Techniques in Motivational Interviewing

Sep 30, 2024

Lecture Notes: Motivational Interviewing - Part 3

Overview

  • Focus on the methodology of motivational interviewing.
  • Emphasizes concrete steps involved in the process.

Four Processes of Motivational Interviewing

1. Engaging

  • Establishes a helpful connection, creating a therapeutic relationship.
    • Key Factors: Desires/goals, importance, positivity, and realistic expectations.
  • Influenced by the clinician's collaborative, conversational style.

2. Focusing

  • Develops a particular agenda for behavior change.
    • Collaboration: Aligns client and provider goals.
    • Clarification: Establish direction and goals.

3. Evoking

  • Elicit the patient’s own motivation for change.
    • Change Talk: Client articulates reasons for change.
    • Techniques: Use evocative questions (e.g., how would you like your life to be different?).

4. Planning

  • Commitment to change and formulating a specific action plan.

Guiding Style

  • Balance: Between directing (therapist-led) and following (patient-led).
  • Collaboration: Guide patients towards discovering useful answers themselves.

Evoking Change

  • Belief: Clients possess the necessary resources for change.
  • Therapist Role: Evoke self-belief and self-efficacy.

Change Talk

  • Predictors of Success: Change talk is linked to successful outcomes.
  • Categories of Change Talk: "DARN"
    • Desire: How the client wants their life to change.
    • Ability: Steps needed to make change possible.
    • Reasons: Justifications for wanting change.
    • Need: Importance of change.

Mobilizing Change Talk

  • "CATS"
    • Commitment: Expressions of intent to change.
    • Activation: Indications of being ready/prepared.
    • Taking Steps: Already taking steps towards change.

Responding to Change Talk

  • "OARS" Technique
    • Open-ended Questions: Encourage elaboration.
    • Affirmations: Positive reinforcement.
    • Reflections: Simple or complex reflections to deepen understanding.
    • Summaries: Recap discussions to confirm understanding.

Sustained Talk

  • Nature: Indicates resistance or commitment to the status quo.
  • Techniques for Addressing:
    • Simple Reflection: Mirror back client statements to show understanding.
    • Amplified Reflection: Increase intensity to prompt client reconsideration.
    • Double-sided Reflection: Reflect both sides of ambivalence.

Conclusion

  • Engagement, change talk, and responding are key to motivational interviewing.
  • Focus on preparatory and mobilizing change talk (DARN & CATS).
  • Use OARS to effectively respond and encourage client reflection.

These notes summarize the methodology and techniques used in motivational interviewing, emphasizing the importance of engaging clients, evoking their motivations, and facilitating behavior change through collaborative means.