MOTIVATIONAL INFLUENCE (A N EW A PPROACH TO C OUNSELING ) Douglas L. - - PowerPoint PPT Presentation
MOTIVATIONAL INFLUENCE (A N EW A PPROACH TO C OUNSELING ) Douglas L. Beck, Au.D. Board Certified Audiologist photo Director of Professional Relations Oticon, Inc., Somerset, NJ dmb@oticonusa.com S TATUS Q UO S ERGEI K OCHKIN M ARKE T RAK VIII
Douglas L. Beck, Au.D. Board Certified Audiologist Director of Professional Relations Oticon, Inc., Somerset, NJ dmb@oticonusa.com
SERGEI KOCHKIN MARKETRAK VIII HEARING REVIEW, OCTOBER 2009
HEARING AID MARKET PENETRATION RATES: CONVENTIONAL, PRACTICAL, AND TAX CREDITS
AMLANI (2010) FEDERAL SUBSIDIES & U.S. HEARING AID MARKET PENETRATION RATE. AUDIOLOGY TODAY 22(3):40-46
SURVEY OF CURRENT BUSINESS PRACTICES REVEALS OPPORTUNITIES FOR IMPROVEMENT.
BRIAN TAYLOR. HEARING JOURNAL, SEPTEMBER 2009
approx 50% do NOT acquire hearing aids.
VAST OPPORTUNITY TO IMPROVE!!!!!!!!!
a different result…
Let’s explore a few different ways to manage this situation…
There are no outcomes-or-evidenced-based studies which scientifically determined the best, most pragmatic or most efficient way to dispense amplification! We do what we do because that’s how we were taught to do it!
Fortunately… people do want to improve/maximize their personal QUALITY OF LIFE!
How to ETHICALLY influence people to make decisions (truly) in their own best interest and to improve the quality of their lives!
Giving back, shaking hands, salutations, charitable groups, sending trinkets. Trial periods with amplification.
Wanting more of what you can only have less of. The perception of scarcity increases demand and desirability. Combine products and skills, dentists, optometrists…
Knowing the professional is an authority, display credentials, certificates etc
People want to be consistent. Words predict behaviors. Important part of Motivational Interviewing
People like to work with people they like. Genuine two way street. Friendly, not threatening.
Seek others JUST LIKE ME, scrapbooks, testimonials
Freud: All major decisions involve ambivalence. The co-existence of opposing thoughts. Love/Hate, Yin/Yang, Yes/No, Good/Bad, Right/Wrong.
Empathy (skillful reflective listening) Develop the Discrepancy (examine the differences between the status quo and the desired goal) Roll with Resistance (do not oppose resistance) Support Self Efficacy (the belief in the ability to change is powerful)
BUILDING MOTIVATIONAL INTERVIEWING SKILLS – A PRACTITIONER WORKBOOK ROSENGREN, DB. (2009): THE GUILFORD PRESS
MI Principles:
R - Resist the RIGHTING REFLEX U - Understand your patient’s motivation L - Listen to the patient (reflective listening) E - Empower your patient
BUILDING MOTIVATIONAL INTERVIEWING SKILLS – A PRACTITIONER WORKBOOK ROSENGREN, DB. (2009):
Metaphorically… Traditional counseling is like wrestling … MI is like ballroom dancing
FROM: BUILDING MOTIVATIONAL INTERVIEWING SKILLS – A PRACTITIONER WORKBOOK ROSENGREN, DB. (2009): THE GUILFORD PRESS
Match your strategy to their readiness to change. Our goal is to move them along the readiness continuum.
Change Is Really Hard Addictive behaviors persist despite negative outcomes. Increasing the severity of the negative outcome doesn’t alter the negative behavior. Heart attacks, imprisonment, hangovers, drunk driving, lung cancer, obesity, diabetes, high blood pressure… People don’t always do what’s in their own best interest.
Change talk is impacted by the style of counseling and the relationship with the counselor. Confrontational styles increase resistance. Dose (length and number of sessions) is irrelevant. Ask the RIGHT questions. Don’t ask the WRONG questions.
IS THIS REALLY THE BEST QUESTION TO ASK AN
ALCOHOLIC?
IS THIS REALLY THE BEST QUESTION TO ASK SOMEONE
WHO’S BEEN REFERRED IN?
“DO YOU HAVE A PROBLEM HEARING?”
The problem is the kids mumble … wife doesn’t speak clearly … mobile phones are terrible … nobody speaks clearly anymore … When I was a lad we were taught to speak clearly …. blah, blah, blah …
Do you think you have hearing loss?
Do you think you need hearing aids?
Does your hearing loss cause problems?
Are you concerned about your hearing loss?
How does that sound?
What caused your hearing loss?
Has your hearing loss gotten worse?
How long have you had hearing loss?
Which is worse; a noisy cocktail party or a noisy restaurant?
Who’s voice is the hardest to understand?
Many of my patients with similar hearing loss tell me women’s and children’s voices are very difficult… Is that true for you, too?
How long have you had difficulty hearing?
When you push, they pull…
Don’t challenge them, don’t draw a line in the sand, don’t back them into a corner.
DO NOT USE THE AUDIOGRAM AS A WEAPON!
Don’t be in such a hurry to help …
On average, physicians interrupt their patients how often?
Before you speak, it is necessary to listen…. “They may not remember what you said or did, but they will remember how you made them feel.
RECOGNIZING PROCESS FOR THE INDIVIDUAL
Gitte Engelund Oticon’s Research Centre
If you intercede before the patient is ready to explore and accept amplification, the chances of success diminish.
The professional should get the PATIENT to do most of the
gonna do…
AND ADMINISTER A QUESTIONNAIRE?”
Suicidal verbalizations Expressions of hopelessness Tearfulness Manifestations of rage Person withdrawing from pleasurable activities Sleep disturbance Isolation (“No one understands”) Recent significant losses, e.g., spouse Abrupt change of behavior
HEALTH PROFESSIONAL
Douglas L. Beck, Au.D. Board Certified Audiologist Director of Professional Relations Oticon, Inc., Somerset, NJ dmb@oticonusa.com These presentations slides will be available at ihsinfo.org To be eligible for CE credit Be sure to have your Attendance Form hole-punched as you exit!