The Language of Change Presented by Brett Dowdy PsyD Why do people Change Given a choice between changing and proving that it is not necessary most people get busy with the proof ID: 459015
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Slide1
Motivational Interviewing:
The Language of Change
Presented by
Brett Dowdy,
Psy.D
.Slide2
Why do people Change
?Slide3
“Given a choice between changing and proving that it is not necessary, most people get busy with the proof.” John GalbraithSlide4
Components of
Change
Resistance
Ambivalence
MotivationSlide5
“People often get stuck, not because they fail to appreciate the down side of their situation, but because they feel at least two ways about it.”
Miller &
RollnickSlide6
Choose a partner.One will be the speaker & one the interviewer.Identify something you want to, need to or should change about yourself but haven’t – something you’re ambivalent about!
Ambivalence ExperimentSlide7
Interviewer – Find out what change the person is considering, and then:Explain why the person should make the change.
Give at least 3 specific
benefits
that would result from making the change.
Tell the person
how
they could make the change.
Emphasize how
important it is to change.
Persuade the person to do it.If you meet resistance, repeat the above.Ambivalence ExperimentSlide8
MI is a collaborative, goal-oriented style of communication with a particular attention to the language of change.
It is designed to strengthen personal motivation for and commitment to a specific goal by
eliciting and exploring
the person’s own reasons for change within an atmosphere of
acceptance and compassion.
Motivational InterviewingSlide9
Moving individuals toward change!
Essential Ingredients:Slide10
Change Talk - words that favor moving in the direction of change
Sustain Talk
- words that favor leaving things the way they are
Change Talk
vs.
Sustain Talk
Listening Strategically:Slide11
Invite the client to argue for change!
Explore
DARN-CATs
Preparatory Change Talk
D
esire – want, prefer, wish, etc.
A
bility – able, can, could, possible
R
easons – specifics for change (i.e., Why do it? What would be good?)Need – important, have to, need to, got to
Implementing Change Talk
C
ommitment – intention, decision, promise
A
ctivation – willing, ready, preparing
T
aking
S
teps
Change TalkSlide12
Plucking Change Talk from the Jaws of Ambivalence
“I really don’t want to do another treatment program,
but I know that I should. I’ve tried them before and
it’s really hard to leave my family.”
Would you say:
You really don’t want to get better.
It’s pretty clear to you that you ought to give it another try.
You’re not sure you can do it again. It’s been so hard.
Recognizing
Change TalkSlide13
Plucking Change Talk from the Jaws of Ambivalence
“You know, I’ve been able to accomplish a lot of things
in my life, but this one is just too big for me. Every
time I think I’ve got it beat, it comes back to bite me.
I’m no match for cocaine. It gets me every time.”
What might you say to elicit change talk?
Eliciting
Change TalkSlide14
Plucking Change Talk from the Jaws of Ambivalence
“I just don’t agree that my drinking is a problem for me.
My mom over-reacts and then she gets my dad to take
her side. They need to loosen up a little. It might not
be a bad idea for me to cut down a little during
the week – get rid of those morning
jitters – but stop completely – no way! ”
What might you say to elicit change talk?
Eliciting
Change TalkSlide15
Strategic use of questions to elicit change talk:What concerns you about your current situation?What strengths are present that makes change possible for you?How does your behavior interfere with who you want to be?What do you think will happen if you don’t make a change?
Open Ended
QuestionsSlide16
Other Strategies to Elicit
Change
TalkSlide17
PROS (Behavior)_____________________________________________
CONS (Behavior)
_______________
_______________
_______________
PROS (Change)
_______________
_______________
_______________CONS (Change)
______________________________ _______________No Change Change
Decisional Balance WorksheetSlide18
Do you remember a time when you weighed a good weight for you? What was it like then?
What were things like before you stopped exercising?
What are the differences between the John of 10 years ago and the John today?
How has your weight stopped you from doing things you might want to do?
Looking BackSlide19
If you make a change, what do you hope to be different?How would you like things to be 10 years from now?
It seems like you are anxious about how things are with you now, how would you like things to be different?
Suppose you don’t make any changes and just continue as you are now, what do you think your life will be in 5 years from now?
Given how you feel now, if you don’t make any changes, how do you think you will feel a year from now?
Looking ForwardSlide20
What are the worst things that might happen if you don’t make this change?
What are the best things that might happen if you do make this change?
Query ExtremesSlide21
Ask, “On a scale from zero to ten, how important is it to you to [target change]
-
where zero is not at all important, and ten is extremely important?
Follow up: And why are you at ___ and not zero?
What might happen that could move you from ____ to [higher score]? Instead of “how important”
(need), you could also ask how much you want (desire), or how confident you are that you could (ability), or how committed are you to ____ (commitment). Asking
“
how ready are you?”
tends to be confusing because it combines competing components of desire, ability, reasons and need.
Change RulerSlide22
Ask what the person’s guiding values are.
What do they want in life? If there is a “problem
”
behavior, ask how that behavior fits in with the
person’s goals or values. Does it help realize a
goal or value, interfere with it, or is it irrelevant?
Explore Values & GoalsSlide23
Explicitly side with the negative (status quo) side of
ambivalence. “Perhaps ____________ is so important to you that you won
’
t give it up, no matter what the cost.”
Coming AlongsideSlide24
“They say you can lead a horse to water, but you can’t make him drink …but I say, you can salt the oats.”
Madeline HunterSlide25
www.motivationalinterview.org
Motivational
Interviewing:Preparing
People for Change
. William R. Miller & Stephen
Rollnick
. 2
nd
Edition. Guilford Press
www.lindnercenterofhope.org 513-536-HOPE (4673)