MH - Motivational Interviewing Techniques

National Youth Mental Health Foundation
Motivational Interviewing and Behaviour Change Techniques Participant Manual
National Ofce p +61 3 8346 8213 f +61 3 9349 5804 info@headspace.org.au www.headspace.org.au
headspace is funded by the Australian Government under the Promoting Better Mental Health Youth Mental Health Initiative
Acknowledgements: This training package was prepared by the headspace Service Provider Education and Training (SPET) program. Project writer: Dr Helen Lindner (APS) Claire Forsyth Project contributors: AUSTRALIAN PSYCHOLOGICAL SOCIETY (APS) Harry Lovelock Laurence Hennessy Allen White THE AUSTRALIAN GENERAL PRACTICE NETWORK (AGPN) Neroli Stayt Tim Roberts The headspace SPET program would like to thank the following individuals for their advice throughout the development phase of the headspace training packages. Strategic Partnership and Planning Group Members Dr Lena Sanci Department of General Practice, University of Melbourne Dr Graham Fleming Australian College of Rural and Remote Medicine Dr Ros Montague NSW Institute of Psychiatry Professor Ann Roche National Centre for Education and Training on Addiction, Flinders University Julie Porrit AGPN Principal Adviser for Nursing in General Practice Professor Jan Schmitzer Batchelor Institute of Indigenous Tertiary Education Chief Inspector John Burgess South Australian Police Force Erica Frydenberg Assoc. Prof. Faculty of Education, University of Melbourne Professor David Kavanagh School of Medicine, University of Queensland Amanda Bode ACT Youth Coalition Copyright 2008 The Australian Psychological Society Ltd This work is copyrighted. Apart from any use permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from the Australian Psychological Society. headspace (The National Youth Mental Health Foundation) is funded by the Australian Government Department of Health and Ageing under the Promoting Better Mental Health Youth Mental Health Initiative. details about headspace visit 2For moreheadspace Facilitator Training Guide www.headspace.org.au
Table of Contents
SECTION: CONTENT: PAGE:
1.
Module A and B workshop overview 1.1 Introduction to headspace 1.2 Training materials and resources 1.3 Structure and content of the workshop 1.4 Training workshop program 1.5 Delivery of workshop 1.6 Evaluation Readings PowerPoint slides & notes pages Module A and B worksheets Participant Worksheets Worksheet 1: Case study - Adam Worksheet 2: Motivational Interviewing techniques Worksheet 3: Case study - Sally Worksheet 4: Case study - Adrian Worksheet 5: Readiness to Change Stages and Process Sheet Worksheet 6: Case study - Eloise Worksheet 7: Case study - Rachel Worksheet 8: Action Plan Form Worksheet 9: Case study - Katrina Worksheet 10: Case study - Travis Homework sheets for Module A and B
6 8 9 10 12 13 16 18
2. 3. 4.
54 55 56 57 59 62 63 64 65 66 58,67
5.
Workshop evaluation Participant Evaluation Form Practice Review Workshop
71 76
6.
headspace MI & BCT Participant Manual
Section 1
Training workshop overview
Section 1.1
Introduction to headspace
headspace: a brief overview headspace is Australias National Youth Mental Health Foundation funded by the Australian Government. The headspace mission is to promote and facilitate improvements in the mental health, social wellbeing and economic participation of young Australians aged from 1225. To this end, headspace aims to be a signicant agent for change in the way that youth mental health issues are responded to across the country. Why headspace?
Mental health and substance use issues are the most serious health problems affecting young people and are a signicant public health issue in the wider community. Approximately one out of every four young people (aged between 12 and 24 years) in Australia will experience a mental or substance use disorder in any given year. These disorders are leading contributors to the burden of disease in young people. Unfortunately, only one in four young people who experience a mental or substance use issue actually receives professional assistance. The current mental health system is not equipped to deal with young people who have mild to moderate mental health issues. This often means that it is difcult for them to obtain timely treatment or nd a service that can respond to their needs. As Australias National Youth Mental Health Foundation, headspace is tackling the issues which stand in the way of young peoples access to appropriate health services.
The headspace model

