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Speaker 1: Welcome back everybody.

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Speaker 2: Today we're gonna be looking at motivational interviewing. So it's

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one of the highest yield psychotherapy approaches on the E

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triple P. One of the reasons that combines therapeutic alliance,

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behavioral change theory, empathy, stages of change, resistant management, client autonomy.

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Motivational interviewing is commonly tested in substance use disorders, health psychology,

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behavioral medicine treatment, adherent psychotherapy, integration.

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Speaker 1: So what is it well.

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Speaker 2: Motivational interviewing was developed by William Miller and later expanded

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with Stephen Rolnick. It is collaborative, person centered, goal oriented,

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and non confrontational. Motivational interviewing is design to help clients

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resolve ambivalence about change. The central idea is people often

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know they should change, but simultaneously want to change and

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do not want to change.

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Speaker 1: This is ambivalence.

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Speaker 2: Ambivalence is having mixed or conflicting feelings about behavioral A

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smoker says, I know cigarettes are heard of me, but

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smoking helps me calm down. Motivation learning interviewing does not

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argue against ambivalents, it explores it. A Motivational interviewing is

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not a simple technique so the therapeutic stance the therapist

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avoids authoritarian control, confrontation, arguing, shaming, or even expert positioning. Instead,

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it emphasizes collaboration, evocation, and autonomy. Collaboration is the therapist

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and the client work together as partners. Instead of saying

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you need to stop drinking, they might say, help me

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understand what alcohol does for you. Motivational learning interviewing rejects

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the expert versus patient model evocation, drawing out the client's

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own motivations and values. What matters most to you about

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becoming healthier. A client, not the therapist voice, has reasons

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for change. Also autonomy, respecting the client's freedom of choice.

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You're the one who ultimately decides what happens. A tip

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could be pressure increases resistance, autonomy reduces defensiveness.

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Speaker 1: Why it works.

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Speaker 2: Motivational interviewing reduces shame, defensiveness, and reactants while increasing intrinsic motivation,

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self efficacy, and therapeutic alliance. Intrinsic motivation is the internal

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desire to change based on personal values and meaning.

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Speaker 1: A client exercises.

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Speaker 2: Because they want energy to play with their children, not

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because others pressure them. Another tip is intrinsic motivation is

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more durable than external pressure self determination theory. Motivational interviewing

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strongly overlaps with self determination theory, and there's three core

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psychological needs autonomy, competence, and relatedness. Autonomy is feeling in

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control of one's decisions. Competence is feeling capable and effective,

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somewhat similar to Bandura's self efficacy.

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Speaker 1: A client begins believing I can actually do this.

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Speaker 2: Relatedness feeling emotionally connected and understood. The client feels expected

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rather than judge, by the therapist. The therapeutic alliance, which

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we know makes up most of the success of therapy,

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is a collaborative emotional bond between therapists and client. One

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of the strongest predictors of positive therapy outcomes across treatment models.

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It resistant adolescents slowly engages because they feel genuinely heard.

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Motivational interviewing places enormous emphasis on alliance building core motivational

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skills like ores. This is extremely important for the E

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triple p ors stands for open ended questions, A for affirmations,

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R for reflective listening, and S for summaries. Let's take

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a look at each one. So open ended questions, questions

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requiring elaboration rather than binary answers like yes or no.

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Speaker 1: Encourage exploration self reflection.

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Speaker 2: For instance, what concerns you most about your current situation?

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Speaker 1: What would you like your life to look like? You

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can't answer these with a yes or no. Why is

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it important?

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Speaker 2: Because the increase engagement promotes self discovery, reduced defensiveness, and

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encourage change. Talk affirmations. These are statements recognizing strengths, efforts,

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or values.

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Speaker 1: It took courage to come here today.

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Speaker 2: Important point affirmations focus on effort, resilience, values, persistence, not

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empty praise. Reflective listening is the heart of motivational interviewing.

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The therapist reflects back meaning and emotion.

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Speaker 1: One of the big reasons is.

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Speaker 2: Because the client would feel heard and understood and emotionally safe.

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Simple reflections repeating or slightly rephrasing the client's statement. I

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just can't stop, says the client. You feel stuck, says

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the therapist. A complex reflection.

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Speaker 1: Would we be like this?

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Speaker 2: You add meaning and emotional depth. The client says, I

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keep relapsing. Part of you feels exhausted and discouraged. Complex

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reflections deep and emotional processing. Double sided reflection is acknowledging

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both sides of the ambivalence. You enjoy drinking because it

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helps you relax, and you're also worried about what it's

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doing to your health. Summarise is when the therapist reviews

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key themes from the conversation. The goals that are reinforced

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insight to ORGANI thoughts, strength and motivation, and couldsolidate change talk.

