Motivational Interviewing (MI) Rolling with Resistance What is ..., Study notes of Job Interviewing Techniques and Skills

Download Motivational Interviewing (MI) Rolling with Resistance What is ... and more Study notes Job Interviewing Techniques and Skills in PDF only on Docsity! There is no way to make people like change. You can only make them feel less threatened by it. Frederick Hayes An equal opportunity/access/affirmative action/pro-disabled and veteran employer Motivational Interviewing (MI) Rolling with Resistance What is resistance?  Resistance is what happens when we expect or push for change when the client is not ready for that change.  Conscious or unconscious defenses against change.  Clients who exhibit resistance are less likely to change. Why does resistance occur?  It arises as a normal, expected product of the interaction.  When resistance emerges, there are good reasons the client is not ready to change in the way we are asking. o The reasons may not be clear to us or to the client, but they exist. o Ignoring them gets us nowhere. What are some of the types of resistance we encounter?  Issue resistance o Related to a specific issue-such as smoking cessation, changing a dietary pattern, physical activity, etc.  Relational resistance o Has to do with the relationship between you and the client. o There is discord in the interactions. o You can tell this by comments made: • You don’t understand. • You can’t help me. How do we know when the client is being resistant? Signs of resistance: • The client may interrupt you. • The client seems distracted (looking at watch, cell phone, etc.). • The client may get defensive. How do we respond to resistance? What doesn’t work---Inappropriate responses:  Persuasion o It’s tempting to try to be helpful by persuading the client about:  The importance or urgency of the problem being addressed.  The benefits of changing a behavior. o Persuasion is not an effective method for resolving ambivalence and will probably backfire on you. o It usually only increases client resistance and decreases the probability of change.  Righting reflex o As health care professionals, we use our corrective lens. o We want to change client behavior and we want to make things right, so we argue or push back with the client. o Since we are arguing for the change side of ambivalence, this usually causes the client to keep voicing sustain talk (the reasons not to change). o With MI, the practitioner doesn’t try to make things right or doesn’t try to change the client’s behavior. o Change comes from the client’s intrinsic motivation. o We have to acknowledge that the righting reflex is present and ask ourselves to override it. o We have to ask it to step aside and focus on the person in front of us. Strategies to use--Appropriate responses With issue resistance, use key strategies of Motivational Interviewing (MI): • Express empathy- • Empathize with the concern and explore. • Non-judgmental. • Assures client is being heard and understood. • Shows you recognize barriers the client faces. • Develop discrepancy - • Help the client see that some behaviors don’t mesh with ultimate goals that are important/valuable. • Help the client see the difference between her core values and her behavior(s). • Define most important goals. • Change won’t occur without discrepancy. • Create gap between where the client is and where she wants to be. • Allows the client to realize current behavior isn’t leading to goal and be more open to change.