headspace is changing the way that assistance to young people at risk of mental health and related issues is approached. The emphasis is on: Increasing the communitys capacity to identify young people who are at risk of mental health and related issues, such as substance use, as early as possible Encouraging help-seeking by young people, their families and carers Responding as early as possible to the risk of mental health and related issues using evidence-based interventions provided through an integrated model of care Ensuring that key components of a young persons social recovery, such as links to education, training and employment, are central to the care provided Ensuring that young people play an active role in shaping the delivery of services Ensuring that the headspace model of care provides for the support of family and friends in recognition of the important roles they play in the mental health of young people. This initiative relies on headspace services increasing the clinical capacity for responding to young people with these types of issues.
Section 1.1
Introduction to headspace
The target group
The target group for headspace is all young people in the 1225 year age range. The criteria for access are not to be more complicated than this. This age range is the period during which the onset of mental health issues escalates and reaches its peak. 75% of mental health problems occur by the age of 25. We know that identifying at-risk young people and encouraging them to seek help at an early stage can have a dramatic effect on the prevention of future mental health problems, the use of acute mental health services, as well as the potential effects that such problems can have on other areas of life. The headspace model aims to engage all types of young people, their families and signicant others, not just marginalised young people within a community. We also know that adolescence can be a turbulent time during which there can be quite marked swings between highs and lows, which can themselves be times of risk if a young person is not provided with appropriate support.
How will headspace work?

The engine rooms of headspace are the funded Communities of Youth Services, or CYS. These are youth-friendly hubs or one-stop shops. A CYS has at its core a private practice comprised of medical, allied health and psychiatric practitioners. These people will work closely with allied health practitioners that have been funded by the Department of Health and Ageings Youth Mental Health Initiative, as well as the headspace staff. There are also practitioners from mental health, drug and alcohol, and vocational assistance organisations. The models must provide for the direct service provision of the four core streams of headspace through the hub; primary health care, mental health, Alcohol or Drug services, and social and vocational services. 30 CYS sites have been established across metropolitan, regional and rural Australia since early 2008.
The headspace biopsychosocial model of intervention

Historically substance use and mental health treatment services have not always worked well together, often resulting in young people with needs across both areas falling between the gaps. Consistent with the view of the Australian Government, headspace does not view substance use and mental health in isolation of each other. headspace aims to provide a coherent understanding of mental health issues in a holistic way that is appropriate to the developmental needs of young people. The headspace biopsychosocial model of intervention seeks to intervene early in the cycle of substance use and mental illness, with the objective of providing timely, concurrent, integrated and less restrictive evidence-based interventions to improve the physical and mental health of a young person.
How is Motivational Interviewing and Behaviour Change Technique (MI & BCT) training relevant to a CYS?
Early detection of emerging mental health and/or substance abuse problems among young people is critical to building the capacity of CYS sites to provide more effective responses. Additionally, the identication of problematic behaviours that support or compound substance use and/or mental health problems is a necessary component for the CYS site. Although identication of mental health or substance use problems with rst contact practitioners, such as general practitioners, community health workers and school counsellors, may be initiated by the young person, there is often a high level of ambivalence in the young person towards engaging in the behaviour changes that are needed to effectively manage the problem. Practitioners will need to feel condent in their ability to engage and communicate with a young person on their ambivalence to making changes related to their mental health or substance abuse problems. To do this, practitioners will need to have a good understanding of the models and skills of motivation to change relevant to the young persons readiness to change, and techniques to support the implementation of behavioural goals.
Section 1.2
Training materials and resources
Participant manual includes: Pre-workshop readings PowerPoint slides and notes pages Participant worksheets (10) Homework sheet (Module A) Homework sheet (Module A & B) Evaluation forms Practice Review workshop materials including: - Mini PowerPoint slides - Notes pages. Pre-workshop requirements
Prior to attending the One Day workshop participants are expected to: Complete a pre-workshop online questionnaire as required Prepare for the workshop by reading the pre-workshop selected readings.
Section 1.3
Structure and content of the workshop
Overview The MI & BCT training package is developed as an eight-hour workshop followed by a two-hour Practice Review session that occurs four weeks following completion of the One Day Workshop. The MI & BCT material is presented as two half-day modules (A & B) that can be run on the same day, or if more convenient for the participants, they can be run across different days as two sequential modules. The assumption for Module B will be that the participants have completed Module A.
The Participant Manual includes notes pages for the two-hour Practice Review workshop. The Practice Review session reinforces the skills developed in the workshop modules. The training package has been developed to be in line with the overall aims of headspace training packages. That is, it aims to adopt an early intervention model of care, that reects content and practice that is evidence-based and theoretically sound, and provides effective and culturally sensitive approaches to working with young people with mental health and/or substance use issues.
Learning objectives
Following the MI & BCT training, participants will have an: Understanding of effective models of service delivery for young people with co-morbid mental health and substance use problems based on harm minimisation Ability to appropriately use a range of effective interventions for young people with co-morbid mental health and substance use problems, including Motivational Interviewing and cognitive-behavioural treatments Ability to introduce harm reduction strategies appropriately to young people who present with co-morbid mental health and substance use problems Ability to use Motivational Interviewing appropriately, in order to resolve ambivalence about changing behaviours and engaging in treatment, improve the young persons intrinsic motivation to change, and maintain low levels of treatment resistance Understanding of relevant behaviour change models, procedures for assessing readiness to change, and how to apply Motivational Interviewing principles with young people to prepare them for cognitive-behavioural treatment interventions Understanding of the cognitive-behavioural model for treatment of co-occurring mental health and substance use problems Ability to undertake an assessment, construct a formulation, and determine appropriate forms of cognitive-behavioural intervention for young people with co-occurring mental health and substance use problems Ability to provide effective behavioural interventions for co-occurring mental health and substance use problems in young people.
Target workshop audience

