Motivational Interviewing: Class I and 2 Combined

Key concepts of Motivational Interviewing: techniques (OARS, DEARS, FRAMES, DARNCAT), and the role of the CRSS/CPRS.

What is Motivational Interviewing (MI)?

Motivational Interviewing is a collaborative, goal-oriented style of communication designed to strengthen a person's own motivation and commitment to change.

What is the role of the CRSS in Motivational Interviewing?

to help the individual to identify and use strategies to prevent relapse, whether it is with substances or with mental illness, and help develop the individual learn skills to support their progress.

What Motivational Interviewing IS:

Relationship based, Empathy, Collaboration, Evoking, Focusing on ambivalence, Majoring on “change talk”, and “Dancing” – with the patient’s fears about attempting change.

What should a CRSS support to help clients move toward positive changes in their recovery?

A CRSS should support clients by helping them recognize their strengths, explore motivations for change, and provide emotional support, all while respecting their pace and decisions.

What does O.A.R.S. stand for?

Open-ended questions, Affirmations, Reflective-Listening, Summaries

What is an affirmation in Motivational Interviewing?

A statement that recognizes and reinforces a client’s strengths, efforts, or positive behaviors.

What are the two main parts of Reflective Listening?

Mirroring and Paraphrasing

What does D.E.A.R.S. stand for?

Develop Discrepancy, Express Empathy, Avoid Being Argumentative, Roll with Resistance, Support Self-Efficacy

What does F.R.A.M.E.S. stand for?

Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy

What are the steps in the Elicit-Provide-Elicit process?

Elicit, Provide, Elicit

Benefits of using motivational interviewing DO NOT include:

It coerces clients into change

Motivational Interviewing is NOT

Solving the patient’s problem.

Motivational Interviewing supports the person in expressing:

Ambivalence about change

What is a S.M.A.R.T goal?

A framework for setting Specific, Measurable, Achievable, Relevant, and Time-bound goals.

What is an “I” statement?

An “I” statement is a way of expressing your thoughts, feelings, and needs without blaming or criticizing others.

Motivation in Treatment

Motivation is essential to substance use and mental health behavior change. It is multi-dimensional, dynamic, and changeable.

Benefits of using motivational interviewing DO NOT include:

Forcing clients to accept treatment recommendations

What is an open-ended question?

An open-ended question is a question that encourages a detailed, thoughtful response, rather than a simple “yes” or “no.”

What are examples of affirmations?

“You’ve taken an important first step by coming here today”

Reflective listening is a process of:

Hearing what the speaker is saying, making a "guess" at what they mean and verbalizing the "guess” in the form of a statement.

What are summaries?

"Here is what I learned. Tell me if I've missed anything...."

The Importance of Values: "The Hook": Help them identify their individual values by asking questions like:

What makes your life worth living?

The 5 A's of Motivational Interviewing:

Ask: Ask for permission to discuss the issue and Explore readiness for change. Advise: Explain the benefits of changes in behavior. Assess: Assess the client’s readiness for change. Assist: Provide education and resources. Arrange: Arrange for visits with other providers or other visits with you.

What does D.E.A.R.S. stand for in MI?

Develop Discrepency, Express Empathy, Avoid Being Argumentative, Roll with Resistance, Support Self-Efficacy

The Guiding R.U.L.E. Philosophy of Motivational Interviewing 

Reject the righting reflex, Understand the person's motivation, Listen to the person, Empower the person

Principles of Motivational Interviewing P.A.C.E.

Partnership, Acceptance, Compassion, Evocation

What is the motivational process?

Engage, Focus, Evoke, Plan

Ambivalence in Recovery

Ambivalence: the mixed thoughts, doubts and feelings surrounding the idea of change, and contradictory feelings towards recovery.

Examples of Ambivalence

Person is unwilling or resistant to change.

What does D.A.R.N.C.A.T stand for?

Desire, Ability, Reasons, Need, Commitment, Activation, Taking Steps

What is feedback?

Feedback: Involves the exchange of information between the CRSS and the client. Ask for information from the client by asking open-ended questions and helping them to open-up more with sharing your lived experience.

Responsibility:

It is the client's role, not the CRSS, to take responsibility for making the change.

Stages of Change

Precontemplation, Contemplation, Preparation, Action, Maintenance

Stages of Change

A stage in which the person is not yet considering change or is unaware that their behavior is a problem.

What is contemplation?

Acknowledging that there is a problem but feeling ambivalent or unsure about changing it

What is preparation?

The stage in which the person has decided to make a change and is preparing to take action by planning and gathering the necessary resources.

What is the action stage?

The stage in which the person actively implements their plan to change behavior, taking tangible steps toward their goal.

What is the maintenance stage?

The stage in which the person has made a change and is working to sustain that change over time, preventing relapse and maintaining new behaviors.