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 Style (Random Assignment) & Client Response 43.6 45 40 35 30 Client Behavior 25 Counts 21.6 21.3 Change Talk 20 12.7 15 Resistance 10 5 0 Directive Empathic Miller,W . R., Benefield, R. G., &T onigan, J. S. (1993). Enhancing motivation for change in problem drinking:A controlled comparison of two therapist styles. Journal of Consulting and Clinical Psychology, 61, 455-461.
160 Obesity n = 150 Dental 140 Asthma Violence 120 Family Health Prom 100 Psychiatric Diabetes n = 93 Cardiac 80 HIV Smoking/Tob 60 Adh/Retention n = 54 Eating Dis Offenders n = 36 Gambling 40 Dual Dx 20 n = 6 AOD 0 1988‐94 1995‐99 2000‐02 2003‐06 2007‐09
Motivational Interviewing MI is a collaborative conversation style for strengthening a Layperson’s person’s own motivation and commitment to change (What is it for?) MI is a person ‐ centered counseling style for addressing the Practitioner's common problem of ambivalence about change (How would I use it?) MI is a collaborative, goal ‐ oriented style of communication with Technical 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?)
Collaboration Acceptance - Absolute worth MI - Accurate Compassion empathy Spirit - Autonomy - Affirmation Evocation
Four Planning Foundational Processes Evoking Focusing Engaging
Flow of Change Talk D esire C ommitment A bility A ctivation Change R easons T aking Steps N eed +/- (DARN) (CAT)
(1) (2) (3) (4) (5) Weakest Weak Moderate Stronger Strongest I hope to I favor I look forward to I am devoted to I guarantee I will try I believe I consent to I pledge to I will I think I will I accept plan to I agree to I promise I suppose I will I aim I resolve to I am prepared to I vow I imagine I will I aspire I expect to I intend to I shall I suspect I will I am inclined I concede to I am ready to I give my word I will consider I anticipate I declare my intention to I assure I guess I will I predict I dedicate myself I know I will I will see (about) I presume
O pen question A ffirmation R eflective Listening-Remember that the learnable skills of reflective listening is Accurate Empathy- S ummary
Skills & Strategies Eliciting & Open Reflections Affirmations Summaries Responding Questions To Change Talk Processes Focusing Planning Engaging Evoking Spirit Partnership Acceptance Compassion Evocation Miller and Rollnick, 2013
0.9 0.77 0.8 0.7 0.6 0.5 0.31 0.4 0.3 0.3 0.2 0.1 0 End of Treatment 4-6 M onths 7-12 M onths Hettema et al. 2005, Annual Review ofClinical Psychology, 1 , 91-111.
MI Training Increased MI Feedback & In- Fidelity vivo Coaching Increased Behavior Patient Change Change Talk
Recommend
More recommend
