MOTIVATIONAL INTERVIEWING & STAGES OF CHANGE

Presented by: Linda Hamilton, LPC, LMFTRegion Ten Community Services BoardFor Charlottesville Health Summit 2010

WHAT IS IT?

Motivational Interviewing is…•A technique to help people recognize and do something about their present or potential problems.

•The primary goal is to assist individuals moving through the Stages of Change

•Particularly useful with individuals who are reluctant or ambivalent about changing.

•Intended to help resolve ambivalence and to motivate the individual to pursue rather than avoid change.

STAGES OF CHANGE

• Precontemplation• Contemplation• Preparation• Action• Maintenance

• Relapse

Precontemplation

Contemplation

Preparation

Action

Maintenance

RELAPSE

Developed by Prochaska & DiClemente, 1984, adapted by Linda Hamilton, 2002

GUIDING PRINCIPLES

• No debates!– Do not argue with the individual or attempt to judge their goals or plans.

Arguing only increases defensiveness and resistance.• Support self-efficacy; respect their decision not to change.

– You have to believe that the person can change, but also respect their decision not to. You cannot force someone else to change; it has to come with from within the individual. If they are not ready, they are not ready.

• See situation through their eyes.– Put yourself in his/her position; walk a few steps in their shoes. Understand

that his/her life experiences are different from yours and attempt to listen without judgment.

• Express accurate empathy.– Truly listen to what the individual is saying. Don’t assume you know or be in

such a hurry to get to what you want to say that you miss important messages.

GUIDING PRINCIPLES(continued)

• Roll with resistance.– Do not focus on their resistance; you don’t even have to acknowledge it. Just

let them express it and continue on. Become skilled at deflecting the resistance; step aside and let it roll on by.

• Look for and leverage discrepancies.– This is one of the most important principles. The individual will give your clues

that what they are doing is not what they necessarily want. Amplify in the person’s own mind the discrepancy between present behavior and stated goals. Ask for what is most important.

• Listen reflectively.– Repeat back to the individual what you heard him/her say. Reflect their

feelings. Check for accuracy.• Force them to choose.

– Decisional balance. Paradox. Use extremes. You can’t have it both ways!