mh - motivational interviewing techniques

National Youth Mental Health Foundation

Participant Manual

Motivational Interviewing and Behaviour Change Techniques

headspace is funded by the Australian Government under the

Promoting Better Mental Health – Youth Mental Health Initiative

National Offi ce

p +61 3 8346 8213

f +61 3 9349 5804

[email protected]

www.headspace.org.au

headspace Facilitator Training Guide2

Acknowledgements:

This training package was prepared by the headspace Service Provider

Education and Training (SPET) program.

Project writer:

Dr Helen Lindner (APS)

Claire Forsyth

Project contributors:

AUSTRALIAN PSYCHOLOGICAL SOCIETY (APS)

Harry Lovelock

Laurence Hennessy

Allen White

THE AUSTRALIAN GENERAL PRACTICE NETWORK (AGPN)

Neroli Stayt

Tim Roberts

The headspace SPET program would like to thank the following

individuals for their advice throughout the development phase of the

headspace training packages.

Strategic Partnership and Planning Group Members

Dr Lena Sanci – Department of General Practice, University of Melbourne

Dr Graham Fleming – Australian College of Rural and Remote Medicine

Dr Ros Montague – NSW Institute of Psychiatry

Professor Ann Roche – National Centre for Education and Training on

Addiction, Flinders University

Julie Porrit – AGPN Principal Adviser for Nursing in General Practice

Professor Jan Schmitzer – Batchelor Institute of Indigenous

Tertiary Education

Chief Inspector John Burgess – South Australian Police Force

Erica Frydenberg Assoc. Prof. – Faculty of Education, University

of Melbourne

Professor David Kavanagh – School of Medicine, University of Queensland

Amanda Bode – ACT Youth Coalition

Copyright

© 2008 The Australian Psychological Society Ltd

This work is copyrighted. Apart from any use permitted under the Copyright

Act 1968, no part may be reproduced without prior written permission from

the Australian Psychological Society.

headspace (The National Youth Mental Health Foundation) is funded by

the Australian Government Department of Health and Ageing under the

Promoting Better Mental Health – Youth Mental Health Initiative.

For more details about headspace visit

www.headspace.org.au

Table of Contents

SECTION: CONTENT: PAGE:

1. Module A and B workshop overview

1.1 Introduction to headspace 6

1.2 Training materials and resources 8

1.3 Structure and content of the workshop 9

1.4 Training workshop program 10

1.5 Delivery of workshop 12

1.6 Evaluation 13

2. Readings 16

3. PowerPoint slides & notes pages 18

4. Module A and B worksheets

Participant Worksheets

Worksheet 1: Case study - Adam 54

Worksheet 2: Motivational Interviewing techniques 55

Worksheet 3: Case study - Sally 56

Worksheet 4: Case study - Adrian 57

Worksheet 5: Readiness to Change Stages and Process Sheet 59

Worksheet 6: Case study - Eloise 62

Worksheet 7: Case study - Rachel 63

Worksheet 8: Action Plan Form 64

Worksheet 9: Case study - Katrina 65

Worksheet 10: Case study - Travis 66

Homework sheets for Module A and B 58,67

5. Workshop evaluation

Participant Evaluation Form 71

6. Practice Review Workshop 76

headspace MI & BCT – Participant Manual 3

Section 1Training workshop overview

6 headspace MI & BCT – Participant Manual

Section 1.1 Introduction to headspace

Why headspace?

Mental health and substance use issues are the most serious health problems affecting young people and are a signifi cant public

health issue in the wider community. Approximately one out of every four young people (aged between 12 and 24 years) in

Australia will experience a mental or substance use disorder in any given year. These disorders are leading contributors to the

burden of disease in young people. Unfortunately, only one in four young people who experience a mental or substance use issue

actually receives professional assistance.

The current mental health system is not equipped to deal with young people who have mild to moderate mental health issues.

This often means that it is diffi cult for them to obtain timely treatment or fi nd a service that can respond to their needs.

As Australia’s National Youth Mental Health Foundation, headspace is tackling the issues which stand in the way of young

people’s access to appropriate health services.

The headspace model

headspace is changing the way that assistance to young people at risk of mental health and related issues is approached.

The emphasis is on:

Increasing the community’s capacity to identify young people who are at risk of mental health and related issues, such as •

substance use, as early as possible

Encouraging help-seeking by young people, their families and carers•

Responding as early as possible to the risk of mental health and related issues using evidence-based interventions provided •

through an integrated model of care

Ensuring that key components of a young person’s social recovery, such as links to education, training and employment, are •

central to the care provided

Ensuring that young people play an active role in shaping the delivery of services•

Ensuring that the • headspace model of care provides for the support of family and friends in recognition of the important

roles they play in the mental health of young people.

This initiative relies on headspace services increasing the clinical capacity for responding to young people with these types

of issues.

headspace: a brief overview

headspace is Australia’s National Youth Mental Health Foundation funded by the Australian Government.

The headspace mission is to promote and facilitate improvements in the mental health, social wellbeing

and economic participation of young Australians aged from 12–25. To this end, headspace aims to be a

signifi cant agent for change in the way that youth mental health issues are responded to across the country.

Section 1.1 Introduction to headspace

The target group

The target group for headspace is all young people in the 12–25 year age range. The criteria for access are not to be more

complicated than this. This age range is the period during which the onset of mental health issues escalates and reaches its peak.

75% of mental health problems occur by the age of 25.

We know that identifying at-risk young people and encouraging them to seek help at an early stage can have a dramatic effect

on the prevention of future mental health problems, the use of acute mental health services, as well as the potential effects that

such problems can have on other areas of life.

The headspace model aims to engage all types of young people, their families and signifi cant others, not just marginalised

young people within a community. We also know that adolescence can be a turbulent time during which there can be quite

marked swings between highs and lows, which can themselves be times of risk if a young person is not provided with

appropriate support.

How will headspace work?

The ‘engine rooms’ of headspace are the funded Communities of Youth Services, or ‘CYS’. These are youth-friendly hubs or

one-stop shops. A CYS has at its core a private practice comprised of medical, allied health and psychiatric practitioners. These

people will work closely with allied health practitioners that have been funded by the Department of Health and Ageing’s Youth

Mental Health Initiative, as well as the headspace staff. There are also practitioners from mental health, drug and alcohol,

and vocational assistance organisations. The models must provide for the direct service provision of the four core streams of

headspace through the hub; primary health care, mental health, Alcohol or Drug services, and social and vocational services.

30 CYS sites have been established across metropolitan, regional and rural Australia since early 2008.

The headspace biopsychosocial model of intervention

Historically substance use and mental health treatment services have not always worked well together, often resulting in

young people with needs across both areas falling between the gaps. Consistent with the view of the Australian Government,

headspace does not view substance use and mental health in isolation of each other. headspace aims to provide a coherent

understanding of mental health issues in a holistic way that is appropriate to the developmental needs of young people. The

headspace biopsychosocial model of intervention seeks to intervene early in the cycle of substance use and mental illness, with

the objective of providing timely, concurrent, integrated and less restrictive evidence-based interventions to improve the physical

and mental health of a young person.