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Speaker 1: To make it stronger. Let me see if I understand

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so far is the beginning of it.

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Speaker 2: The four processes of motivational interviewing unfolded four major stages.

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Speaker 1: One is engaging.

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Speaker 2: The goal is to build trust and connection, empathy, listening,

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alliance building, So engagement comes before advice as a tip.

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Speaker 1: Number two is focusing.

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Speaker 2: Clarify the target behavior for change the client, I want

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to address alcohol, use, medication, diet.

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Speaker 1: Number three is evoking.

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Speaker 2: The heart of motivational interviewing, you want to elicit as

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the goal change talk. Change talk is where the client

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statements favor change. For instance, some of the forms of

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change talk include desire, I want to, ability, I could,

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the reasons this would help me?

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Speaker 1: Need? I need to?

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Speaker 2: So what's the big deal about change talk? The more

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clients verbalize reasons for change.

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Speaker 1: The more likely change becomes.

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Speaker 2: For instance, I'm tired of losing relationships because of drinking.

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This predicts greater readiness for change. Remember, tired is going

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to give us the reason writing, So we move on

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planning as the fourth step goal move toward concrete behavioral action.

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Planning happens only after sufficient motivation exists. Premature advice give

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a game increases resistance. Then you have smart goals, often

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integrated into motivational interviewing. Smartest specific, measurable, achievable, relevant, and

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time limited. You also have sustained talk, supporting continuation of

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current behavior.

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Speaker 1: It's not that bad.

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Speaker 2: As an example, I've tried before, I'm not ready. Sustained

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talk is problematic. Change talk moves towards change, Sustained talk

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moves away from it. How does that therapist respond to

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the state?

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Speaker 1: Talk?

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Speaker 2: Motivational entering does not argue, shame or confront. Instead, it reflects, explores,

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it validates the ambivalence Resistance a traditional view is client

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pathology or stubbornness, and the view of motivational interviewing, the

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resistance is a relational signal. It often means the therapists

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push too hard. Autonomy feels threatened and the client fields misunderstood,

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rolling with resistance, responding without confrontation. I don't think therapy

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will help, says the client. Therapist says, you've probably had.

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Speaker 1: Experiences where people don't really understand what we're going through.

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Resistance decreases. When pressure decreases, then we go to the trance.

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Speaker 2: Theoretical model the Stages of Change by Prochaska and Di Clemente.

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Motivational interviewing aligns closely with the model. You have pre

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contemplation where the client does not recognize the problem. I

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don't drink too much contemplation. Maybe I should quit someday.

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They have ambivalents about change, explore the pros and cons.

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Number three is preparation and tending to act soon, and

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I'm looking into treatment programs here. Your goal is to

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strengthen the commitment. Number four is action, actively making changes,

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attending therapy and reducing substance use.

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Speaker 1: The goals to support the momentum.

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Speaker 2: Number five is maintenance, sustaining behavioral changes, remaining sober for

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over six months. The goals prevent relapse and finally relapse

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return to previous behavior patterns. Motivational interviewing views relapses common

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expected and non moral relapse is not viewed as failure.

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Applications of motivational interviewing developed for substance use dis orders,

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not widely using health psychology. Common areas include smoking, diabetes, obesity,

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exercise adherence, medication compliance, and mental health. It's useful for

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treatment engagement, depression, anxiety, psychosis, and bipolar disorder. Adolescence is

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highly effective because of their respects, independence, identity, development, and autonomy.

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It's great for medication adherence, especially useful in schizophrenia, bipolar

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and chronic medical illness often.

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Speaker 1: Prepares clients for CBT.

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Speaker 2: The important difference, though, is CBT focuses on changing thoughts

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and behaviors, while m I focus on increasing readiness change.

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MII overlaps with act acceptance and commitment therapy. Both emphasize values, autonomy,

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and psychological flexibility. So some common questions which skills consider

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the heart of m If you said reflective listening, you're right.

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Speaker 1: What is change talk?

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Speaker 2: It's client statements favoring change. Which stage includes ambivalence contemplation?

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How does motivational interviewing view resistance as a relational signal

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not client pathology? And the last one, what does ORRS

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stand for? Open ended questions, affirmations, reflective listening, and summaries

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high yield pearls. Here am I is collaborative, not confrontational.

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The therapist evokes rather than persuades reflective listening. Essential resistance

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usually means a therapist is pushing too hard. Change talk

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predicts me behavior change. MI is heavily tied to autonomy

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and self determination theory, and MI is specially useful for

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ambivalent clients. Motivational interviewing is less about convincing clients and

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more by helping them hear themselves clearly. Therapist helps uncover

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motivation that already exists underneath fear and shame and hopelessness.

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Well that's it for today Motivational Interviewing. Hopefully you enjoy that,

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and we'll talk to you all next time