  • Double-sided Reflection: Reflect back both sides of ambivalence.

Conclusion

• Emphasize engagement, create and respond to change talk.
• Techniques to minimize sustained talk and enhance change talk.

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These notes summarize the key elements of the lecture on motivational interviewing, focusing on methodology and practical strategies to facilitate behavior change effectively. The frameworks and techniques outlined provide a structure for both recognizing and eliciting change talk, while also addressing resistance to change.