The following materials have been developed as a face-to-face training package suitable for psychologists, allied health workers (e.g. social workers, occupational therapists) and others who work with young people (e.g. youth workers, teachers, police) to develop skills in effective interventions for young people, aged from 1225 years, with mental health and/or substance use problems. The specic content of this training package is the development of skills in Motivational Interviewing, behaviour change processes and strategies relevant to the young persons readiness to change, and goal setting techniques. The workshop has been constructed for training a maximum of 24 participants at a time.
Section 1.4
Training workshop program
Motivational Interviewing & Behaviour Change Techniques Module A: Half-day training schedule TIME 9.009.15 9.159.45 WORKSHOP OUTLINE Session 1: Welcome and introductions Session 2: Awareness of the ambivalent young person Case example to focus workshop aims Adam Group discussion on typical scenarios 9.4510.30 Session 3: Summary of research evidence on efcacy of MI & BCT Background on MI & BCT 10.3010.45 10.4511.30 Tea break Session 4: Knowledge on MI and readiness to change model MI principles and techniques, and readiness to change framework 11.3011.45 Session 5: Practice of MI and readiness to change model MI demonstration 11.4512.15 Session 5 (continued): Practice of MI and readiness to change model MI group activity and discussion Summary of mornings training 12.1512.30 Session 5 (continued): Practice of MI and readiness to change model Summary of Module A skills 12.301.00 Homework activities or lunch
10
Section 1.4
Training workshop program
Module B: Half-day training schedule TIME 1.001.15 WORKSHOP OUTLINE Session 6: Processes of readiness to change model Revisit case study Adam as an introduction and summary of previous half-day training (MI and readiness to change) 1.151.45 Session 6 (continued): Processes of readiness to change model Processes for change 1.452.30 Session 7: Application of the processes of change Group activity on processes of change for contemplation and preparation stages Discussion 2.302.50 2.503.30 Tea break Session 8: Skills in behaviour change, including goal setting Specic BCT for action stage Goal setting 3.303.45 Session 9: Development of skills in behaviour change Demonstration of techniques 3.454.30 Session 9 (continued): Development of skills in behaviour change Group activities and discussion on actiongoal setting techniques 4.304.50 Session 9 (continued): Development of skills in behaviour change Review of Module A and Module B 4.505.00 Session 9 (continued): Development of skills in behaviour change Strategies to embed training skills into client work 5.00 Evaluation and nish
11
Section 1.5
Delivery of workshop
Overview The workshop will be delivered on a face-to-face basis. The workshop is structured to be the primary strategy to assist in the learning of new information and skills. The Practice Review Workshop comprises the secondary strategy to assist learners in consolidating and extending workshop-based learning into their work environment, as well as to reect upon and discuss implementation issues including any difculties that may arise.
The MI & BCT training package: Includes interactive learning activities such as case discussions, role-plays and other simulated practice activities Uses an adult and problem-based learning approach Is based on theoretically derived information and evidence-based research. The workshop activities aim to: Improve the professionals communication skills with young people Be clinically relevant to the real-life settings Assist with the implementation of the new learning in the workplace.
Specialist trainers
The MI & BCT workshop is designed to be delivered by a specialist trainer recruited through the headspace Service Provider Education and Training (SPET) program.
Case studies
It is noted that the workshop material has been designed for a maximum of 24 participants. The skill development activities involve the participants working in groups of three participants. The review by the facilitator of a maximum of eight groups (each with three participants) during each training activity has been determined to be the maximum number of groups viable for the effective training of professionals. The essence of the training is centred on person-focused assessment techniques and intervention development approaches. The case-based application of knowledge and skills presented in the following materials will train the professional to meet the different development needs of young people across the age range, the differences in remote as opposed to urban lifestyles, and a range of socioeconomic circumstances. Various case studies will be provided, but often the most appropriate case studies can be generated from the training group. The facilitation of training should accommodate cases presented from the local participants, who are familiar with the socioeconomic and cultural realities of the local area or a particular age group that is the focus of the local headspace activities. The facilitator is also encouraged to actively seek out case examples that capture issues relevant to the local community, Aboriginal and Torres Strait Islander people and culturally and linguistically diverse people in the area.
12
Section 1.6
Evaluation
The principal aim of headspace Service Provider Education and Training (SPET) packages is to increase practitioners skills in engagement and assessment and the use of evidence-based medical and psychosocial interventions appropriate for young people with mental health and/or related substance use issues. There is an internal and external evaluation process for headspace SPET packages. External evaluation
headspace will evaluate each training package in a pre- and post- online format. The pre-evaluation will take place shortly before participants attend the workshop. This questionnaire requests information pertaining to the participants professional background and their level of understanding, knowledge, skills and condence related to the learning objectives of the training packages. The post-workshop evaluation will take place in the weeks following the training. The questionnaire will assess the degree of change in participant responses to the above questions and any perceived change in participant skills in practice as a result of the training.
Internal evaluation
The headspace Service Provider Education and Training (SPET) program will evaluate the quality of the training delivery from the participants and facilitators viewpoint. This evaluation will take place on the day of the workshop. Facilitators need to ensure that time is made available at the end of the workshop for participants to complete these internal evaluations. Along with the Facilitator Feedback Form, facilitators are asked to post the participants evaluations to the SPET program as detailed on the evaluation forms. The Evaluation Forms are located in the Appendice section of this guide.
13
Section 2
Readings
Section 2
Readings
16
Section 3
PowerPoint slides & notes pages
Section 3
Motivational Interviewing & Behaviour Change Techniques

