Video Demonstration and Review

'''Abstract''': The trainer uses expert videotapes to demonstrate skills and increase understanding.

'''Overview''': A videotape demonstration typically follows a didactic presentation and is used to illustrate a particular method or concept. Videotape review may help "pull together" several techniques to demonstrate a general strategy, or to emphasize the sequential use of techniques or strategies.

'''Guidelines''': Participants may be given specific oral or written instructions to guide observation of a taped segment, or the trainer may use a play-pause-discuss sequence to guide participants to a greater appreciation of the interplay of specific techniques and client

'''Example 1:'''
Join Up - To demonstrate the spirit of MI, participants are asked to watch for elements of this horse training video (timed segment in the round pen) that correspond to elements of MI.
Video is started at beginning of training demonstration, stopped when clock is stopped on tape.
A series of questions for participants follows: What is similar? What lessons can you use to help your practice? Does the horse ever do anything she doesn't want to do? Does she do things that she didn't plan to do? Etc. Followed by a summary statement from the presenter along the lines of: "In this video, the trainer demonstrates that he can read and follow the moment-by-moment cues of the horse at the same time that he leads the horse to want to engage in activities that the horse had no "intention" of engaging in. The trainer never pushes the horse to do anything she doesn't want to, and yet the horse goes through one of the most profoundly changing events of her lifetime. What does this mean for us?"

'''Example 2: CASAA 98 Tape B B Bill Miller with "John" (Native American Man)'''

Pass 1 - To focus on empathy. Participants are asked to focus attention on the client, not the therapist. Participants may be given a written set of questions to consider while they watch the
segment, then discuss afterward, such as the following:
1) What thoughts, feelings and experiences do you think the client has during the interview?
2) How might the client feel about being asked to come to the center? About the events that have taken place? About his relationship with his wife?
3) How does the client react to and perceive the therapist?
4) What is important to the client?

Pass 2 - To demonstrate advanced reflective listening (can be confusing if used for this purpose early in training). Participants are given an OARS ''Observer Tracking'' coding form (or other observer sheet) and asked to tally therapist behaviors. This serves to both emphasize the value of deep reflective responses in conducting an interview that "pulls" for the question/answer trap, and challenges participants to consider the role of advanced reflective statements in the context of hypothesis testing.

Discussion may include differentiating between empathy and agreement (e.g., when the therapist labels wife's behavior as "nagging"), the skill of matching pacing to client pacing and honoring client latencies, the potential trap of questions in reinforcing passivity, and how reflective listening can harvest considerable information in a short time from a relatively nonverbal client.

CASAA98 B B. Miller and EAP John B To demonstrate interweaving of multiple MI principles and strategies, and focus on principle of developing discrepancy, participants watch this video, with regular pauses for review and discussion, and accompanied by a partial therapist transcript, labeling techniques/strategies, e.g.:
'''Develop discrepancy - "stepped over a line, then another line....where am I headed here?"'''
Support self-efficacy, "confidence that if you were to decide, that you could make the change"
Reflect cons of change, "in some ways don't want see the need, it's a letting go of something dear to you"
Emphasize personal choice, develop discrepancy - Asomeone would make you make that change...it is up to you, no one can make that choice for you. It really is your own choice, how you live your life, what do you do about drugs, where you're headed

'''Other video segments''': CASAA 98 B T. Moyers and Rounder B "Amplify ambivalence", entry interview, roll with resistance
Allyn/Bacon 2000 B B. Miller and Soccer guy B Rolling with resistance
APA 2002 B B. Miller and Debbie B end segment includes discussion/clips of Miller answering
FAQs about various treatment issues

'''Notes''': CASAA 98 B MI/ Not-MI demonstration B S. Rollnick, Heart patient
Other demonstration tapes at http://motivationalinterview.org/training/videos.html