How is Motivational Interviewing and Behaviour Change Technique (MI & BCT) training relevant to a CYS?

Early detection of emerging mental health and/or substance abuse problems among young people is critical to building the

capacity of CYS sites to provide more effective responses. Additionally, the identifi cation of problematic behaviours that support

or compound substance use and/or mental health problems is a necessary component for the CYS site. Although identifi cation

of mental health or substance use problems with ‘fi rst contact’ practitioners, such as general practitioners, community health

workers and school counsellors, may be initiated by the young person, there is often a high level of ambivalence in the young

person towards engaging in the behaviour changes that are needed to effectively manage the problem. Practitioners will need

to feel confi dent in their ability to engage and communicate with a young person on their ambivalence to making changes

related to their mental health or substance abuse problems. To do this, practitioners will need to have a good understanding of

the models and skills of motivation to change relevant to the young person’s readiness to change, and techniques to support the

implementation of behavioural goals.



Pre-workshop requirements

Prior to attending the One Day workshop participants are expected to:

Complete a pre-workshop online questionnaire as required•

Prepare for the workshop by reading the ‘pre-workshop’ selected readings.•

Participant manual includes:

Pre-workshop readings•

PowerPoint slides and notes pages•

Participant worksheets (10)•

Homework sheet (Module A)•

Homework sheet (Module A & B)•

Evaluation forms•

Practice Review workshop materials including:•

- Mini PowerPoint slides

- Notes pages.

Section 1.2 Training materials and resources

The Participant Manual includes notes pages for the two-hour Practice Review workshop. The Practice Review session reinforces

the skills developed in the workshop modules.

The training package has been developed to be in line with the overall aims of headspace training packages. That is, it aims to

adopt an early intervention model of care, that refl ects content and practice that is evidence-based and theoretically sound, and

provides effective and culturally sensitive approaches to working with young people with mental health and/or substance use issues.

Learning objectives

Following the MI & BCT training, participants will have an:

Understanding of effective models of service delivery for young people with co-morbid mental health and substance use •

problems based on harm minimisation

Ability to appropriately use a range of effective interventions for young people with co-morbid mental health and substance •

use problems, including Motivational Interviewing and cognitive-behavioural treatments

Ability to introduce harm reduction strategies appropriately to young people who present with co-morbid mental health and •

substance use problems

Ability to use Motivational Interviewing appropriately, in order to resolve ambivalence about changing behaviours and •

engaging in treatment, improve the young person’s intrinsic motivation to change, and maintain low levels of treatment

resistance

Understanding of relevant behaviour change models, procedures for assessing readiness to change, and how to apply •

Motivational Interviewing principles with young people to prepare them for cognitive-behavioural treatment interventions

Understanding of the cognitive-behavioural model for treatment of co-occurring mental health and substance use problems•

Ability to undertake an assessment, construct a formulation, and determine appropriate forms of cognitive-behavioural •

intervention for young people with co-occurring mental health and substance use problems

Ability to provide effective behavioural interventions for co-occurring mental health and substance use problems in young people.•

Target workshop audience

The following materials have been developed as a face-to-face training package suitable for psychologists, allied health workers

(e.g. social workers, occupational therapists) and others who work with young people (e.g. youth workers, teachers, police) to

develop skills in effective interventions for young people, aged from 12–25 years, with mental health and/or substance use

problems. The specifi c content of this training package is the development of skills in Motivational Interviewing, behaviour

change processes and strategies relevant to the young person’s readiness to change, and goal setting techniques.

The workshop has been constructed for training a maximum of 24 participants at a time.

Section 1.3 Structure and content of the workshop

Overview

The MI & BCT training package is developed as an eight-hour workshop followed by a two-hour Practice

Review session that occurs four weeks following completion of the One Day Workshop. The MI & BCT

material is presented as two half-day modules (A & B) that can be run on the same day, or if more

convenient for the participants, they can be run across different days as two sequential modules. The

assumption for Module B will be that the participants have completed Module A.



Section 1.4 Training workshop program

Motivational Interviewing & Behaviour Change Techniques

Module A: Half-day training schedule

TIME WORKSHOP OUTLINE

9.00–9.15 Session 1:

Welcome and introductions

9.15–9.45 Session 2:

Awareness of the ambivalent young person

Case example to focus workshop aims – ’Adam’•

Group discussion on typical scenarios•

9.45–10.30 Session 3:

Summary of research evidence on effi cacy of MI & BCT

Background on MI & BCT•

10.30–10.45 Tea break

10.45–11.30 Session 4:

Knowledge on MI and readiness to change model

MI principles and techniques, and readiness to change framework•

11.30–11.45 Session 5:

Practice of MI and readiness to change model

MI demonstration•

11.45–12.15 Session 5 (continued):


MI group activity and discussion•

Summary of morning’s training•



Summary of Module A skills•

12.30–1.00 Homework activities or lunch

Module B: Half-day training schedule

TIME WORKSHOP OUTLINE

1.00–1.15 Session 6:

Processes of readiness to change model

Revisit case study ’Adam’ as an introduction and summary of previous half-day •

training (MI and readiness to change)


Processes of readiness to change model

Processes for change•

1.45–2.30 Session 7:

Application of the processes of change

Group activity on processes of change for contemplation and preparation stages•

Discussion•

2.30–2.50 Tea break

2.50–3.30 Session 8:

Skills in behaviour change, including goal setting

Specifi c BCT for action stage•

Goal setting•

3.30–3.45 Session 9:

Development of skills in behaviour change

Demonstration of techniques•



Group activities and discussion on action–goal setting techniques•



Review of Module A and Module B•



Strategies to embed training skills into client work•

5.00 Evaluation and fi nish

Section 1.4 Training workshop program



The MI & BCT training package:

Includes interactive learning activities such as case discussions, role-plays and other simulated practice activities•

Uses an adult and problem-based learning approach•

Is based on theoretically derived information and evidence-based research. •

The workshop activities aim to:

Improve the professional’s communication skills with young people•

Be clinically relevant to the real-life settings•

Assist with the implementation of the new learning in the workplace.•

Specialist trainers

The MI & BCT workshop is designed to be delivered by a specialist trainer recruited through the headspace Service Provider

Education and Training (SPET) program.

Case studies

It is noted that the workshop material has been designed for a maximum of 24 participants. The skill development activities

involve the participants working in groups of three participants. The review by the facilitator of a maximum of eight groups (each

with three participants) during each training activity has been determined to be the maximum number of groups viable for the

effective training of professionals.

The essence of the training is centred on person-focused assessment techniques and intervention development approaches. The

case-based application of knowledge and skills presented in the following materials will train the professional to meet the different

development needs of young people across the age range, the differences in remote as opposed to urban lifestyles, and a range of

socioeconomic circumstances. Various case studies will be provided, but often the most appropriate case studies can be generated

from the training group. The facilitation of training should accommodate cases presented from the local participants, who are

familiar with the socioeconomic and cultural realities of the local area or a particular age group that is the focus of the local

headspace activities. The facilitator is also encouraged to actively seek out case examples that capture issues relevant to the local

community, Aboriginal and Torres Strait Islander people and culturally and linguistically diverse people in the area.

