motivational interviewing (mi) w11

8/8/2019 Motivational Interviewing (Mi) w11

1/9

MOTIVATIONAL INTERVIEWING (MI)

Abad ke 20 the myth of the unmotivated client

Abad ke 21 new substance abuse paradigm MI sbg amalan

utama & kaunselor perlu kompeten menggunakan MI

Andaian asas MI atau Temuduga Bermotivasi ialah klien hanya

akan berubah jika

a) kehidupan terlalu menyakitkan/menyiksakan utk bertahan

ATAU

b) menerima tekanan2 luaran yang kuat yg mendorong utk

bertindak


2/9

Many of the clients we see have had no dearth of suffering. Humiliation, shame & guilt are not the primaryengines of change. Ironically, such experiences can evenimmobilize the person, rendering change more remote.Instead, constructive behavior change seem to arisewhen the person connects it with something of intrinsic

value, something important, something cherished.Intrinsic motivation for change arises in an accepting,empowering atmosphere that makes it safe for theperson to explore the possibly painful present in relationto what is wanted and valued (Miler & Rollnick, 2002,p.12 dlm J.A.Lewis., et.al. (2007). Substance AbuseCounselling. Brooks/Cole, Cengage Learning.


3/9

Utk keberkesanan MI, kaunselor perlu percaya dankomited thdp proses perubahan yg dinyatakan di atas

Hanya dgn mendalami & respek pandangan klien spt diatas, kaunselor akan mula mencipta persekitaran ygselamat, menerima dan empowering amalan ygkompeten


4/9

Definisi MI

- a goal-directed, client-centered counselling style foreliciting behavior change by helping client to explore andresolve ambivalence.

1. client centered & goal directed

- berasal dari Carl Rogers client centered / person centeredyg menekankan kepentingan hubungan klien & kaunselor

- kebolehan kaunselor mempamerkan keaslian,

penerimaan tanpa syarat & empati

- menggunakan kemahiran mendengar PCC & meneguhkan

perubahan percakapan klien (clients change talk)


5/9

Positive relationship is necessary but not sufficient.

MI can be thought of as client-centered therapy with atwist. Unlike client-centered therapy, MI has specificgoals: to reduce ambivalence about change and toincrease intrinsic motivation to change. In this sense, MI

is both client-centered and directive. The MI therapistcreates an atmosphere in which the client rather thanthe therapist become the main advocate for change aswell as the primary agent of change (Arkowitz & Miller,2008, p.4 dlm. J.A.Lewis., et.al. (2007). Dlm. Substance

Abuse Counselling. Brooks/Cole, Cengage Learning.


6/9

2. Eliciting behavior change

- jika kaunselor dpt mengenalpastikan change talk, ia dptbelajar bgmana utk melakukannya lebih dari itu perubahan t/laku

The intentional effort to ellcit client change talk, rather

than simply waiting for it to occur, is a strategic skill thatdifferentiates MI from other therapeutic approaches.

(e.g. In what ways might this change be a good thing?), and is cautious with questions the answer to which isresistance (e.g., Why havent you changed?). Whenchange talk occurs, the counselor may reflect it, affirm it,

or ask for elaboration or examples all of which are likelyto elicit more change talk.


7/9

Eliciting talk of change & keeping focus on change are at

the heart of MI

Andaian tntg motivasi yg mendasari MI ialah:

a) manusia mempunyai dlm dirinya apa yg diperlukan utk

ia berubahb) kemahuan thdp perubahan disedarkan dlm lingkungan

konteks interpersonal


8/9

3. Ambivalence Resolving

Resolving ambivalence can be the key to change, and,indeed, once ambivalence has been resolved, little easemay be required for change to occur. However, attemptsto force resolution in a particular direction (as by direct

persuasion or by increasing punishment for inaction) canlead to a paradoxical response, even strengthening thevery behavior they were intended to diminish.

Spirit & prinsip MI adalah terlalu berbeza dgn memberi

nasihat @ tekanan kpd klien, akan tetapi resolusiambivalen akan membawa kpd perubahan yg positif.


9/9

Soalan Perbincangan

Bincangkan prinsip-prinsip MI (dlm handout yg diberi) :

i. Express empathistancey

ii. Develop discrepancy

iii. Roll with resistance

iv. Support self-efficacy

motivational interviewing (mi) w11

Documents