This is the slide deck from Second Life event #1 on Motivational Interviewing,

1. Stephen R. Andrew, LCSW LADC CCS

2. Engaging Patients
Attitudes and behaviors
What you’ve done or witnessed

3. MI: What is it?
Definition: Motivational interviewing is a
collaborative, person-centered evidence-
based, guiding method of communication for
enhancing and strengthening intrinsic
motivation for change.
Spirit: Collaboration, Autonomy, Respect,
Compassion

4. Motivational
Interviewing...
assumes motivation is fluid and can be
influenced
motivation is influenced in context of a
relationship
principle task: to guide conversation towards
eliciting motivation for change
goal: to influence change in the direction of
health

5. Communication is hard...
Here are the places it can break down.
Speaker Listener
1. What the speaker means
2. What the speaker says
3. What the listener hears
4. What the listener
thinks the speaker
means

6. What is listening?
Focus all purpose, attention, and energy on
understanding
What is the person experiencing right now?
Hearing what they are NOT
saying

7. Five General Principles
Express accurate empathy
Amplify ambivalence
Avoid arguments
Support self-efficacy
Roll with resistance

8. *Power/Control
*Connection
What People Seek/Need

9. Imagine...

10. Motivational Interviewing
Process: The Structure
AmbivalenceAmbivalence CHANGE TALK
Desire
Ability
Reason
Need
CHANGE TALK
Desire
Ability
Reason
Need
COMMITMENT
LANGUAGE
COMMITMENT
LANGUAGE CHANGE
BEHAVIOR
TOWARDS and/or
HEATLH
CHANGE
BEHAVIOR
TOWARDS and/or
HEATLH
IncreaseIncrease
desiresdesires
ObserveObserveNoticeNotice
1
LowerLower
10

11. The Skills
“OARS”
“OARS”
O = open-ended questions
A = affirm
R = reflection
S = summarize

12. Amplify Ambivalence

13. The Accuracy Function of Reflection
Speaker Listener
1. What the speaker means
2. What the speaker says
3. What the listener hears
4. What the listener
thinks the speaker
means
Bridge the gap by
reflection

14. The Case
53 year-old male came to clinic one week ago
for concern of high blood pressure reading at
work. He presents now for follow up and BP
is in control.

15. “Now that we have a plan to manage
your blood pressure, Mr. Jones, I
wonder if I can talk with you about
some preventive health care.
Specifically, I wanted to mention
some recommendations for all
patients over age 50 to undergo colon
cancer screening. Would it be okay
with you to talk a little about this
today?”

16. Jones: “ Geez, doc, like I said, I only
came in ‘cause my wife made me
after that nurse at work got that
abnormal blood pressure reading. I’m
not here for the works. You know
what I’m say-in’?”

17. What is this patient telling
you?
How will you respond?
How will you respond?

19. Next Steps
We’ll teleport up to two sky platforms in order
to practice your MI technique
Click on your assigned color (red or blue)
teleport device, to the left or right of the screen
See you at 300 meters!