Section 1.5 Delivery of workshop

Overview

The workshop will be delivered on a face-to-face basis. The workshop is structured to be the ‘primary

strategy’ to assist in the learning of new information and skills. The Practice Review Workshop comprises

the ‘secondary strategy’ to assist learners in consolidating and extending workshop-based learning into

their work environment, as well as to refl ect upon and discuss implementation issues including any

diffi culties that may arise.

Section 1.6 Evaluation

External evaluation

headspace will evaluate each training package in a pre- and post- online format. The pre-evaluation will take place shortly

before participants attend the workshop. This questionnaire requests information pertaining to the participants’ professional

background and their level of understanding, knowledge, skills and confi dence related to the learning objectives of the training

packages. The post-workshop evaluation will take place in the weeks following the training. The questionnaire will assess the

degree of change in participant responses to the above questions and any perceived change in participant skills in practice as

a result of the training.

Internal evaluation

The headspace Service Provider Education and Training (SPET) program will evaluate the quality of the training delivery from

the participants’ and facilitator’s viewpoint. This evaluation will take place on the day of the workshop.

Facilitators need to ensure that time is made available at the end of the workshop for participants to complete these internal

evaluations. Along with the Facilitator Feedback Form, facilitators are asked to post the participant’s evaluations to the SPET

program as detailed on the evaluation forms.

The Evaluation Forms are located in the Appendice section of this guide.

The principal aim of headspace Service Provider Education and Training (SPET) packages is to

increase practitioners’ skills in engagement and assessment and the use of evidence-based medical and

psychosocial interventions appropriate for young people with mental health and/or related substance use

issues. There is an internal and external evaluation process for headspace SPET packages.


Section 2Readings


Section 2 Readings

Section 3PowerPoint slides & notes pages


Motivational Interviewing &

Behaviour Change Techniques

headspace training program

Slide i

Program structure

• Module A: Motivational Interviewing (four hours)

• Module B: Behaviour Change Techniques (four hours)

• Option 1: run both Modules A & B on a single day

• Option 2: run Module A, followed by Module B within

a two-week period

Slide ii

Section 3 PowerPoint slides & notes pages

Aims of the MI & BCT

workshop

Develop interaction skills to support young

people with:

• Identification and resolution of ambivalence

to attitude and behaviour change

• Development of skills that will empower the

young person to successfully achieve

behaviour change.

Slide iii




headspace is Australia's National Youth Mental Health Foundation and is

funded by the Australian Government. headspace is delivering its core

programs and strategies through a consortium of the following organisations:

Youth Services Development Fund – headspace National Office

Centre of Excellence – ORYGEN Research Centre

Service Provider Education and Training – The Australian Psychological

Society in partnership with the Australian General Practice Network

Community Awareness – Brain and Mind Research Institute, University

of Sydney

Slide 1.1

Overview

Why headspace?

The headspace Model

The target group

How will headspace work

How is MI & BCT training relevant to a CYS?

Slide 1.2


Program outline: Module A

9.00–9.15 Welcome and introductions

9.15–9.30 Setting the scene: Case example of

‘Adam’ to focus workshop aims

9.30–9.45 Group discussion on youth scenarios

9.45–10.30 Background on Motivational

Interviewing (MI) and Behaviour

Change Techniques (BCT)

10.30–10.45 Tea break

Slide 1.3

Program outline: Module A

10.45–11.00 Outline readiness to change

framework

11.00–11.30 MI principles and techniques

11.30–11.45 MI demonstration and discussion

11.45–12.15 MI participant activity

12.15–12.30 Discussion of MI activity

Summary of Module A skills

12.30–1.00 Homework activities or lunch

Slide 1.4




Program outline: Module B

2.50–3.30 Specific BCT for action stage,

including goal setting

3.30–3.45 Demonstration of techniques

3.45–4.15 Participant activities on action–goal

setting techniques

4.15–4.30 Group discussion of BCT activity

4.30–4.50 Strategies to embed training skills

into client work

4.50–5.00 Review of session and feedback

5.00 Finish

Slide 1.6


Program outline: Module B

1.00–1.15 Revisit case study ‘Adam’ as an

introduction and summary of

previous half-day training (MI and

readiness to change)

1.15–1.45 Group activity – processes for

change

1.45–2.30 Group discussion of processes for

change activity

2.30–2.50 Tea break

Slide 1.5

Discussion

‘Adam’ scenario:

• Wants life to be better/different

• It’s too hard to change

• Unsuccessful attempts to change behaviours

• Ambivalence to change

Slide 2.2


Case study:

Adaddadadaamamaammamma

Slide 2.1



Motivational Interviewing (MI)

• Motivational Interviewing is a directive,

patient-centred counselling style for

eliciting behavior change by helping the

client to explore and resolve ambivalence(Rollnick & Miller, 1995)

• Focused

• Goal-directed

Slide 4.1


Efficacy of Motivational

Interviewing and Behaviour

Change Techniques

• Self-efficacy

• Motivational Interviewing

• Readiness to change

• Behaviour change

Cognitive behaviour interventions

Goal setting

Slide 3.1

Characteristics of MI style

• Seeking to understand the young person’sframe of reference, particularly by reflectivelistening

• Expressing acceptance and affirmation

• Eliciting and selectively reinforcing theyoung person’s own self-motivationalstatement, expressions of problemrecognition, concern, desire, intention tochange, and ability to change

Slide 4.2


Characteristics of MI style

• Affirming the young person’s freedom of

choice and self-direction

• Monitoring the young person’s degree of

readiness to change

Slide 4.3



Unhelpful (but common)

assumptions

• This young person wants to change

• This young person’s health situation is a

prime motivating factor for them to change

• A tough approach is always best

• I’m the expert, so the young person will

follow my advice

Slide 4.5


Aims of Motivational

Interviewing

• Assisting young people to change their

behaviour while respecting their choices

about the change

Slide 4.4

Assessment of

motivation to change

Motivation = Importance + Confidence

Importance – do I want to change?

Confidence – can I change?

Slide 4.6

Assessment of importance

and confidence

On a 1 to 10 scale, how important is it to you

that you can change . . . ?

On a 1 to 10 scale, how confident are you that

you can change . . . ?

Slide 4.7





Method of motivation to

change behaviours

Increase importance and build confidence

• Why so high?

• What could make you move higher?

• How high would you need to be to give it

a go?

Summarise and help the young person to decide

what to do next.

