Eight Stages in Learning

==Eight Stages in Learning Motivational Interviewing==

1. Overall Spirit of MI
Openness to a way of thinking and working that is collaborative rather than prescriptive, honors the client=s autonomy and selfdirection, and is more about evoking than installing. This involves at least a willingness to suspend an authoritarian role, and to explore client capacity rather than incapacity, with a genuine interest in the client=s experience and perspectives.

2. OARS: Client-Centered Counseling Skills
Proficiency in client-centered counseling skills to provide a supportive and facilitative atmosphere in which clients can safely explore their experience and ambivalence. This involves the comfortable practice of open-ended questions, affirmation, summaries, and particularly the skill of accurate empathy as described by Carl Rogers.

3. Recognizing Change Talk and Resistance
Ability to identify client Achange talk@ and commitment language that signals movement in the direction of behavior change, as well as client resistance. Change talk includes desire, ability, reasons, and need for change, which favor increased strength of commitment.

4. Eliciting and Strengthening Change Talk Ability to evoke and reinforce client change talk and commitment
language. Here the client-centered OARS skills are applied strategically, to differentially reinforce change talk and commitment.

5. Rolling with Resistance
Ability to respond to client resistance in a manner that reflects and respects without reinforcing it. The essence is to roll with rather than opposing resistance.

6. Developing a Change Plan
Ability to recognize client readiness, and to negotiate a specific change plan that is acceptable and appropriate to the client. This involves timing as well as negotiation skills.

7. Consolidating Commitment
Ability to elicit increasing strength of client commitment to change, and to specific implementation intentions.

8. Transition and Blending
Ability to blend an MI style with other intervention methods and to transition flexibly between MI and other approaches.

from Miller, W. R., & Moyers, T. B. (2006). Eight stages in learning motivational interviewing. Journal of Teaching in the Addictions

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===Where MI Clinicians Can Get Stuck:===

1. Letting go of the expert role
2. Using complex reflections
3. Missing opportunities for MI
4. Giving insufficient direction
5. Opposing resistance
6. (Not) moving on to Phase 2
7. (Not) attending to commitment language
8. (Not) letting go of MI
(from TNT2008)