Welcome and thank you for bearing with me through some technical difficulties. Here are the resources I referred to during the workshop. If I’ve missed anything, just comment on this post or send me an email.
We weren’t able to see a new video featuring Bill Miller as the counselor, but here are some excerpts from a “classic” 1998 interview. The first clip demonstrates the use of reflective listening in the processes of engagement and focusing, and the second clip illustrates using the decisional balance to cultivate change talk and soften sustain talk with a client at very low readiness to change.
Writing my last post had me interested in finding out more about Motivational Interviewing in dentistry. Here are some resources.
From the journal Evidence-Based Dentistry, a summary of 2 recent reviews covering a total of 26 randomized clinical trials. The authors note that the evidence for MI in promoting oral health behavior change is inconclusive, but that “three studies showed consistent positive effects of MI on clinical and behavioural outcomes and were the only three to be rated as good quality by both review papers.”
Part I includes 2 hours of discussion among Bill Miller, Steve Rollnick, and Terri Moyers outlining and clarifying key concepts and clinical nuances of the updated MI model. The conversation – which truly complements the book – is broken into four sections, each of which has briefer sub-sections. The contents of Part I include:
What is Motivational Interviewing?
How does Motivational Interviewing work?
Clinical challenges in applying Motivational Interviewing
Challenges in applying Motivational Interviewing
Part II includes 4 hours of demonstration interviews by Bill Miller, Steve Rollnick, Terri Moyers, and Carolina Yahne. All of the examples are unscripted roleplays with actors portraying clients/patients. The 14 interviews include 6 new demonstrations of MI in a variety of contexts and levels of clinical complexity; 2 examples that contrast MI-consistent and inconsistent styles with the same client; 2 examples demonstrating common pitfalls in health behavior change consultations (overuse of directing and following); 2 of Miller’s previously unreleased original demonstrations of MI dating to 1989; and 2 of the “greatest hits” of the 1998 training video series (“Quiet Man” and “Rounder”). Several of the case examples include debriefing interviews so we hear the client/patient perspective on the process. The package also includes annotated transcripts.
This is one of my new favorite videos. The first vignette in particular demonstrates the four processes of Motivational Interviewing outlined in the third edition of the Miller and Rollnick text – Engaging, Focusing, Evoking, and Planning – as they unfold over the course of about 15 minutes in realistic, unscripted roleplay.
The inaugural issue of Motivational Interviewing: Training, Research, Implementation, Practice (MITRIP; the journal of the Motivational Interviewing Network of Trainers) is now available online. An open-access, “author-friendly” journal, MITRIP accepts submissions of all kinds related to motivational interviewing (MI) practice, training, implementation, and research: qualitative as well as quantitative studies, case presentations, descriptions of innovations in MI practice or training, and theoretical or conceptual articles, as well as informal contributions related to the activities of MINT members worldwide. Submissions are invited from any author, regardless of affiliation, who wishes to contribute to the ongoing conversation about MI.
This new guide (published in 2012) is a companion to Motivating Offenders to Change: A Guide for Probation and Parole. Whereas the earlier guide detailed the application of MI in correctional settings, this guide focuses on implementation issues. After a very brief overview of MI, more detailed chapters cover how MI is learned, supervising and coaching to support implementation, assessing MI skills, and organization-level planning to develop MI skills in a correctional setting. The guide is very readable and appears to provide enough information to assist experienced agency leaders in identifying and working through relevant issues in successful implementation of MI.
Treatment Improvement Protocols (TIPs) are best practice guidelines for the treatment of substance abuse, provided as a service of the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment (CSAT). This TIP, published in 2006, was written to help clinicians address the expansion of intensive outpatient treatment represented by the development and adoption of new approaches to treat a wider variety of clients.
Grounded in evidence-based practice, the TIP describes the core services every program should offer, the enhanced services that should be available on site or through links with community-based services, and the process of assessment, placement, and treatment planning that helps clinicians address each client’s needs. Based on research and clinical experience, the consensus panel discusses major clinical challenges and surveys the most common treatment approaches used in intensive outpatient programs. More specialized sections address treatment of specific groups of clients.
Most pertinent to readers interested in Motivational Interviewing are chapters on building on existing motivation and employing MI in treatment. The section on employing MI in treatment realistically addresses a number of strengths and challenges faced when bringing MI into typical IOP practice.
Here is another in the growing field of SBIRT (Screening, Brief Intervention, and Referral to Treatment) resources and videos. Them emphasis here is on screening and intervening with problem drinkers in the Emergency Department.
Boston University School of Public Health SBIRT (Screening, Brief Intervention, and Referral to Treatment) Institute has posted 12 videos illustrating this MI-consistent approach to intervention with alcohol and drug users in medical settings. Includes illustrations of interventions with adults and adolescents.
Treatment Improvement Protocols (TIPs) are best practice guidelines for the treatment of substance abuse, provided as a service of the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment (CSAT). This TIP, published in 2008, is primarily concerned with outlining key elements of programming for co-occurring disorders in substance abuse treatment agencies. A secondary audience is mental health agencies and other service systems that seek to coordinate mental health and substance abuse services for their clients who need both.
Clients are said to have co-occurring disorders when they have one or more disorders relating to the use of alcohol and/or other drugs of abuse as well as one or more mental disorders, diagnosed independently of each other. The TIP begins with an overview of recent developments in the treatment of this large and highly diverse population. Subsequent chapters detail assessment, diagnosis, and treatment at the level of the system as well as specific approaches and techniques.
On the same web page as the TIP are a suite of related products, including inservice training materials and “Quick Guides” for addiction treatment clinicians, mental health clinicians, and program administrators,