Slide 4.8

Readiness to change model

• A theoretical model of behaviour change

• Aimed to develop effective interventions to

promote health behaviour change

• Developed by Prochaska, DiClemente and

Norcross (1992)

• Model of intentional change

• Focuses on the decision making process

Slide 4.9


Components of the

readiness to change model

Stages of change

• 5 temporal dimensions

Outcome measures

• Decisional balance scales

• Temptation scales

Processes of change

• 10 cognitive and behaviour activitiesthat facilitate change

Slide 4.10




Stages of change

1. Pre-contemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

Slide 4.11

No intention to take action in the next 6months

• Uninformed or under-informed ofconsequences of behaviours

• Demoralised about ability to change

Avoid reading, talking or thinking about riskbehaviours

• Perceived as resistant or unmotivated

Pre-contemplation Slide 4.12

Contemplation

• An intention to change in the next 6 months

• Aware of pros and cons of changing

• Ambivalence about change

• Not ready for action oriented programs

Slide 4.13

Preparation

• Intention to take action in the near future

• Joined a health education class

• Bought a self-help book

• Suitable to be recruited for action-orientedprograms, for example:

Smoking cessation program

Weight loss group

Exercise class

Slide 4.14




Action

• Overt modifications to health behaviours in

the past 6 months

Smoking cessation

Less than 30% of calories from fat

• Applying change processes frequently

• Vigilance against relapse is critical

Slide 4.15

Maintenance

• Working to prevent relapse

• Applying change processes less frequently

than when in Action stage

• Self-efficacy high

Slide 4.16


Outline of strategies for MI

• Investigating importance

• Investigating confidence

• Looking forward

• Reviewing previous successes

Slide 4.17

MI strategies to increase

readiness to change

Investigating Importance

Ask:

• What are the good things about …?

• What are some of the not so good things

about …?

Summarise pros and cons. Check with the

young person on these.

Ask the young person –

• Where does that leave you now?

Slide 4.18




Looking Forward

Looking Forward has the young person envision two

futures:

1. If they continue on the same path without

any changes where they might be five or ten

years from now.

2. If – and the emphasis is on if – they decided

to make a change in their behaviour, what

that future might look like.

Slide 4.19

Looking Forward

The health practitioner’s job is not to argue one

position or another, but rather just elicit the

information and then ask the young person to

comment on these imaginings.

Slide 4.20


Reviewing previous

successes

Here, we build rapport while gathering

information. The health professional avoids a

focus on problems, focusing instead on how

the behaviour goals fit into the young person’s

life.

‘Can we spend a few minutes going through the

last few days. What happened, and how did

you try to work towards achieving your goals?’

Slide 4.21

Demonstration:

large group activity

1. MI assessment

2. MI strategies to increase readiness

to change

Slide 5.1




Role-playgroup activity

1. Define goal for change

2. Assess level of

motivation to change

(importance and

confidence)

3. Confirm stage of change

4. Use at least one of the strategies for

change: good/not so good reasons,

reviewing successes, looking forward,

summary of where to next

Slide 5.2


Discussion about role-plays

• Key successes

• Challenges

Slide 5.3

Summary of Module A training

Motivation to change

• High ambivalence to change

• Assess the importance to change behaviour in next week

• Assess the confidence to change behaviour in next week

Readiness to change

• Five stages of change

• Strategies to support change

• Understand the young person’s perspective

• Work with the young person’s goals

• Looking forward

• Reinforce any positive change

Slide 5.4




Homework for Module A

1. Identify two specific existing or new clients with

whom you will use MI skills at the next session

2. Identify a colleague to whom you are going to

explain MI skills

3. Identify a ‘buddy’ in your work group that you can

discuss your progress with the MI skills

• Make a time in the coming week to meet or

telephone

• Discuss your successes and challenges in

using MI with the young person

Slide 5.5


continued ...

Questions to answer with your colleague

• Did you use reflective listening and paraphrasing?

• Did you assess the importance and confidence of

the young person to change the chosen

behaviour?

• Could you identify the young person’s stage of

change for a specific behaviour?

• Did you seek to confirm your assessment of the

stages of change with the young person?

• Did you manage your urge to offer ‘solutions’ too

early or unrequested?

Slide 5.6


Introduction to Module B

Welcome to the second half-day MI and BCT

training session

• Review of training from previous half-day training

(Module A)

• Reflections on the successes and challenges of

implementing the MI skills.

Slide 6.1

Stages of change

Not everyone is ready to change!

1. Pre-contemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

Slide 6.2




Processes of change

Covert and overt activities

• Ten common processes

Change is best achieved by appropriatematching of processes with the stage ofchange

Two general categories of processes

• Experiential processes

• Behavioural processes

Slide 6.3


Experiential processes

of change

1. Consciousness Raising (increasing awareness)

• I recall information people had given me onhow to stop smoking

2. Dramatic Relief (emotional arousal)

• I react emotionally to warnings aboutsmoking cigarettes

3. Environmental Re-evaluation (social reappraisal)

• I consider the view that smoking can beharmful to the environment

Slide 6.4

Experiential processes

of change

4. Social Liberation (environmental

opportunities)

• I find society changing in ways that

make it easier for the non-smoker

5. Self Re-evaluation (self re-appraisal)

• My dependency on cigarettes makes

me feel disappointed in myself

Slide 6.5




Behavioural processes

of change

6. Stimulus Control (re-engineering)

• I remove things from my home thatremind me of smoking

7. Helping Relationship (supporting)

• I have someone who listens when Ineed to talk about my smoking

Slide 6.6

Behavioural processes

of change

8. Counter Conditioning (substituting)

• I find that doing other things with myhands is a good substitute for smoking

9. Reinforcement Management (rewarding)

• I reward myself when I don’t smoke

10. Self Liberation (committing)

• I make commitments not to smoke

Slide 6.7


Summary as guideline for

processes sheet activity

Assessment of readiness to change

• Stages of change

• Importance and confidence

Strategies to increase readiness to change

• Processes

• Good/not so good

• Looking forward

• Reviewing successes

Slide 7.1

Discussion on

case study activity

• Key successes

• Challenges

Slide 7.2




Behaviour change techniques

• Goal setting

• Brainstorming

• Action plan

Slide 8.1

Goal setting

• Identifying the goal for change

• Brainstorming for goals

Slide 8.2


Brainstorming for goals

Principles:

• There is usually not one but many possible

courses of action

• I can tell you about what has worked for

others

• You will be the best judge of what works

for you

• Let’s go through some on the options

together

Slide 8.3




General goal Strategy Specific goals

Lose weight Eat less food Cut out fried potatoes

No red meat during the week

No full-fat milk

Start eatingnew foods

Fruit once a day

Replace

certain foods

Baked potatoes or rice instead

of chips

Fruit instead of pudding 3/7 days

Get more

exercise

Walk to work

Arrange sport or dancing once a week

Use the stairs

Example of general goals to

specific goals

(Rollnick, Mason, & Butler, 2000: Health Behaviour Change)

Slide 8.5


General goals to

specific goals

Goal Strategy Target

• Lose weight

Slide 8.4

Goal setting: action plan

An action plan should include:

WHAT I am going to do?

HOW MUCH I am going to do?

WHEN I am going to do it?

HOW MANY days in the week I am goingto do it?

For example, this week I will walk (what) aroundthe block (how much) after school (when)three times (how many).

Slide 8.6

Action Plan Form

This week I will:

__________________________________ (what)

__________________________________ (how much)

__________________________________ (when)

__________________________________ (how many times)

How confident am I that I will achieve this?

