MOTIVATIONAL INTERVIEWING BOOK
Motivational Interviewing: Helping People Change, 3rd Edition (Applications of Motivational Interviewing): Medicine & Health Science Books. Editorial Reviews. Review. "A superb, readable guide to theory and practice. MI has ppti.info: Motivational Interviewing, Third Edition: Helping People. Voted one of the 10 Most Influential Books by Psychotherapy Networker readers! Sign up for e-alerts on upcoming titles on Motivational Approaches (with.
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Compre o livro Motivational Interviewing: Helping People Change na Amazon. ppti.info: confira as ofertas para livros em inglês e importados. Motivational Interviewing book. Read 78 reviews from the world's largest community for readers. This bestselling work has introduced hundreds of thousand. Providing tools to enhance treatment of any clinical problem, this book shows how integrating motivational interviewing (MI) and cognitive-behavioral therapy.
Maybe we can help him learn how to tell you he loves you and is worried about you in a more positive and acceptable way. In another example, the concept of relative tolerance to alcohol provides a good opportunity for reframing with problem drinkers Miller and Rollnick, Many heavy drinkers believe they are not alcoholics because they can "hold their liquor. Thus, reframing is not only educational but sheds new light on the client's experience of alcohol.
Rolling With Resistance Momentum can be used to good advantage. Perceptions can be shifted. New perspectives are invited but not imposed. The client is a valuable resource in finding solutions to problems.
Siding with the negative One more strategy for adapting to client resistance is to "side with the negative"--to take up the negative voice in the discussion. This is not "reverse psychology," nor does it involve the ethical quandaries of prescribing more of the symptom, as in a "therapeutic paradox. If your client is ambivalent, your taking the negative side of the argument evokes a "Yes, but Be cautious, however, in using this too early in treatment or with depressed clients. Client: Well, I know some people think I drink too much, and I may be damaging my liver, but I still don't believe I'm an alcoholic or in need of treatment.
Clinician: We've spent considerable time now going over your positive feelings and concerns about your drinking, but you still don't think you are ready or want to change your drinking patterns.
Maybe changing would be too difficult for you, especially if you really want to stay the same. Anyway, I'm not sure you believe you could change even if you wanted to.
Support Self-Efficacy Many clients do not have a well-developed sense of self-efficacy and find it difficult to believe that they can begin or maintain behavioral change.
Improving self-efficacy requires eliciting and supporting hope, optimism, and the feasibility of accomplishing change. This requires you to recognize the client's strengths and bring these to the forefront whenever possible. Unless a client believes change is possible, the perceived discrepancy between the desire for change and feelings of hopelessness about accomplishing change is likely to result in rationalizations or denial in order to reduce discomfort.
Because self-efficacy is a critical component of behavior change, it is crucial that you as the clinician also believe in your clients' capacity to reach their goals. Discussing treatment or change options that might still be attractive to clients is usually helpful, even though they may have dropped out of other treatment programs or returned to substance use after a period of being substance free.
It is also helpful to talk about how persons in similar situations have successfully changed their behavior. Other clients can serve as role models and offer encouragement. Nonetheless, clients must ultimately come to believe that change is their responsibility and that long-term success begins with a single step forward. The AA motto, "one day at a time," may help clients focus and embark on the immediate and small changes that they believe are feasible.
Education can increase clients' sense of self-efficacy. Credible, understandable, and accurate information helps clients understand how substance use progresses to abuse or dependency.
Making the biology of addiction and the medical effects of substance use relevant to the clients' experience may alleviate shame and guilt and instill hope that recovery can be achieved by using appropriate methods and tools. A process that initially feels overwhelming and hopeless can be broken down into achievable small steps toward recovery. Self-Efficacy Belief in the possibility of change is an important motivator.
The client is responsible for choosing and carrying out personal change. There is hope in the range of alternative approaches available. Five Opening Strategies For Early Sessions Clinicians who adopt motivational interviewing as a preferred style have found that the five strategies discussed below are particularly useful in the early stages of treatment.
They are based on the five principles described in the previous section: express empathy, develop discrepancy, avoid argument, adjust to rather than oppose client resistance, and support self-efficacy. Helping clients address their natural ambivalence is a good starting point.