headspace training program
Slide i
Slide ii
Program structure
Module A: Motivational Interviewing (four hours) Module B: Behaviour Change Techniques (four hours) Option 1: run both Modules A & B on a single day Option 2: run Module A, followed by Module B within a two-week period
18
Section 3
Aims of the MI & BCT workshop

Develop interaction skills to support young people with:
Slide iii
Identification and resolution of ambivalence to attitude and behaviour change Development of skills that will empower the young person to successfully achieve behaviour change.
19
Section 3
Slide 1.1
headspace is Australia's National Youth Mental Health Foundation and is funded by the Australian Government. headspace is delivering its core programs and strategies through a consortium of the following organisations:
Youth Services Development Fund headspace National Office Centre of Excellence ORYGEN Research Centre Service Provider Education and Training The Australian Psychological Society in partnership with the Australian General Practice Network Community Awareness Brain and Mind Research Institute, University of Sydney
Overview
Why headspace? The headspace Model The target group How will headspace work
Slide 1.2
How is MI & BCT training relevant to a CYS?
20
Section 3
Program outline: Module A

9.009.15 9.159.30 9.309.45 9.4510.30 Welcome and introductions
Slide 1.3
Setting the scene: Case example of Adam to focus workshop aims Group discussion on youth scenarios Background on Motivational Interviewing (MI) and Behaviour Change Techniques (BCT) Tea break
10.3010.45
Program outline: Module A

10.4511.00 11.0011.30 11.3011.45 11.4512.15 12.1512.30 12.301.00 Outline readiness to change framework MI principles and techniques
Slide 1.4
MI demonstration and discussion MI participant activity Discussion of MI activity Summary of Module A skills Homework activities or lunch
21
Section 3
Program outline: Module B

1.001.15
Slide 1.5
Revisit case study Adam as an introduction and summary of previous half-day training (MI and readiness to change) Group activity processes for change Group discussion of processes for change activity Tea break
1.151.45 1.452.30 2.302.50
Program outline: Module B

2.503.30 3.303.45 3.454.15 4.154.30 4.304.50 4.505.00 5.00
Slide 1.6
Specific BCT for action stage, including goal setting Demonstration of techniques Participant activities on actiongoal setting techniques Group discussion of BCT activity Strategies to embed training skills into client work Review of session and feedback Finish
22
Section 3
Slide 2.1
Case study: Adam da da am
Discussion
Slide 2.2
Adam scenario: Wants life to be better/different Its too hard to change Unsuccessful attempts to change behaviours Ambivalence to change
23
Section 3
Efficacy of Motivational Interviewing and Behaviour Change Techniques