Circle a number (1 = not at all sure and 10 = certain)

1 2 3 4 5 6 7 8 9 10

Slide 8.7





Demonstration of

goal setting

• Behaviour change strategies

• Goal setting

• Assumption of an action stage of change

but suitable for action aroundinformation gathering for preparationof contemplation stages of change

Slide 9.1

Group activity

• The young person will

identify the goal for

discussion (assumes

action stage of change)

• Behaviour change

strategies and goal setting

Slide 9.2

Group activity discussion

• Key successes

• Challenges

Slide 9.3




Summary of training

Motivational Interviewing

• Communications: reflective listening,

paraphrasing

• Importance & confidence of behaviour

change: 1–10 scale

• Looking forward and previous successes

Stages of readiness to change behaviour

• pre-contemplation, contemplation,

preparation, action and maintenance

Slide 9.4

Summary of training

Processes of change

• Awareness raising, reflection of self and

others on behaviour change

• Preparation and placing in action

behaviours for change

• Monitoring, cues for action, control of

temptations and social support

Goal setting relevant to stage of readiness

to change

Slide 9.5ß






explain MI skills

3. Identify a ‘buddy’ in your work group that you can

discuss your progress with the MI skills

• Make a time in the coming week to meet or

telephone

• Discuss your successes and challenges in

using MI with a young client

Slide 9.6

Homework for Module

A continued ...

Questions to answer with your colleague:

• Did you use reflective listening and

paraphrasing?

• Did you assess the importance and confidence

of the young person to change the chosen

behaviour?

• Could you identify the young person’s stage of

change for a specific behaviour?



• Did you manage your urge to offer ‘solutions’ too

early or unrequested?

Slide 9.7




Practice Review

workshop details

The headspace training program organises a two-hour

follow-on session for participants. Aims of the follow-on

workshop are to:

• Reinforce and extend the MI and BCT skills

developed in Module A and Module B

• Build self-efficacy and capacity of professionals

to use the MI and BCT skills with young people

• Give professionals an opportunity to identify the

success and challenges of using MI and BCT

skills with young people.

Details of date and venue to be announced

by facilitator.

Slide 9.8

Thank you for participating in the

Motivational Interviewing and Behaviour

Change Techniques workshop.

Any final comments?

Slide 9.9


Section 4Module A & B worksheets

headspace MI & BCT – Participant Manual54

Section 4 Worksheet 1

Case study:

AdamAdam is a 16-year-old male who has presented to you for help with his alcohol use. He does not want

to attend the appointment but has done so at the recommendation of his school coordinator who has

expressed concern with his performance. Adam enjoys going to school and aspires one day to be a business

man. However, he has a reputation for being ‘the class clown’ and disrupting classroom activities.

Adam’s parents have recently separated and he has been fi nding it diffi cult to cope with the change. His

parents are both well educated and have established careers. He is currently living with his mum and two

older brothers. He doesn’t really get along with his mum but has a good bond with his eldest brother, who

has been worried about Adam’s moods being up and down.

Adam goes to parties every weekend with his mates. They consume excessive amounts of alcohol and

Adam often ends up drunk. Sometimes he passes out when he gets home and experiences memory loss.

Adam fi nds that drinking alcohol makes him relax. When he is drunk he doesn’t get as angry and gets

along better with other people. He has begun having a drink every day to achieve this relaxed feeling,

consuming about six cans of pre-mixed drinks during a single day.

Adam is physically well-built and enjoys playing football on the weekends. He has the potential to play for

his district team if he attends training more regularly and applies himself. This has been quite diffi cult for

him lately as he has been feeling depressed. Adam knows that his drinking is unhealthy but doesn’t see any

way of changing it.

Notes:

Motivational Interviewing techniques

1. Listen, build rapport – attitude of being respectful of the adolescent’s values and choices.

2. Acknowledge your agenda and the adolescent’s diffi culty or ambivalence to changing behaviour –Motivational Interviewing

involves collaboration.

3. Focus on a specifi c behaviour.

4. Assess importance and confi dence:

(a) ‘How important is it to you, from 1 to 10?’

(b) ‘Why so high?’

(c) ‘What would help you move higher?’

(d) ‘How high would you have to be to change?’

(e) ‘How confi dent are you about changing, from 1 to 10?’

(f) ‘What would help you move higher?’

(g) ‘How high would you have to be to change?’

5. Work on importance

(a) ‘What are the good things about the behaviour?’

(b) ‘What are some of the not so good things about it?’

(c) Share information about risks: don’t push information, ask what they already know, whether they want to know more, allow

the adolescent to make the links

(d) Manage resistance: Shift focus, express empathy, emphasise the adolescent’s control, summarise their position

(e) Summarise the pros and cons.

6. Build confi dence

(a) ‘Is there anything you’ve found helpful in previous attempts to change?’

(b) ‘Is there anything you can learn from any problems you had last time you tried?’

(c) ‘Do you know other people who have successfully changed? What worked for them?’

7. Summarise both importance and confi dence with ‘Where does that leave you now?’

(a) I’m not interested in changing

- ‘As your psychologist/health professional I am concerned about … (my agenda). If you want to discuss this again,

I’m here’

(b) I want to do it!

- Talk about how (practical aspects/preparation stage of change/goal setting)

(c) I’ve got to think about it

- Encourage refl ection/monitoring (processes relevant to contemplation stage of change/diary/pros and cons).

Reference

Litt, J., Ali, R., & Pols, R. (1993). Brief alcohol intervention in general practice: Motivational Interviewing techniques

[video recording]. Flinders Media.





Case study:

SallySally is a 17-year-old female who is in the fi nal year of secondary school. She has presented to you at the

recommendation of her parents after they caught her smoking cigarettes behind the garage before school.

Sally is an only child and lives at home with her parents. Sally gets along with her parents quite well but

feels they hold quite high expectations of her. Her parents want her to go to university to study Law but she

feels that she cannot achieve a high enough university entrance score.

Sally has been extremely anxious and stressed about her studies and her future. Sometimes she feels as

though there is no point continuing her education, and that she is a failure. Most of Sally’s friends do not

intend to go to university so do not study and spend most of their weekends going to parties. She fi nds her

friends don’t understand the pressures in her life, or why she won’t go out with them every weekend.

One of Sally’s friends introduced her to cigarettes, telling Sally they would help her to relax after school

or whilst studying. All of her friends smoke and Sally thought that taking up smoking might eliminate

her reputation for being a ‘good girl’. Sally fi nds smoking reduces her anxiety, helping her cope with the

stresses of studying, and pressures from her parents. Sally now smokes at least one pack a day and feels

she can’t get by without them.

On the rare occasion that she goes out on a weekend with her friends, she has experimented with

marijuana. Whilst at the moment she reports that she does not use marijuana regularly, she does have easy

access to it, and she could see herself using it to manage her stress. Sally recognises that she is not coping

well and needs help with other ways of handling her stress, but she feels she has already tried everything,

and it is useless.

Notes:


Case study:

AdrianAdrian is a 19-year-old male who presents to you because his girlfriend is concerned about his binge

drinking habit. He doesn’t really want to be at the appointment with you but his girlfriend is threatening to

end their relationship unless he seeks some help.

