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ACTSHEET December 2017 WHAT’S INSIDE Motivational Interviewing: verview A Primer for Child Welfare hen to use Professionals motivational interviewing Motivational interviewing is a method professionals asics of motivational can utilize to support families who may be ambivalent interviewing or hesitant about support from the child welfare oring toward change system. It was designed to help engage individuals and assist them in exploring and resolving their raining 1 ambivalence about change. Given that families often become involved in the child welfare system onclusion involuntarily and that engagement may be a challenge eferences for caseworkers, motivational interviewing is a method caseworkers may want to consider in their practice (Mirick, 2013). This factsheet provides child welfare professionals with an overview of motivational interviewing, describes circumstances when it could be applied, and highlights the basics of the method. It also provides links to additional resources. 1 Ambivalence is a common term in the motivational interviewing literature. It refers to the client’s state of both wanting and not wanting to change or, in other words, having simultaneous conflicting motivations. For example, a client may see the negative consequences of her substance use e.g., impairing her ability to parent but at the same time continue using substances. hildren’s ureauAFAF .. mail infochildwelfare.gov httpswww.childwelfare.gov Motivational Interviewing: A Primer for Child Welfare Professionals https://www.childwelfare.gov verview process includes four overlapping processes—engaging, focusing, evoing, and planning—that are discussed in otivational interviewing was developed by . . iller greater detail in the asics of otivational Interviewing and . ollnic. It was first introduced in the 1s as section. a method to engage and support adults coping with substance use issues and has since been adapted to meet When to se Motivational the needs of other helping fields, including child welfare, Interviewing criminal ustice, and health. iller and ollnic 1, p. define motivational interviewing as follows he use of motivational interviewing may be most applicable when the following circumstances are present otivational interviewing is a collaborative, goal ilovsy, ¤effingwell, echt, oriented style of communication with particular he client has a specific target behavior that is leading attention to the language of change. It is designed to to negative outcomes. strengthen personal motivation for and commitment to a specific goal by eliciting and exploring he client is ambivalent about change. the person’s own reasons for change within an hoices that could benefit the client and family are atmosphere of acceptance and compassion. available. otivational interviewing was intended for a counseling ¥iven that many parents involved with child welfare relationship that could extend several wees, but it may have substance use disorders and that children has also been shown to be effective during shorter with parents who use substances are more liely to be interventions for substance use, smoing cessation, and maltreated, motivational interviewing holds promise for peer violence iggins, 1. According to the alifornia use with child welfare clients hild elfare Information videnceased learinghouse for hild elfare , ¥ateway, 1. uch lie clients in the substance use motivational interviewing can be used with caregivers field, child welfare clients may be ambivalent to change, of children, as well as with adolescents , n.d.. which maes them good candidates for the use of Additionally, awarded the method its highest rating motivational interviewing. hild welfare practice also “wellsupported by research evidence”. he method has tends to embrace some of the same tenets present in been shown to help engage clients and enhance their motivational interviewing, such as engaging clients in motivation to use and complete services—including those decisions and focusing on their strengths. Additionally, related to child welfare—that can support them in maing motivational interviewing incorporates selfdetermination, positive life changes terrett, ones, alot, hoo, which is one of the tenets of traumainformed care. 1 ¡amashe, ¡oughty, are, ilovsy, 11. ¢sing esearch has shown that motivational interviewing is also motivational interviewing also may help caseworers effective when paired with other treatment strategies, assess families’ readiness to change and assist families in such as cognitive behavioral therapy ubstance Abuse better understanding the steps necessary for changes to and ental ealth ervices Administration, 1¦. occur. otivational interviewing may also be beneficial when £ractitioners of motivational interviewing approach the supporting youth involved with child welfare who are method with a perspective that includes partnership exhibiting negative behaviors. Adolescents often feel with the client, acceptance of the client, compassion, they are being udged or told what to do by providers, and an evocation i.e., helping bring forth what is needed which is not effective. Instead, using a nonconfrontational for change from the client iller ollnic, 1. and nonudgmental approach such as motivational hese four components are often called the “spirit” of interviewing can help them explore ways to change their motivational interviewing. he motivational interviewing behaviors ohman, arnett, hillington, 1. his material may be freely reproduced and distributed. owever, when doing so, please credit hild elfare Information ¥ateway. his publication is available online at httpswww.childwelfare.govpubsmotivationalinterviewing. 