Therapist Empathy 60 Miller,Taylor &West (1980) Client - - PowerPoint PPT Presentation

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Jun 13, 2023 126 likes •478 views

Therapist Empathy 60 Miller,Taylor &West (1980) Client Drinking Outcomes Accounted for by Therapist Empathy 6 months 1 year 2 years r = .82 r = .71 r = .51 26% 67% 52% Miller & Baca (1983) BehaviorTherapy 14 : 441-448 Counselor

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Therapist Empathy

Miller,Taylor &West (1980)

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Client Drinking Outcomes Accounted for by Therapist Empathy

6 months r = .82 1 year r = .71 2 years r = .51

Miller & Baca (1983) BehaviorTherapy 14: 441-448

67% 52% 26%

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Counselor Style (Random Assignment) & Client Response

30 25 20 15 10 5 45 40 35 Directive Empathic

Miller,W . R., Benefield, R. G., &T

nigan, J. S. (1993). Enhancing motivation for change in problem drinking:A controlled comparison of two therapist styles. Journal
f Consulting and Clinical Psychology, 61, 455-461.

21.3 43.6 21.6 12.7

Client Behavior Counts Change Talk Resistance

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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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Layperson’s

MI is a collaborative conversation style for strengthening a person’s own motivation and commitment to change (What is it for?)

Practitioner's

MI is a person‐centered counseling style for addressing the common problem of ambivalence about change (How would I use it?)

Technical

MI is a collaborative, goal‐oriented style of communication with particular emphasis to the language of change. It is designed to strengthen personal motivation for and commitment to a specific behavior by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion (How does it work?)

Motivational Interviewing

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Collaboration Compassion Evocation

Acceptance

Absolute worth
Accurate

empathy

Autonomy
Affirmation

MI Spirit

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Planning Evoking Focusing Engaging Four Foundational Processes

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Desire Ability Reasons Need (DARN)

Flow of Change Talk

Commitment Activation Taking Steps (CAT) 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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Open question Affirmation Reflective Listening-Remember that the learnable skills of reflective listening is Accurate Empathy- Summary

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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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0.77 0.31 0.3

0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 End of Treatment 4-6 M onths 7-12 M onths

Hettema et al. 2005, Annual Review ofClinical Psychology, 1, 91-111.

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MI Training Feedback & In- vivo Coaching Increased MI Fidelity Behavior Change Increased Patient Change Talk

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