These opening strategies ensure your support for your client and help the client explore ambivalence in a safe setting. The first four strategies, which are derived from client-centered counseling, help clients explore their ambivalence and reasons for change. The fifth strategy is specific to motivational interviewing and integrates and guides the other four. In early treatment sessions, determine your client's readiness to change or stage of change see Chapters 1 , 4 , and 8.
Be careful to avoid focusing prematurely on a particular stage of change or assuming the client is at a particular stage because of the setting where you meet. As already noted, using strategies inappropriate for a particular change stage or forming an inaccurate perception regarding the client's wants or needs could be harmful. Therefore, try not to identify the goals of counseling until you have sufficiently explored the client's readiness.
Ask Open-Ended Questions Asking open-ended questions helps you understand your clients' point of view and elicits their feelings about a given topic or situation. Open-ended questions facilitate dialog; they cannot be answered with a single word or phrase and do not require any particular response. They are a means to solicit additional information in a neutral way.
Open-ended questions encourage the client to do most of the talking, help you avoid making premature judgments, and keep communication moving forward see Figure Listen Reflectively Reflective listening, a fundamental component of motivational interviewing, is a challenging skill in which you demonstrate that you have accurately heard and understood a client's communication by restating its meaning.
That is, you hazard a guess about what the client intended to convey and express this in a responsive statement, not a question. Reflective listening strengthens the empathic relationship between the clinician and the client and encourages further exploration of problems and feelings.
This form of communication is particularly appropriate for early stages of counseling. Reflective listening helps the client by providing a synthesis of content and process.
It reduces the likelihood of resistance, encourages the client to keep talking, communicates respect, cements the therapeutic alliance, clarifies exactly what the client means, and reinforces motivation Miller et al. This process has a tremendous amount of flexibility, and you can use reflective listening to reinforce your client's positive ideas Miller et al.
The following dialog gives some examples of clinician's responses that illustrate effective reflective listening. Essentially, true reflective listening requires continuous alert tracking of the client's verbal and nonverbal responses and their possible meanings, formulation of reflections at the appropriate level of complexity, and ongoing adjustment of hypotheses.
Clinician: What else concerns you about your drinking? Client: Well, I'm not sure I'm concerned about it, but I do wonder sometimes if I'm drinking too much.
Clinician: Too much for? Client: For my own good, I guess. I mean it's not like it's really serious, but sometimes when I wake up in the morning I feel really awful, and I can't think straight most of the morning. Clinician: It messes up your thinking, your concentration.
Client: Yes, and sometimes I have trouble remembering things. This bestselling work has introduced hundreds of thousands of professionals and students to motivational interviewing MI , a proven approach to helping people overcome ambivalence that gets in the way of change. William R. Miller and Stephen Rollnick explain current thinking on the process of behavior change, present the principles of MI, and provide detailed guidelines f This bestselling work has introduced hundreds of thousands of professionals and students to motivational interviewing MI , a proven approach to helping people overcome ambivalence that gets in the way of change.
Miller and Stephen Rollnick explain current thinking on the process of behavior change, present the principles of MI, and provide detailed guidelines for putting it into practice.
Case examples illustrate key points and demonstrate the benefits of MI in addictions treatment and other clinical contexts. The authors also discuss the process of learning MI.
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Be the first to ask a question about Motivational Interviewing. Lists with This Book. Community Reviews. Showing Rating details. More filters. Sort order. I read an earlier addition of this manual when I was in school working towards my MA.
Motivational Interviewing: Preparing People for Change
I thought it was brilliant back then. But I had no idea how effective this stuff would be in practice. The first time I experienced a client drop dramatic, sudden, emphatic change talk in a session my jaw just about hit the floor. I was with a client who was on the verge of becoming homeless, but could I read an earlier addition of this manual when I was in school working towards my MA. I was with a client who was on the verge of becoming homeless, but could not seem to take action due to depression and overwhelm.
We explored the ambivalence, non-judgmentally, for just a few minutes, and suddenly she startled as if she were jerking awake from a deep sleep and said " oh my god, I have to go find a place to live".
