Directing <=> Guiding <=> Following - - PowerPoint PPT Presentation

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Dec 23, 2023 184 likes •459 views

Directing <=> Guiding <=> Following Behavior therapy Cognitive therapy Dr. Phil????? Motivational interviewing Solution-focused therapy Psychodynamic psychotherapy Directing <=> Guiding <=>

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Directing <=> Guiding <=> Following

Behavior therapy Cognitive therapy

Dr. Phil?????

Motivational interviewing Solution-focused therapy Psychodynamic psychotherapy

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Directing <=> Guiding <=> Following

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The Spirit of MI

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Planning Evoking Focusing Engaging Four Foundational Processes

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Open question Affirmation Reflective Listening-Remember that the learnable skills of reflective listening is Accurate Empathy- Summary

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▪ Change talk: any patient speech which favors movement in the direction of change on a particular behavior ▪ Shows up as natural language ▪ Several types ▪ Sustain talk: maintaining status quo

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DARN

Desire to change (want, wish, hope) Ability to change (can, could) Reason to change (if… then) Need to change (have to, got to)

Mobilizing Change Talk: CAT

Commitment to change (I will, I’m going to) Activation (I’m preparing, I’m ready) Taking steps (I already…)

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Desire Ability Reasons Need (DARN)

Flow of Change Talk

Commitment Activation Taking Steps (CAT) Change

+/-

=

Change

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(1) Weakest (2) Weak (3) Moderate (4) Stronger (5) Strongest

I hope to I will try I think I will I suppose I will I imagine I will I suspect I will I will consider I guess I will I will see (about) I favor I believe I accept I aim I aspire I am inclined I anticipate I predict I presume I look forward to I consent to plan to I resolve to I expect to I concede to I declare my intention to I dedicate myself I am devoted to I pledge to I agree to I am prepared to I intend to I am ready to I guarantee I will I promise I vow I shall I give my word I assure I know I will

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In MI, the practitioner’s task is to:

a. Recognize change talk
b. Proactively elicit it, and
c. Strategically respond to

it.

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50000 40000 30000 20000 10000 1983 1987 1991 1995 1999 2003 2007 2011 2015 Annual Cumulative

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160 Obesity Dental n = 150 120 140 Asthma Violence Family 100 Health Prom Psychiatric Diabetes Cardiac HIV Smoking/Tob Adh/Retention Eating Dis Offenders Gambling Dual Dx n = 93 60 80 n = 54 20 40 n = 6 n = 36 1988‐94 1995‐99 2000‐02 2003‐06 2007‐09 AOD

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Partnership Acceptance Compassion

Spirit

Engaging Planning Evoking Evocation

Processes

Open Questions Reflections Affirmations Summaries

Eliciting & Responding To Change Talk

Skills & Strategies

Miller and Rollnick, 2013

Focusing

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