Final presentation for the Scaife Advanced Student Medical Seminar by Angela Condo

4. Primary Chronic Disease
Motivation Choice

6. What is Motivational Interviewing?

7. Transtheoretical Model of Change

8. I can control my behavior. I know
my triggers and how to handle
them.
I am making changes. I avoid
people, places, and things.
I want to change. I can…
Yeah, I have a problem; but it’s too hard
to change or I don’t want to change.
I don’t have a problem.
I can stop if I want to.

9. Principles of Motivational Interviewing
• Express Empathy
– “Put yourself in my shoes.”
• Support Self Efficacy
– Previous successes not failures
• Roll with Resistance
– “dancing, rather than wrestling”
• Develop Discrepancy
– Current Behavior and Values
– Current Circumstances and Future Goals

10. Spirit of Motivational Interviewing
• Collaboration
• Not hierarchy
• Evocation
• Not imposing or externally driven
• Client Autonomy
• Not authority or coercion

11. MI: Progression through the
Stages of Change
Open ended questions
Affirmations
Reflections
Summaries

12. Role of Motivational Interviewing
Increase Change Talk & Readiness to Change
Increase Client Exp. Of Discrepancy
 Increase Client Engagement
 Decrease Resistance
 Improve Retention, Motivation,
and Outcomes

13. Role of Primary Care Physicians
Motivational interviewing is an effective substance abuse
intervention when used by clinicians such as primary care
physicians who are non-specialists in substance abuse
treatment; it can enhance entry to and engagement in more
intensive substance abuse treatments. (Dunn et al, 2001)
Form a Therapeutic Alliance
Adhere to the spirit of MI
Begin a discussion of change

14. References
American Society of Addiction Medicine [ASAM]. (2011). Definition of addiction. Retrieved from
http://www.asam.org/research-treatment/definition-of-addiction
Apodaca, T. R., & Longabaugh, R. (2009). Mechanisms of change in motivational interviewing: a
review and preliminary evaluation of the evidence. Addiction, 104, 705-715.
Britt, E., Hudson, S. M., & Blampied, N. M. (2003). Motivational interviewing in health settings: a
review. Patient Education and Counseling, 53, 147-155.
DiClemente, C.C., Nidecker, M., & Bellack, A. S. (2008). Motivation and the stages of change among
individuals with severe mental illness and substance abuse disorders. Journal of Substance
Abuse Treatment, 34, 25-35.
DiClemente, C. C., Schlundt, D., & Gemmell, L. (2004). Readiness and stages of change in addiction
treatment. The American Journal on Addiction, 13, 103-119.
Dunn, C., Deroo, L., & Rivara, F. P. (2001). The use of brief interventions adapted from motivational
interviewing across behavioral domains: a systematic review. Addiction, 96, 1725-1742.
Jensen, C. D., Cushing, C. C., Aylward, B. S., Craig, J. T., Sorell, D. M., & Steele, R. G. (2011).
Effectiveness of motivational interviewing interventions for adolescent substance use behavior
change: a meta-analytic review. Journal of Counseling and Clinical Pyschology, 79, 433-440.
Kalivas, P. W., Volkow, N. D. (2005). The neural basis of addiction: a pathology of motivation and
choice. American Journal of Psychiatry, 162, 1403-1413.

15. Kazdin, A. E., & Nock, M. K. (2003). Delineating mechanisms of change in child and adolescent
therapy: Methodological issues and research recommendations. Journal of Child
Psychology and Psychiatry, 44, 1116-1129.
Miller, W. (2004). Toward a theory of motivational interviewing. Retrieved from
http://www.motivationalinterview.org
Miller, W. R., Baca, C., Compton, W. M., Ernst, D., Manuel, J. K., Pringle, B., Schermer, C. R.,
Weiss, R. D., Willenbring, M. L., and Zweben, A. (2006). Addressing substance abuse in health
care settings. Alcoholism: Clinical and Experimental Research, 30, 292-302.
Miller, W. & Rollnick, W. (2010). What’s new since MI-2? Retrieved from
http://www.motivationalinterview.org
Miller, W. R., Yahne, C. E., & Tonigan, S. (2003). Motivational interviewing in drug abuse services:
a randomized trial, Journal of Consulting and Clinical Psychology, 71, 754-763.
Motivational Interviewing. (2012). Overview of motivational interviewing. Retrieved from
http://www.motivationalinterview.org
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.
Velicer, W. F, Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998). Smoking
cessation and stress management: Applications of the Transtheoretical Model of behavior
change. Homeostasis, 38, 216-233.