We scribbled out a quick list and she bolted for the door to go get some urgent and important stuff done.
The next day she came into my office with the proud news that she got the apartment.
Listening with empathy and reflecting in a forward direction can transform an otherwise superficial or circular conversation into an insight and action provoking depth charge. As an addendum I'm including the following progress update to the above mentioned clients status.
She did in fact find and move in to the apartment. But as it turns out its is a meth house, and she has subsequently become hopelessly relapsed in her meth addiction I was treating her opiate addiction at the time of writing, her meth addiction was in remission. One step forward three steps back I guess. This of course does not at all reflect poorly on MI, but it does remind us that long term adaptive behavioral change takes sustained long term effort and commitment.
As a new therapist, I often struggle over one thing—my client does not appear motivated enough. We have followed the CBT approach, but they are not doing thought records, they are not doing their exposures, they are not paying attention to our discussions from previous sessions. In short, they are not doing what we want them to do.
But this stance is exactly the root of all the problems. My initial response was twofold: I either blamed myself or the client. It could be that I have pushed to As a new therapist, I often struggle over one thing—my client does not appear motivated enough. It could be that I have pushed too far or too fast, or that the process was not collaborative enough. It could also be that the client is ambivalent about treatment, i. However, my subsequent actions seem to make things even worse—I tried to correct and pushed even more.
The assumption is: I am the expert and I know your situation the best, you will get better as long as you follow my solution. I will follow you wherever you go, but you bear the responsibility to make changes.
It follows four steps: The analogy is that a therapist acts like a fitness coach. The therapist, on the contrary, knows how to set reasonable goals and has access to a variety of tools.
As you would imagine, this client can be quite ambivalent about abandoning his lifestyle—drinking beer, eating junk food, sitting on the coach and watching TV, and the list goes on. He is here not to hear the downside of obesity and the benefit of eating less and exercising more—I am sure he is aware of all these. He is not here to hear that he needs to walk two hours a day plus 30 minutes of cardio—I am also sure that he knows how to get healthier.
The key is that he wants to change but is not fully prepared to change. Our role is to help him explore how much he wants to change desire , how much he can change ability , and how much he needs to change need. We want to cultivate this intention to change and once the client is determined to move into a certain direction, planning and acting would follow naturally and effortlessly. This is why planning is only the last one of the four-step process in MI engaging-focusing-provoking-planning.
In a way, MI is not a new therapeutic approach. The field of psychotherapy seems to follow a circular course—what was popular at one time found its way back decades later.
It is not something that you can obtain by taking a two-day workshop. To me, the spirit is far more important than the techniques. Many professionals are already practicing MI without even knowing its name.
Many are not practicing MI even though they think they are well-trained in it. Clients are paying money to see us.
Motivational Interviewing: Preparing People for Change
We are not meant to lecture them or give them directions or take the stance of an expert. Instead, they come here with some purposes although they can be vague and ambiguous. If you want to know the root of their psychopathology, ask them. If you want to come up with strategies to help and wonder what is realistic, ask them.
If you want to assess treatment efficacy, ask them. They are not fools, in fact, they know themselves better than you do. No change is sustainable unless it is premeditated and performed by the client themselves.
No talk is more powerful than the one that originates from the client. However, to find the car key takes two people—one searches and the other holds the flashlight. New to This Edition: Reflects major advances in understanding and teaching MI. Fully restructured around the new four-process model. All chapters now authored by Miller and Rollnick.
Additional case examples and counseling situations. Reviews the growing evidence base and covers ways to assess MI fidelity. Pedagogical Features Include: Online reflection questions and annotated cases, ideal for classroom discussion.
Bulleted key points at the end of each chapter. Engaging boxes with special topics and personal reflections. Extended bibliography and quick-reference glossary.Wendy Townsend Would highly recommend this book, high demand for loan.
Error rating book. How do you recognize resistance? This was part of my Tobacco Treatment Specialist Training. The scenarios are easy to follow, and the authors are very careful to integrate MI with existing professional protocols. Motivational Interviewing in Groups Christopher C.
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