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Recommended Books / Web Sites / Session-Specific Resources
"Teaching Patient" Roleplay Guidelines
Session 1 / Session 2 / Session 3 / Session 4 / Session 5 / Session 6 / Session 7 / Session 8
Recommended Books
Main text:
Health Behavior Change: A Guide for Practitioners (HBC) by Stephen Rollnick, Pip Mason, and Chris Butler
• Motivational Interviewing adapted for medical settings
• Presents a framework for very brief treatment encounters
• Strategies are presented in terms of principles, examples, and counterexamples with an emphasis on practicality.
Read my detailed review
See more information at Amazon.com
Or, if you just want the bare essentials:
Lifestyle Change by Chris Dunn and Stephen Rollnick
• Pocket-size "how-to" guide
• Super-streamlined 3-step model
• Focus on simple, structured techniques to help engage patients in a constructive conversation about change
Read my detailed review
See more information at Amazon.com
And if you really love this stuff, and want an expanded approach with all the theory:
Motivational Interviewing, Second Edition: Preparing People for Change (MI2) by William R. Miller and Stephen Rollnick
• Theoretical underpinnings, empirical evidence
• Some detailed examples of strategies and techniques with an emphasis on general principles
• Specialty settings, populations, topics featured in extensive edited section
Read my detailed review
See more information at Amazon.com
Web Sites
Steve Rollnick's practice-oriented online discussion board
Session-Specific Resources
Session 1 - Definition, Principles, and Evidence
HBC Chapters 1-2 (relevant to sessions 1-3)
Findings From Clinical Trials - Updated December 2004 (online slide presentation; or, download the Powerpoint file)
A Meta-Analysis of Motivational Interviewing Outcome Trials - November 2004 (online slide presentation; or, download the Powerpoint file)
Toward a Theory of Motivational Interviewing - November 2004 (online slide presentation; or, download the Powerpoint file)
MI may be conceptualized as a particular form of the "guiding" style of communication with patients - see Steve Rollnick and colleagues' recent British Journal of Medicine article for more about incorporating MI into daily practice without over-reliance on structured interventions.
"Teaching Patient" Roleplay Guidelines -
When in the role of the teaching patient, your job is to help each other learn MI.
The teaching patient is NOT the patient from Hell!
The teaching patient should also NOT be based solely on a single real patient.
Develop a role that is familiar from your work and that you can role-play convincingly.
Consider: demographics (age, gender, race, marital status, household composition); socioeconomic background; the clinician's and client's perspective on what is the presenting problem (these may disagree); the patient's goals and values; the pros and cons of the problem behavior from the patient's perspective; the pros and cons of the desired behavior from the patient's perspective.
Keep roleplays short and focused on one specific skill at a time. Allow the person in the clinician role to set - and change! - the level of readiness or resistance displayed by the teaching patient. Audiotape the roleplays for review.
Session 2
HBC Chapter 3
Evidence for a relationship between therapist clinical skills and client involvement in MI:
Moyers, T. B., Miller, W. R., & Hendrickson, S. M. L. (2005). How does Motivational Interviewing work? Therapist interpersonal skill predicts client involvement within Motivational Interviewing sessions. Journal of Consulting and Clinical Psychology, 73, 590-598.
Suggested roleplay prompts for practicing OARS with a roleplay buddy - audiotape and review together. Where could you have used open instead of closed questions? Where could you have used even more reflective listening instead of questioning? Keep roleplays short and focused, and respect the Talker's desire to end the conversation whenever he/she is ready.
- What have you read lately that you would recommend?
- Who in your family are you most like?
- Tell me about a memorable trip you took. What made it memorable?
- What is your dream job?
- What do you like about yourself?
- What is the best advice you ever received?
Audio clip (MP3 format) demonstrating the Behavior Change Counseling model: To download the file, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)
Rollnick interviewing a patient about his drinking (12 MB, 8:44 minutes)
Session 3
HBC Chapter 3
Audio clip (MP3 format) demonstrating the the use of importance and confidence rulers: To download the file, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)
Rollnick interviewing a patient about smoking (6.09 MB, 4:29 minutes)
Session 4
HBC Chapter 4
Audio clips (MP3 format) demonstrating use of specific techniques to elicit change talk: To download the files, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)
The good things and the not-so-good things about smoking - 6.86MB, 5 minutes. From the Health Behavior Change video.
Exploring values, fruits and vegetables - Demonstration of an MI-based peer counseling program developed by the National Cancer Institute for African-American churches. 4.12MB, 3 minutes. From the Body and Soul peer counselor training DVD.
If you like theory and research, check out a recent series of literature reviews regarding "change talk" - several articles in recent issues of the MINT Bulletin. Look for "what the research says" articles by Grant Corbett in October 2004, May 2005, September 2005 issues.
Session 5
HBC Chapter 5
Session 6
HBC Chapter 5
My best examples of feedback-based interventions are all addictions-focused. If you know of any online examples feedback-based interventions for health-related behavior, let me know!
Motivational Enhancement Therapy serves as a model for a feedback-based intervention in the addictions. See my resources page for more information about some of the variations.
Reid Hester's online Drinker's Check-up provides feedback regarding alcohol use. Results of a 12-month trial.
Alcoholscreening.org provides similar feedback - but in a less MI-consistent manner - for free.
Some excerpts from a drinker's check-up feedback-based intervention. First (3.31 MB MP3, 2:24 minutes), a brief example of giving personal feedback. Next (5.97 MB MP3, 4:20 minutes), a summary of feedback given over a lengthy session, and example of eliciting change talk and managing resistance (in this case, demoralization more than argumentation). To download the files, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)
Session 7
HBC Chapter 4
Session 8
HBC Chapter 6, 8
Change Plan Worksheet
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