motivational interviewing: elicit change talk
TRANSCRIPT
Motivational Interviewing
Session 2: Elicit and Strengthen Change Talk
Stephen R. Andrew, LCSW LADC CCS
An MI Conversation
Target/purpose
Express empathy
OARS
Develop discrepancy/Amplify
ambivalence
Change talk/ “Change Theory”
Change plan
Commitment language
Goal-Oriented Interventions
Empathic reflection
Elicit, options, elicit...
Importance, confidence and ruler
Remember: We are responsible for the intervention, not the outcome
Find Out Where the Patient isMeet them where they are
Continuum of ambivalence
Explore importance and confidence
Readiness Ruler
Importance. How important is it for you right now to prevent illness? On a scale of 1-10, how important is it?
1-------------------------------10
How come you are a ___ and not a ___? What would it take to go from __ to __?
Confidence Ruler
Confidence. How confident are you that you could complete a colon cancer screening test?
How come you are a ___ and not a ___? What would it take to go from __ to __?
Strategies to Increase Importance and
ConfidenceELicit & reflect change talk
Explore goals & values
Highlight personal strengths & supports
Brainstorm solutions
Hypothetical change (“I wonder if...”)
Resistance or Change Talk?
“I want to lose weight.”
“I’d like to spend less money.”
“I could if I wanted to, but I don’t really want to.”
Resistance or Change Talk?
“I wish people understood me better.”
“I want to get along with my wife.”
“I wish my parents would stop nagging me.”
Resistance or Change Talk?
“I don’t want the colonoscopy but I need to do it for my family.”
“I don’t want to go looking for trouble with those tests. I feel fine.”
“I’m scared. But if you tell me I need it, I will do it.”