Adrian is an apprentice plumber and enjoys his work. His boss believes that Adrian is doing really well and

is planning to continue employing him after he fi nishes the apprenticeship. Adrian is a keen soccer player

who plays regularly in the district B team, with an occasional position in the A team. He has developed a

good friendship group through soccer.

Adrian goes to nightclubs every Friday night with his soccer mates, but does not take his girlfriend. He

often gets into fi ghts with people at the clubs and gets kicked out. Adrian often feels quite ‘hung over’

the next day and fi nds it hard to perform well at soccer. He has been cautioned by the police recently for

drunken and disorderly behaviour.

Adrian lives at home with his parents and fi ve brothers and sisters. His parents migrated from Italy before

the children were born and still maintain conservative views on behaviour. Adrian reports that his drinking

and aggressive behaviour is disgracing his family. His parents have threatened that if he comes home

intoxicated next weekend he will be no longer be welcome in their home.

Adrian thinks that his behaviour and drinking is pretty harmless. He recognises that some weekends he

does go overboard, but he doesn’t want to lose his family or girlfriend over his drinking.

Notes:



An important aspect of the training in Motivational Interviewing is the determination of opportunities and supports to practice

the skills outside the training session. If we want to be good at anything, we need to practice. Additionally, the reinforcement of

skills learnt in the training cannot be left to chance.

Strategies to reinforce your training:

1. Identify two specifi c existing or new clients with whom you will use MI skills at the next session

2. Identify a colleague to whom you are going to explain the skills of MI

3. Identify a ‘buddy’ in your work group that you can discuss your progress with the MI skills

- Make a time in the coming week to meet or telephone

- Discuss your successes and challenges in using MI with an adolescent client.


Did you use refl ective listening and paraphrasing?•

Did you assess the importance and confi dence of the adolescent to change the chosen behaviour?•

Could you identify the adolescent’s stage of change for a specifi c behaviour?•

Did you seek to confi rm your assessment of the stages of change with the adolescent?•

Did you manage your urge to offer ‘solutions’ too early or unrequested?•

Homework sheet for Module A Motivational Interviewing skills

Readiness to Change stages and processes sheet

The following examples of discussion and intervention focus on a range of behaviour change goals including reduced alcohol

and drug usage, increasing healthy eating, exercise and school/work attendance, positive social interactions, improved sleeping

patterns and quitting smoking.

STAGES OF

CHANGE PROCESSES SPECIFIC EXAMPLES

Pre-

contemplation

Processes in this stage need to encourage thinking about change, not doing change.

Do not make a plan for action.

Consciousness

raising

1. Keeping a diary of their weekly sleeping patterns (e.g. bed time, wake time, sleep

duration, sleep quality, etc.).

2. Recalling information about the desired amount of sleep per night for a person

their age.

3. Discuss with the person the benefi ts of exercise to help negative mood.

4. Evaluate the cost of drugs/alcohol and poor education outcomes over time versus

the adoption of healthy and achievement oriented behaviours.

5. Budget the cost of a holiday with mates.

6. Recalling a time when energy levels were good and identify the behaviours from

that time.

Dramatic

relief

1. Discuss that any reduction in substance abuse (marijuana, alcohol, nicotine, hard

drugs) can help to feel more in control.

2. All things being equal, people without addictions are happier and healthier.

3. Reacting emotionally to the idea that they will miss out on success and good friends

if they continue along the current life-path.

4. Discuss the consequences of continued drug habits even in terms of worst-case

scenarios.

5. Refl ection of the emotions around being a person with a substance abuse problem.

That is, how do you feel, how do people treat you and how could life be better?

6. Feeling disappointed that they will no longer be smoking and this may restrict

shared activities such as catching up with work colleagues or friends when at the

’smoking spot’. They can still go out with friends and enjoy themselves without

going outside for a smoke.

7. Discuss that managing a substance abuse problem can be of value to them and not

just for the practitioner or their family.

8. Substance abuse control gives the young person more power and fl exibility with

their life choices.

9. It is safer for the person to know their blood alcohol levels.

Environmental

re-Evaluation

1. Discuss feeling disappointed that travelling, having a good job and other activities

is not possible because they have a substance abuse problem.

2. Thinking that avoidance of physical exercise is hurting their partner and family by

restricting the possibility of shared activities (picnics, beach trips, bush walking, etc).

3. Think about the avoidance of social activities that arise from being unable to

commit to healthy food choices.

4. Consider the future impact your substance abuse problem is having on others –

the burden for family and friends.




STAGES OF

CHANGE PROCESSES SPECIFIC EXAMPLES

Contemplation Processes in this stage are focused on encouraging the contemplation to extend into preparation.

Get them to try healthy behaviour changes in small amounts and then perhaps to build up.

Self re-

evaluation

1. Discuss the benefi ts of not drinking alcohol for themselves and their family (impact

of alcohol long-term and quality of life).

2. Would their self-image be improved if they saw themselves as a less-drunk person

at parties?

3. Evaluate and list the barriers of having a weekend without drugs or alcohol and

determine things that can be changed easily and those that will take time.

4. Think about how a change in smoking can impact on other chronic problems you

may experience such as asthma.

5. Would their self-image be improved if they had more control over their use of drugs

and alcohol?

Preparation Processes in this stage are focused on developing achievable goals or preparation to extend into action.

Build on any previous healthy behaviours and encourage goal-focused strategies.

Self-liberation 1. Discuss with the person the types of activities they are planning to start to help

improve their mental health.

2. Discuss the benefi ts of making goals and a plan.

3. List the types of activities they have found particularly enjoyable in the past

(e.g. exercise, socialising, fi lms, etc.).

4. Discuss career options to assist in making a decision to attend school regularly.

5. Enrol in karate or group exercise classes.

6. To inform yourself of the wealth of opportunities available.

7. Sign a contract to eat healthily for a certain number of meals per week or snack on

healthy alternatives.

8. Discuss the benefi ts of making goals and a plan.

Social

liberation

1. Discuss the support available to have a substance-free weekend.

2. Identify the support available for avoiding depressed or anxious feelings.

3. Form a new group of friends.

4. Involve a family member in assisting you to make healthy choices.

Action Processes in this stage are focused on achieving the set goals.

Develop possible strategies for managing the barriers to regular healthy behaviours.

Stimulus

control

1. Discuss associating physical activity with a specifi c daily activity (’pairing’ the

activities together).

2. Have a list of future outings that will be enjoyed as mood improves

3. Have friends who do not offer cigarettes to you.

4. Improve your personal hygiene and appearance (hair cut, clean clothes etc.).

5. Work on planning small time-limited exposure to high risk situations.

Section 4 Worksheet 5 (continued)

STAGES OF

CHANGE PROCESSES AIMS AND SPECIFIC EXAMPLES

Counter-

conditioning

1. Organise alternative social activities to replace high risk situations (e.g. work/school

nights, weekends, holidays etc.).

2. Substitute sitting watching an afternoon program on TV with going for a run.

3. Have a number of different activities planned.

4. Drink water in place of having a cigarette.

5. Walk to meet friends to establish a healthy mindset before you are offered cigarettes.

6. Allow oneself a reward if goals are achieved (e.g. download music, new running shoes).

7. Substitute drinking a second can of beer with a glass of water.

Helping

Relationships

1. Participate in a sporting group to get support in developing an interest in new

activities.