2 Motivational Interviewing: A Primer for Child Welfare Professionals https://www.childwelfare.gov hild welfare professionals should be aware of power otivational interviewing relies on four core differentials and families’ values when using motivational communication sills to help guide professionals iller interviewing. he power differential between a ollnic, 1 caseworer and parent—or youth—could create As ing oenended estions: penended additional resistance or negative reactions from the questions allow clients to expound upon issues and parent iric, 1. £arents may feel forced to comply provide richer detail than would be elicited through with a suggested or mandated activity due to the threat a closedended question, which typically can be of court action e.g., removal of the child from the home, answered with a oneword response or little detail. termination of parental rights rather than an internal xamples of openended questions include “hat motivation to change ilovsy et al., . hat would brought you to spea with me today¨” or “ow has this run counter to the premise of motivational interviewing. issue affected your family¨” Additionally, motivational interviewing should not be used to compel families to tae actions that are in contrast to Affirming: hese statements acnowledge client their values ilovsy et al., . strengths and are encouraging. Affirmations can help in several ways, including strengthening providerclient asis of Motivational Interviewing relationships, reducing defensiveness, and facilitating change. An example of an affirming statement is his section summari§es the basics of motivational “ou’ve been woring very hard to attend all the interviewing. his information is not intended as a sessions of your parenting class.” training for child welfare professionals about how to efleting: hese statements help show clients that use motivational interviewing with a client. For more you are understanding them. hey repeat or rephrase information about becoming trained in motivational what the client has said. eflective statements can interviewing, refer to the oring oward hange encourage the client to further explore an issue. section. otivational interviewing utili§es several types of reflections, each of which has a particular purpose in ather than occurring in distinct stages, motivational helping guide the conversation and client exploration. interviews progress through the following four processes For example, a simple reflection provides nearly in varying combinations and orders depending on the the exact meaning intended by the client and helps flow of the discussion and client needs iller ollnic, show the provider understands what the client has 1 said. lient “It’s been very difficult to meet all the Engaging: he provider and client develop a woring court requirements.” £rovider “ou’ve had a lot of relationship. difficulty meeting the court requirements.” A complex osing: he provider and client develop and reflection, on the other hand, is a restatement of what maintain a focus on the client achieving a particular the client said with some additional meaning inferred change goal. by the provider. lient “It’s been very difficult to meet all the court requirements.” £rovider “ he difficulty Evo ing: he provider helps the client to express his meeting the court requirements is probably pretty or her own motivation for change. stressful and frustrating.” Planning: he provider wors with the client to Smmariing: ummaries are essentially reflections cultivate the client’s commitment to change and how that tie together several of the client’s statements, that change will occur. which can provide clients with an opportunity to hear a retelling of their experiences and their thoughts about change. his material may be freely reproduced and distributed. owever, when doing so, please credit hild elfare Information ¥ateway. his publication is available online at httpswww.childwelfare.govpubsmotivationalinterviewing. 3 Motivational Interviewing: A Primer for Child Welfare Professionals https://www.childwelfare.gov Wor ing Toward Change Training otivational interviewing is focused on helping clients raining in motivational interviewing, as well as ongoing consider their readiness and willingness to change to coaching, is essential to helping practitioners ensure improve their lives and, particularly in child welfare, the they are properly utili§ing its techniques and progressing lives of their family members. otivational interviewing is toward the best possible outcomes for clients nyder, not about persuading a client to change, though it sees ¤awrence, eatherholt, ©agy, 1. he otivational to help the client develop his or her own motivation to Interviewing ©etwor of rainers website httpwww. change. motivationalinterviewing.org provides details about upcoming training as well as other educational materials. It is important for providers to recogni§e change tal that indicates a client is willing to change e.g., “I really want he following resources provide additional information to get myself together so I can get my ids bac.” and about motivational interviewing help elicit additional change tal, with an eventual goal “otivational Interviewing echniques in hild of client commitment to change and a plan for how to elfare” ªvideo« enter for Advanced tudies in achieve it. hen change tal does occur, providers can hild elfare httpcascw.umn.eduportfolioitems help clients progress toward actual change by asing motivationalinterviewingmodule questions or maing statements about the clients’ desires, abilities, reasons, and commitments related to “otivational Interviewing as a £ractice Innovation the change. otivational interviewing also includes a in hild elfare” ªvideo« ©ational hild elfare variety of techniques to help evoe change tal if the orforce Institute httpsvimeo.com¦¦¦ client is more focused on sustain tal i.e., statements that Motivational Interviewing in Child Welfare Services support not changing. For example, a provider can as ©orthern alifornia raining Academy https the client how important something is for them e.g., “n humanservices.ucdavis.edusitesdefaultfiles11¬ a scale from to 1, how important is it for you to ensure 11¬I¬video¬guide¬revised¬¦1. your children are safe at home¨” and then as a followup pdf question based on the response to initiate change tal Encouraging Motivation to Change: Am I Doing e.g., “hy are you at a and not a ¨”, “hat would it this Right? enter for videnceased £ractice tae to go from a to a ¦¨”. Another method is to as httpwww.centerforebp.case.educlientfilespdf questions regarding the extremes of their concerns, miremindercard.pdf such as “hat would be the bestworst outcome if you changed the way you discipline your children¨” £roviders may also encounter discord, or resistance, when woring with clients. ithin the context of motivational interviewing, discord occurs when the clientprovider relationship is not optimal e.g., the client perceives the provider as pushing him or her toward change, which some practitioners see as a sign that the provider has veered from the fundamentals of motivational interviewing all ohman, 1. ignals of possible discord include defensiveness, oppositional statements, interrupting, and withdrawal iller ollnic, 1. £roviders should be aware of their own contributions to resistance and respond accordingly, perhaps through reflections, an apology, or even shifting the focus. his material may be freely reproduced and distributed. owever, when doing so, please credit hild elfare Information ¥ateway. his publication is available online at httpswww.childwelfare.govpubsmotivationalinterviewing. 4
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