Deborah H. A. Van Horn, Ph. D., LLC - Motivational Interviewing Training
Course Materials and Resources for Davita Intro to MI 8-Week Teleclass: May-June, 2007
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Course Materials / Recommended Books / Web Sites / Session-Specific Resources /
"Teaching Client" Roleplay Guidelines
Session 1 / Session 2 / Session 3 / Session 4 / Session 5 / Session 6 / Session 7 / Session 8 /
I encourage you to keep the handout on hand during the calls to help focus your attention on the main points of the discussion. Click on the link below to view the handout, and then choose "save a copy" to save to your computer.
Course handout (302k PDF)
If you can't open the course handout, click here to download Adobe Reader for free. 
Motivational Interviewing, Second Edition: Preparing People for Change (MI2) by William R. Miller and Stephen Rollnick
- Includes extensive (but highly readable) discussion of 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
A briefer, more practice-oriented text focusing on application in medical settings (may supplement or substitute for MI2):
Health Behavior Change: A Guide for Practitioners (HBC) by Stephen Rollnick, Pip Mason, and Chris Butler
- Designed for application in medical settings; does not assume a background in general counseling skills
- 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
Steve Rollnick's practice-oriented online discussion board
The Motivational Interviewing Page
"Teaching Client" Roleplay Guidelines
If you have the opportunity to work with a role-play partner, then you can develop a "teaching client/patient" role to help maximize your learning.
When in the role of the teaching client, your job is to help each other learn MI. The teaching client is NOT the client from Hell! The teaching client is also most useful when it is NOT be based solely on a single real client or 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 client's goals and values
- the pros and cons of the problem behavior from the client's perspective
- the pros and cons of the desired behavior from the client's perspective.
Keep the 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 client. Audiotape the roleplays for review.
MI2 Chapters 1-4, 11 (annotated case example), 16-17
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)
New Mexico video tape A (also good for insomnia); tape B part 2 (extended initial interview with a substance-abusing patient)
Here is the complete "Rounder" interview we began listening to during the phone call:
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.
For more about motivation and the stages-of-change approach:
Overview of the Transtheoretical (Stages-of-Change) Model from the URI Cancer Prevention Research Center
MI2 Chapter 15
Changing for Good by James O. Prochaska, John Norcross, Carlo DiClemente
Broadly applicable self-help book that models a patient-friendly way to present stage-matched interventions.
Read my review
See more information at Amazon.comHere is the case example we listened to on the phone call:
MI2 Chapters 6-7
Suggested roleplay prompts for practicing OARS with your 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?
Case Example: An initial session in which the counselor (Bill Miller) uses reflective listening almost exclusively, even when it seems entirely forgivable to ask a question or 2. What is the effect of that choice on the nature of the interaction with the client?
Just for fun: A YouTube posting from someone who attended an MI training at her church. I love how she explains/demonstrates reflective listening. She starts out talking about her hair, but gets around to it eventually.
MI2 Chapter 5-7
HBC Chapter 4
New Mexico video tape B (parts 1 and 2)
Literature review regarding "change talk" - several articles in recent issues of the MINT Bulletin. Look for the updated "consensus statement on change talk" in the July 2006 issue. Also, look for "what the research says" articles by Grant Corbett in October 2004, May 2005, September 2005 issues.
A link to the values card sort may be found toward the bottom of the Motivational Interviewing Website Library Page.(opens in a new window).
Audio clip (MP3 format) demonstrating use of a values checklist to elicit change talk: Click on the link to listen using your browser's media player.
Exploring values, fruits and vegetables - 4.12MB, 3 minutes. Demonstration of an MI-based peer counseling program developed by the National Cancer Institute for African-American churches. From the Body and Soul peer counselor training DVD.
Video clips:
1. This is the pros and cons example that we listened to on the call.
2. Here is an example of pros and cons of smoking, with a patient at very low readiness to change. The clip starts toward the end of importance and confidence scales - you will hear a bit regarding a confidence level of 2 or 3.
HBC Chapter 5
Unfortunately, most of my materials illustrating feedback and information exchange are specific to the addictions, not health care. But, you can take a look anyway:
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.
Audio clips (MP3 format): Click on the link to listen using your browser's media player. Or, 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)
Example of elicit-provide-elicit to provide information to increase importance of change (4.43 MB, 3.13 minutes).
Example of elicit-provide-elicit to provide information to increase confidence for change (5.17 MB, 3:46 minutes)
Some excerpts from a feedback-based intervention. First (3.31 MB MP3, 2:24 minutes), a brief example of giving personal feedback regarding drinking. 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).
MI2 Chapter 8
HBC Chapter 5
New Mexico video tape C
Video clips of strategic responses - click on links to Google video clips (links open a new browser window). Clips range from 1 to 3 minutes each.
Shifting focus:
Emphasizing personal control :
Reframing:
Agreement with a twist:
Siding with the negative:
MI2 Chapter 9-10
HBC Chapter 4
New Mexico video tape F
Change Plan Worksheet adapted from Project MATCH manual (Word document)
MI adherence measures (PDF format):
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Updated May 3, 2007