2. Arrange a health coach (could be a friend) to discuss the healthy living program

(goals, barriers, motivational strategies, etc).

3. Arrange an exercise partner to whom they can compare progress.

4. Have regular reviews with your practitioners.

5. Develop relationships with new friends.

6. Recruit supportive family members to ride the roller-coaster with you, provide

stability.

Reinforcement

Management

1. Encourage family and friends to acknowledge the improvements in health,

behaviours and mood.

2. Identify the benefi ts in health (energy, sleep etc) from being substance free.

3. Close friends and family might be aware of an improvement in mood since

exercising and changing substance use behaviours.

4. Keep a diary of positive comments people are making about your choices or

appearance changes.

5. Examine the benefi ts of better health in terms of time management: less time

sleeping, recovering from a hangover etc.

6. Give yourself health rewards.

7. Family and friends are not worrying about you so much.

Maintenance Processes in this stage aim to reinforce the action stage of behaviour change.

Reinforce behaviour change strategies that maintain healthy behaviours.

Relapse

prevention

1. Set up a system of visual reminders in the bedroom or on the mobile phone.

2. Give an example to young children that drug habits could have an impact on the

child’s future health.

3. Develop a plan if behaviours start to slide.

4. Construct a support system if new behaviours begin to diminish

5. Refl ect on the benefi ts of the change on a regular basis.

6. Plan new and healthy adventures (e.g. holidays, study, work etc).

Section 4 Worksheet 5 (continued)




Case study:

EloiseEloise is a 15-year-old female who lives in a small country town with her parents and older sister. She is

not close to her sister but gets along well with her parents. Eloise does quite well at school and has been

learning to play the guitar for the past four years.

Eloise feels self-conscious about her appearance and very aware of how the other girls at school look and

behave. She has been struggling with being overweight since she started secondary school. She has two

classmates that she spends time with in class and during the breaks. She doesn’t spend any time with them

outside of school. Eloise has never had a boyfriend and feels attracted to another female student at her

school. She has not told anyone as she believes that her friends and family will hate her if she comes out as

being gay.

Her sister’s boyfriend has been supplying her with marijuana for the past six months as he felt sorry

that she didn’t have a social life. Eloise reported that the marijuana helped her to deal with the stress

associated with her poor social life and sexuality.

Eloise has recently been feeling depressed and unlike herself. Whilst the marijuana makes it easier for

Eloise to cope with her sexuality, she is fi nding it harder to concentrate at school and feeling increasingly

distant from her family. She is really unhappy and feels that she wants things to change.

Notes:


Case study:

RachelRachel is a 19-year-old female who has presented to you for help with her smoking at the suggestion of

her partner. She has a nine-month old baby and is not coping with the stress of her new role as a parent.

She fi nds that the baby’s ever-changing routine and demands for attention are wearing her out.

Rachel dropped out of her fi nal year of high school when she found that she was pregnant. She began

working as a receptionist at that time to earn money for when the baby arrived. Since the baby has arrived

her work has allowed her to continue her employment one day a week. Her mother looks after the baby

whilst she works. Rachel currently lives with her partner who is very supportive of her and the baby,

however, he works long days and most of the time Rachel fi nds herself at home caring for the baby alone.

Both Rachel’s parents are supportive, but they want Rachel to take responsibility for the baby herself and

not rely on them for babysitting.

Rachel began smoking as a 15-year-old and only quit when she learnt she was pregnant. The stress of

caring for a child has led Rachel to take up smoking again to calm her nerves during the day. Her partner

is concerned that Rachel’s smoking will harm the baby and has urged her to quit. Rachel agrees with her

partner’s concerns but doesn’t know how to cope without the cigarettes.

Notes:




Action Plan Form

When writing my action plan, I like it to include:

What• I am going to do

How• much I am going to do

When• I am going to do it

How• many days in the week I am going to do it.

Goal

Chew gum instead of smoking. For example, this week I will chew gum (what) everyday (how much) when I feel tempted to

smoke (when) for at least ten minutes or until the cravings reduce (how many).

This week I will:

How confi dent am I that I will achieve this? Circle a number: 1 = not at all sure, 10 = certain

1 2 3 4 5 6 7 8 9 10

DAY TICK OFF COMMENTS

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Tips to help me achieve my goal

Fit my goal into my everyday lifestyle•

Create reminders to help me remember my goal•

Remove temptations•

Use a diary to monitor my progress (such as the table on the front of this page)•

Make a written agreement between me and someone else•

Change my habits bit by bit•

Copy someone else•

Imagine a pleasant scene•

Reward myself when I achieve my goal.•

I can choose to use more than one tip for each goal. Different goals may need different tips.

Reference

Kelly, J., Menzies, D., & Taylor, S. (2003). The Good Life Club: Methodology and study design – a discussion. The Australian Journal

of Primary Health, 9, 186–191.

(what)

(how much)

(when)

(how many times)

Case study:

KatrinaKatrina is a 21-year-old female who has presented to you for help with her drug habit at the

recommendation of her sister. Katrina lives at home with her mother and sister; her father was an alcoholic

and the family no longer have contact with him. Katrina is close to her mother and sister.

Katrina is currently unemployed as she was made redundant when the company in which she was working

was downsized. She receives unemployment benefi ts and spends a lot of her day at home watching TV.

Prior to losing her job, Katrina would regularly go to nightclubs on weekends and spend time with her close

friendship group. Whilst she didn’t have a steady boyfriend, there were always boys interested in dating her.

Katrina started smoking marijuana on a daily basis since being unemployed. Katrina’s sister and her friends

are concerned about her as she rarely leaves the house or socialises. Katrina feels depressed by her life and

feels that her future is hopeless. Katrina recognises that she has a fairly low quality of life and doesn’t want

her friends to worry, but she doesn’t know how to change things.

Notes:





Case study:

TravisTravis is a 20-year-old male who has presented to you because his girlfriend is anxious that he is becoming

addicted to marijuana and wasting his life. Travis completed high school two years ago with moderate

results. He is now concentrating on pursuing a football career full-time in a league-level training squad.

Travis lives at home with his parents and younger sister. Travis is really close to his mum who has recently

been diagnosed with cancer. He used binge drinking to cope with stressful events in his teen years, but is now

using marijuana. Travis feels that smoking marijuana numbs his mind and stops him worrying about his mum.

Travis has noticed that he has been feeling depressed but has not had any suicidal thoughts or experienced

any psychotic episodes. Travis feels as though he is slipping back into the old coping patterns he used as a

teenager and recognises he needs help. He just feels that there is no other way to deal with his mother’s

medical condition.

Notes:

An important aspect of the training in Motivational Interviewing (MI) and Behaviour Change Techniques (BCT) is the

determination of opportunities and supports to practice the skills outside the training session. If we want to be good at

anything, we need to practice. Additionally, the reinforcement of skills learnt in the training cannot be left to chance.

