Engaging, Focusing, Evoking and Planning in Motivational Interviewing - A structure with which we can help people to consider change - www.miinlondon.org

1. December 2016
with John Russell
www.miinlondon.org / miclub@miinlondon.org
Follow us on Twitter @miinlondon / Tweet #miinlondon
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Topic: The 4 MI Processes
Welcome to MI Club

2. Four MI Processes
2
Aims and
Objec0ves

3. 3
Aims of today
1. To recognise the 4 processes in MI.
2. To learn how to flow through each process
and recognise they are not always linear.
3. To practise open questions in each process.
4. To watch a trainer demonstration.
5. Have a laugh! This is a safe place to practise.

4. Objectives
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• 18:00 – 4 Processes (Ps): Your experience
• 18:10 – 4 Ps: What are they / Why use them?
• 18:20 – Practise (yay!)
• 18:40 – Trainer Demonstration
• 18:50 – Debrief

5. Four MI Processes
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What does
good look
like?

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Think about a time when someone
tries to make a plan or set a goal
with you, but you’re not ready to.
1. How do you react?
2. Have you ever tried to make a plan with someone who
you thought was ready but wasn’t. How did this go?
3. Talk to the person/people next to you to discuss (5 mins)
4. Then we’ll all have the chance to feedback as a group
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7. Four MI Processes
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What does MI
literature say?

8. 8
The 4 MI Processes
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Engaging
Focusing
Evoking
Planning

9. 9
The 4 MI Processes
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Following the 4 MI Processes set’s an informal
structure of where to guide your client.
We may use different uses of OARS throughout.
Today we’ll focus on open questions, and how
these may differ through each of the processes.

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Process 1: Engaging
“Engaging is the process by which
both parties establish a helpful
connection and a working relationship”
– Miller and Rollnick, 2012
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11. TIP
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Remove the ‘Chat Trap’
“In one treatment study, higher
levels of in-session informal chat
predicted lower levels of client
motivation for change”
(Bamatter et al., 2010)

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Process 1: Engaging
WHAT MIGHT YOU BE ASKING IN THIS PROCESS
“What is is that’s brought you here today?”
“What’s been your experience of XYZ condition?”
“I’m wondering how things have gone for you since we
spoke?”
NEXT: FOCUSING
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13. 13
Process 2: Focusing
“Focusing is the process by which you
develop and maintain a specific
direction in the conversation about
change” – Miller and Rollnick, 2012
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14. 14 Send us a Tweet: @MIinlondon

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Process 2: Focusing
WHAT MIGHT YOU BE ASKING IN THIS PROCESS
“Would you be willing to go thorugh an agenda map?”
“I have some things I’d like to chat about today [such as
XYZ], what are some of the things you might like to
discuss?”
NEXT: EVOKING
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Process 3: Evoking
“Evoking is having the person voice
the arguments for change” – Miller and
Rollnick, 2012
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Step 3: Evoking
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Evoke:
“To elicit or
draw forth”

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Step 3: Evoking
WHAT MIGHT YOU BE ASKING IN THIS PROCESS
“Would would some advantages be of XYZ change?”
“What might get worse if things stayed the same?”
“How might life be different for you if you did change?”
NEXT: PLANNING
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19. 19
Process 4: Planning
“Planning is a process of negotiation
and collaboration drawing on the
client's expertise (as well as your
own).” – Miller and Rollnick, 2012
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20. TIP
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Don’t plan too soon!
“If you try to develop a change plan
before the client is sufficiently ready
you may undo whatever progress you
have made through engaging, focusing
and evoking.”

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Process 4: Planning
WHAT MIGHT YOU BE ASKING IN THIS PROCESS
“What do you think would be some ways to take this
forward?”
NEXT: LET’S PRACTISE
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22. Four MI Processes
22
MI Skills
Prac0se

23. MI Snakes and
Ladders
(MI is 10% theory, 90% practise)
23 Send us a Tweet: @MIinlondon

24. 10 minutes group practise.
Using open questions
• Please get into groups of 3!
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25. 4 Processes Snakes & Ladders:
1. Receive a game board & one set of colours
2. Choose a counter per person
3. Choose who goes first, this is the person
whose birthday is nearest to Christmas!
4. This person is player 1, to the left of you is
player 2, to the next left is player 3.
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26. 4 Processes Snakes & Ladders:
1. I will draw two cards in place of dice, these
added together will be the number of
squares moved by whomever’s go is next.
2. We will then go to player 2 and repeat, etc.
3. This will continue until we have a winner
from each team!
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27. Debrief in your groups
Discuss:
1. Did you find any one process more
difficult the others?
2. How might you work on that in the
future?
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28. Debrief as a full team
What comments, questions or
observations do you have?
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29. Four MI Processes
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Trainer
Demonstra0on

30. Live Trainer Demo
Can I have a volunteer?
4 Processes on next slide…
30 Send us a Tweet: @MIinlondon

31. 31
The 4 MI Processes
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Engaging
Focusing
Evoking
Planning

32. Four MI Processes
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Summary of
today +
Ques0ons

33. Ques1ons
Q: How do you know when the right 1me is go towards the planning stage?
A: Whilst there are always opportune moments to veer towards the collabora1ve joy that is the
planning there are plenty of piDalls to avoid. As we discussed during the ‘mul1ple op1ons’ during
the trainer demonstra1on today, trying to planning too soon, and on the interviewers agenda can
set the conversa1on back and cause the other person to withdraw.
Moving towards planning can be achieved through the process of recapitula1on, the art of giving
a skilled transi1onal summary that is awash with change talk. This allows you to ‘test the water’
and offer a key ques1on (one that is open, searching but noncommiMal in nature). Such as
“where does this leave you” or “What do you think of all this”, “I wonder what you might decide
to do?”, “What might someone in your situa1on do next?”, “What’s in your mind at the
moment?”, “What are you thinking about at this point?”. Let the person decide what is next for
them, let them tell you.
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34. 34
Merry Christmas!
Have a one.

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See you on Tuesday
7th February 2017
Thanks for coming!
Send us an email: miclub@miinlondon.org