3. engagement and motivation for cep workshop (nxpowerlite)
TRANSCRIPT
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CEP Workshop Series 2013
Module 3: Engagement & Motivation
Fraser Todd and Michelle Fowler
2013
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Workshop Introduction
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Workshop Agenda
Mihi, Introductions, Housekeeping & Workshop overview
Introduction to the Workshop & Exercise 1
Strategies to enhance engagement
Exercise 2
Motivation
Models of Motivation
Motivation Tools
Session Structure and the Motivational Framework
The Spirit of MI
Change Talk
Exercise 3
Implementation Intention and Mental Contrasting
Exercise 4
Action Planning Take Home
Homework
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Three Dimensions of CEP Practice
Spirit Principles - Techniques:
Spiri"
7 Key Principles
Techniques
1. Cultural Considerations
2. Recovery & Well-being
3. Engagement
4. Motivation
5. Assessment
6. Management
7. Integrated Care
Person-focused care
Well-being orientated care Integrated care
Walk the Talk
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Engagement
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Principle 3: Engagement
The Importance of Engagement:
35 - 50% of all CEP patients drop out of treatment 50% of MH patients do not comply with treatment Factors Associated wit Poor Engagement
o Lack of belief that treatment is effectiveo Low sense of psychological safety in treatment
(stigma, MH environment)
o Single mode treatment (psychotherapy ORpharmacotherapy
o Young ageo Lack of social pro-treatment supporto
Male gendero Drug dependenceo High levels of daily stress
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Principle 3: Engagement
What is Engagement? :
!"#$#%&%"'
#$"% &'$($&$)( #$"% *+,-$&+ #$"% .)()/+.+(" 0')(
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1 1
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Exercise 1: Presence
9++ 7)/+ : 2; "%+ #2,
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Principle 3: Engagement
A Structure for Thinking About Engagement :
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1
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Principle 3: Engagement
Factors Influencing Engagement:
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Principle 3: Engagement
Strategies to Enhance Engagement 1:
Values, vision of well-being
Cognitive mapping
MI Engagement Interview
Autonomy-supportive environment
(3-5 choices)
Treat hostility, emotional dysregn early
Clearly structured sessions
Adapt to coping style
Remove barriers
Consistency of approach
Peer Support to engageAssertive follow-up
Adapt for cultural needs
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Principle 3: Engagement
Cognitive Mapping:
82/($4-+ E)00$(/J(&,+)*+* +(/)/+.+("35 KBL>
7,+*+(" $(;2,.)42(
)* ) 6$)/,).
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")
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Principle 3: Engagement
Cognitive Mapping:
82/($4-+ E)00$(/J(&,+)*+* +(/)/+.+("35 KBL>
7,+*+(" $(;2,.)42(
)* ) 6$)/,).
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.)5 &2.0'+"+ $"
1H2 6$*4(&" &%)((+'* ;2,
")
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Principle 3: Engagement
Cognitive Mapping:
82/($4-+ E)00$(/J(&,+)*+* +(/)/+.+("35 KBL>
7,+*+(" $(;2,.)42(
)* ) 6$)/,).
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")
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Principle 3: Engagement
Cognitive Mapping:
82/($4-+ E)00$(/J(&,+)*+* +(/)/+.+("35 KBL>
7,+*+(" $(;2,.)42(
)* ) 6$)/,).
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")
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Principle 3: Engagement
Rachel Cognitive Map of Formulation:
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Principle 3: Engagement
Autonomy-Supportive Environment:
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Principle 3: Engagement
The Engagement Intervention:
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Exercise 2: Rachel Engagement
9++ 7)/+ KO 2; "%+ #2,
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Motivation
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Model of Motivated Behaviour:
Principle 4: Motivation
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Principle 4: Motivation
Key Principles of General Motivation:
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Principle 4: Motivation
Implications of the Key Principles of General Motivation:
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Principle 4: Motivation
Stages of Change (Prochaska & DiClemente):
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Non-autonomous Autonomous
Amotivation Extrinsic Motivation Internal
Motivation
External
Regulation
Introjected
Regulation
Indentified
Regulation
Integrated
Regulation
Intrinsic
Regulation
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Principle 4: Motivation
Self-determination Theory (Ryan &Deci):
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Principle 4: Motivation
Theory of Planned Behaviour Change (Azjen):
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Internal
Motivation
MI
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Principle 4: Motivation
Crucial Transitions:
V)&"2,* "%)" $(%$3$" "%+ $($4)42( 2; )&42(S2H *+';C+c&)&5S2H 3+%)-$2A,)' &2(",2' 2-+, "%+ )&4-$"5P(H$''$(/(+** "2 *AY+, *%2," "+,. &2*"* ;2, '2(/ "+,. /)$(*h$/% $.0A'*$-$"5 e6$*",)&42(fS)&< 2; -)'A+ )\)&%+6 "2 "%+ /2)' e2A"&2.+ +>0+&")(&5fEA'40'+ /2)'*9",+** J(&2(/,A+(&+ 3+"H++( J.0'$&$"_+>0'$&$" .24-+*
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Principle 4: Motivation
The Spirit of MI MI3:
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Principle 4: Motivation
MI Process:
KB =(/)/+OB
J6+(4;5 7,23'+.*
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Principle 4: Motivation
Readiness Rulers:
T2" F+)65 P(*A,+ F+)65
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Principle 4: Motivation
Readiness Rulers:
T2" 82(j6+(" P(*A,+ 82(j6+("
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Principle 4: Motivation
Use of the Rulers:
P*+ 2; "%+ ,A'+, H$"%$( EJM
G*< "%+ 0+,*2( "2 ,)"+ 2( "%+ ,A'+, H%+,+ "%+5 ),+ (2H $( "+,.* 2; 3+$(/ ,+)65"2 &%)(/+m
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Principle 4: Motivation
Readiness + Confidence:
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82(j6+(&+
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Kn
n
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Principle 4: Motivation
Readiness + Confidence:
F+)6$(+**
82(j6+(&+
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Kn
Kn
n
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J("+/,)"+
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J("+/,)"+
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Principle 4: Motivation
Change Talk:
I+*$,+
33$'$"5
%"1?;/"# 58$"#% G$=EJ
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Exercise 3: Identifying Change Talk3
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Exercise 4: Reflective Listening3
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Self-Efficacy:
Principle 4: Motivation
1%+ &2(-$&42( "%)" 2(+ &)( *A&&+**;A''5 &),,5 2A" "%+ 3+%)-$2A,*
(++6+6 "2 0,26A&+ ) &+,")$( 2A"&2.+
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Self-Efficacy:
Principle 4: Motivation
9",)"+/$+* "2 $.0,2-+ *+';C+c&)&5M
=>0+,$+(&+* 2; .)*"+,582/($4-+ ,+*",A&"A,$(/N$&),$2A* +>0+,$+(&+F+6A&+ *",+**@ )(>$+"5@ ;)4/A+ )(6 ')&< 2; *'++090+&$j& ;++63)&< ? )&&A,)"+ 3A" +(&2A,)/$(/92&$)' *A002,"820$(/ *$+"5 )(6 *",+**9%2,"C"+,. )&%$+-)3'+ /2)'*G-2$6 &2.0),$*2( H$"% 2"%+,*9A002," )A"2(2.5
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Principle 4: Motivation
Mental Contrasting and Implementation Intentions (MCII):
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Exercise 5: Mental Contrasting and
Implementation Intentions
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Implicit Motivation:
Principle 4: Motivation
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Action Plans