Strategies to reinforce your training:

Identify two specifi c existing or new clients with whom you will use MI & BCT skills at the next session•

Identify a colleague to whom you are going to explain the skills of MI & BCT•

Identify a ‘buddy’ in your work group that you can discuss your progress with the MI & BCT skills•

Make a time in the coming week to meet or telephone•

Discuss your successes and challenges in using MI & BCT with an adolescent client.•

Questions to answer with your colleague:

Did you use refl ective listening and paraphrasing?•

Did you assess the importance and confi dence of the adolescent to change the chosen behaviour?•

Could you identify the adolescent’s stage of change for a specifi c behaviour?•

Did you seek to confi rm your assessment of the stages of change with the adolescent?•

Did you manage your urge to offer solutions too early or unrequested?•

Did you use appropriate processes for the readiness to change?•

Did you use goal setting?•

Did you use an Action Plan form?•

Homework sheet for Module B Motivational Interviewing skills & behaviour change techniques


Section 5Participant Evaluation Form


Section 5 Participant Evaluation Form

Participant Evaluation Form

Participant professional background

Please specify headspace CYS location

1. HOW WOULD YOU RATE THE WORKSHOP IN ASSISTING YOU TO MEET

THE FOLLOWING LEARNING OBJECTIVES?

NOT

MET

= 1

PARTIALLY

MET

= 2

ENTIRELY

MET

= 3

(a) An understanding of effective models of service delivery for young people

with co-morbid mental health and substance use problems based on harm

minimisation

1 2 3

(b) An ability to appropriately use a range of effective interventions for young

people with co-morbid mental health and substance use problems, including

Motivational Interviewing and cognitive-behavioural treatments

1 2 3

(c) An ability to introduce harm reduction strategies appropriately to young

people who present with co-morbid mental health and substance use problems1 2 3

(d) An ability to use Motivational Interviewing appropriately, in order to

resolve ambivalence about changing behaviours and engaging in treatment,

improve the young person’s intrinsic motivation to change and maintain low

levels of treatment resistance

1 2 3

(e) an understanding of relevant behaviour change models, procedures for

assessing readiness to change and how to apply Motivational Interviewing

principles with young people to prepare them for cognitive-behavioural

treatment interventions

1 2 3

(f) An understanding of the cognitive-behavioural model for treatment of co-

occurring mental health and substance use problems1 2 3

(g) an understanding to undertake an assessment, construct a formulation and

determine appropriate forms of cognitive-behavioural intervention for young

people with co-occurring mental health and substance use problems

1 2 3

(h) An ability to provide effective cognitive-behavioural interventions for co-

occurring mental health and substance use problems in young people1 2 3

2. Please rate to what degree your learning needs were met?

1 2 3

Not met Partially met Entirely met

3. Please rate to what degree this activity is relevant to your practice:

1 2 3

Not relevant Partially relevant Entirely relevant

Date: Venue:


4. Please rate the following statements according to what is true for you.

FACILITATOR

STRONGLY

DISAGREE

= 1

DISAGREE

= 2

NEITHER

AGREE

NOR

DISAGREE

= 3

AGREE

= 4

STRONGLY

AGREE

= 5

The facilitator was prepared and delivered

the workshop in a timely manner 1 2 3 4 5

The facilitator’s style was engaging

and interesting1 2 3 4 5

The facilitator was confi dent and

knowledgeable in their presentation1 2 3 4 5

The facilitator was open to further

questioning and provided quality feedback1 2 3 4 5

SLIDE PRESENTATION

The number of slides was appropriate for

the content1 2 3 4 5

The slide presentation was informative

and interesting1 2 3 4 5

The slides presented matched the content

of the discussion and/or activity1 2 3 4 5

APPROPRIATENESS OF CONTENT

There was an appropriate balance between

knowledge and skill development activities1 2 3 4 5

The case studies/role-plays were

relevant and applicable to the content

of the workshop

1 2 3 4 5

The case studies/role-plays contributed

further to my understanding of the

topic discussed

1 2 3 4 5

The content of the training was appropriate

to my work place needs1 2 3 4 5

Notwithstanding my prior knowledge,

the training material was useful

and appropriate

1 2 3 4 5



5. If you rated any of the above items in section 1 as ’Strongly Disagree’ or ’Disagree’ could you please explain why?

6. What changes would you suggest to improve the workshop?

7. Would you like to make any further comments?

Thank you for completing this form.

Please hand the Evaluation Form in to the facilitator prior to leaving the workshop.


Section 6Practice Review Workshop


Refer participants to the following worksheets that form part of the MI & BCT workshop. These are found in Section 4 of the

Participant Manual and include:

Worksheet 2: Motivational Interviewing Techniques•

Worksheet 5: Readiness to Change Stages and Process Sheet•

Worksheet 8: Action Plan Form.•

Inform participants that they will be referring to the information contained in these worksheets as part of discussion throughout

the workshop.

Section 6 Practice Review Workshop

headspace MI & BCT – Participant Manuall 77

Motivational Interviewing &

Behaviour Change Techniques

headspace Practice Review Workshop

Slide 1

Aims of the Practice

Review Workshop

• Reinforce and extend the MI and BCT skills

developed in Module A and Module B

• Build self-efficacy and capacity of

professionals to use the MI and BCT skills

with young people

• Give professionals an opportunity to identify

the success and challenges of using MI and

BCT skills with young people

Slide 2

Section 6 Mini PowerPoint slides & notes pages


Summary of training

Motivational Interviewing

• Communications: reflective listening,

paraphrasing

• Importance & confidence of behaviour

change: 1–10 scale

• Looking forward

• Previous successes

Stages of readiness to change behaviour

• Pre-contemplation, contemplation,

preparation, action, maintenance

Slide R1

Summary of training

Processes of change

• Awareness raising, reflection of self and

others on behaviour change

• Preparation and placing in action behaviours

for change

• Monitoring, cues for action, control of

temptations, social support

Goal setting

• Relevant to stage of readiness to change

Slide R2



Homework from workshop




explain MI skills

3. Identify a ‘buddy’ in your work group that you

can discuss your progress with the MI skills

• Make a time in the coming week to meet

or telephone

• Discuss your successes and challenges

in using MI with a young client

Slide R3

Homework from workshop


• Did you use reflective listening and paraphrasing?

• Did you assess the importance and confidence

of the young person to change the chosen

behaviour?

• Could you identify the young person’s stage

of change for a specific behaviour?



• Did you manage your urge to offer ‘solutions’

too early or unrequested?

Slide R4



Activity:

Review of skill development

Each practitioner to report in turn on:

•Key successes and challenges in using Motivational

Interviewing and Behaviour Change Techniques with

their clients

•Discussing the training with colleagues

•Adapting the skills within professional current

practice

•Using skills within the organisational structure

of the workplace

Slide R5

Additional topics for

discussion

• Future support for skill development

• Opportunities and needs for further training

Slide R6



Thank you for participating in the

headspace Motivational Interviewing and

Behaviour Change Techniques workshop

Practice Review follow-up session

Any final comments?

Slide R7


mh - motivational interviewing techniques

Documents