Funded by: www.sbirtonline.org Alan Lyme, LCSW Sylvia Shellenberger, PhD Southeastern Consortium for Substance Abuse Training – Advanced Practice Registered Nurses Funded by Grant 1U79T1025372-01 Substance Abuse and Mental Health Services Administration (SAMHSA) Last revised: March 31, 2014 Motivational Interviewing The Basics Funded by: SECSAT-APRN Southeastern Consortium for Substance Abuse Training - Advanced Practice Registered Nurses
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Funded by: www.sbirtonline.org
Alan Lyme, LCSW
Sylvia Shellenberger, PhD
Southeastern Consortium for Substance Abuse Training – Advanced Practice Registered Nurses
Funded by Grant 1U79T1025372-01
Substance Abuse and Mental Health Services Administration (SAMHSA)
Last revised: March 31, 2014
Motivational InterviewingThe Basics
Funded
by:
SECSAT-APRNSoutheastern Consortium for Substance Abuse Training -
Advanced Practice Registered Nurses
Key Contributors &SECSAT – APRN Site Coordinators
Mercer University, School of MedicineJ. Paul Seale, MD
Principal Investigator
Annie Biers, LPC, Project Coordinator
Sylvia Shellenberger, PhD
Mercer University, Georgia Baptist College of NursingDr. Frieda Fuller Dr. Laura K. Baraona
“Motivational interviewing is a patient-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.”
Miller & Rollnick, Motivational Interviewing: Helping People Change, 3rd edition, 2013
Not acceptance of unhealthy behaviors or high risk lifestyle, but acceptance of the person who is struggling with competing needs, feelings and concerns.
Empathy is the ability to see that to struggle with shortcomings is to be human.
Empathy is also the ability to recognize that everyone has strengths, and small strengths can pull us through bad times.
• Speaker (Partner A) share something about yourself – where you are from, what kind of work you do, what you like about your life (home, family, work).
Example: “You enjoy your work, and doing well in your job is very important to you, and sometimes when you drink during the week, you can’t get out of bed to get to work. Last month, you said you missed 5 days.”
Dance with Discord So as to avoid patients thinking…
When will
this be
over?You’re wrong
Yes, but...
If I just play along…45
Traditionally viewed as patient denial or resistance
– “I don’t think my drinking is that bad.”
Now thought to be a product of a practitioner who utilizes a confrontational interviewing style –creating discord
– “Can’t you see that your drinking is seriously damaging your liver?”
Motivational Interviewing in Health Care Settings: Opportunities and Limitations. Karen M. Emmons, PhD, Stephen Rollnick, PhD. Am J Prev Med 2001;20(1) 68-74
Dance with Discord Confrontation may have a deleterious impact on
patient self-efficacy
– The more practitioners confront patients about their drinking, the more patients drink at follow-up
An empathic approach builds self-efficacy
Practitioners are more effective if they elicit arguments for change from the patients themselves
Motivational Interviewing in Health Care Settings: Opportunities and Limitations. Karen M. Emmons, PhD, Stephen Rollnick, PhD. Am J Prev Med 2001;20(1), 68-74