Self-efficacy Motivational Interviewing Readiness to change Behaviour change
Cognitive behaviour interventions Goal setting
Slide 3.1
Motivational Interviewing (MI)
Slide 4.1
Motivational Interviewing is a directive, patient-centred counselling style for eliciting behavior change by helping the client to explore and resolve ambivalence
(Rollnick & Miller, 1995)
Focused Goal-directed
24
Section 3
Characteristics of MI style
Slide 4.2
Seeking to understand the young persons frame of reference, particularly by reflective listening Expressing acceptance and affirmation Eliciting and selectively reinforcing the young persons own self-motivational statement, expressions of problem recognition, concern, desire, intention to change, and ability to change
Characteristics of MI style
Slide 4.3
Affirming the young persons freedom of choice and self-direction Monitoring the young persons degree of readiness to change
25
Section 3
Aims of Motivational Interviewing
Slide 4.4
Assisting young people to change their behaviour while respecting their choices about the change
Unhelpful (but common) assumptions
Slide 4.5
This young person wants to change This young persons health situation is a prime motivating factor for them to change A tough approach is always best Im the expert, so the young person will follow my advice
26
Section 3
Assessment of motivation to change
Slide 4.6
Motivation = Importance + Confidence Importance do I want to change? Confidence can I change?
Assessment of importance and confidence
Slide 4.7
On a 1 to 10 scale, how important is it to you that you can change . . . ? On a 1 to 10 scale, how confident are you that you can change . . . ?
27
Section 3
Method of motivation to change behaviours
Slide 4.8
Increase importance and build confidence Why so high? What could make you move higher? How high would you need to be to give it a go? Summarise and help the young person to decide what to do next.
28
Section 3
Readiness to change model

A theoretical model of behaviour change Aimed to develop effective interventions to promote health behaviour change
Slide 4.9
Developed by Prochaska, DiClemente and Norcross (1992) Model of intentional change Focuses on the decision making process
Components of the readiness to change model

Stages of change 5 temporal dimensions Outcome measures Decisional balance scales Temptation scales Processes of change 10 cognitive and behaviour activities that facilitate change
Slide 4.10
29
Section 3
Stages of change
1. 2. 3. 4. 5. Pre-contemplation Contemplation Preparation Action Maintenance
Slide 4.11
Pre-contemplation
No intention to take action in the next 6 months Uninformed or under-informed of consequences of behaviours Demoralised about ability to change Avoid reading, talking or thinking about risk behaviours Perceived as resistant or unmotivated
Slide 4.12
30
Section 3
Contemplation
Slide 4.13
An intention to change in the next 6 months Aware of pros and cons of changing Ambivalence about change Not ready for action oriented programs
Preparation
Slide 4.14
Intention to take action in the near future Joined a health education class Bought a self-help book Suitable to be recruited for action-oriented programs, for example: Smoking cessation program Weight loss group Exercise class
31
Section 3
Action
Slide 4.15
Overt modifications to health behaviours in the past 6 months Smoking cessation Less than 30% of calories from fat Applying change processes frequently Vigilance against relapse is critical
Maintenance
Slide 4.16
Working to prevent relapse Applying change processes less frequently than when in Action stage Self-efficacy high
32
Section 3
Outline of strategies for MI

Investigating importance Investigating confidence Looking forward Reviewing previous successes
Slide 4.17
MI strategies to increase readiness to change
Slide 4.18
Investigating Importance Ask: What are the good things about ? What are some of the not so good things about ? Summarise pros and cons. Check with the young person on these. Ask the young person Where does that leave you now?
33
Section 3
Looking Forward
Slide 4.19
Looking Forward has the young person envision two futures: 1. If they continue on the same path without any changes where they might be five or ten years from now. 2. If and the emphasis is on if they decided to make a change in their behaviour, what that future might look like.
Looking Forward
Slide 4.20
The health practitioners job is not to argue one position or another, but rather just elicit the information and then ask the young person to comment on these imaginings.
34
Section 3
Reviewing previous successes
Slide 4.21
Here, we build rapport while gathering information. The health professional avoids a focus on problems, focusing instead on how the behaviour goals fit into the young persons life. Can we spend a few minutes going through the last few days. What happened, and how did you try to work towards achieving your goals?
Demonstration: large group activity

1. MI assessment 2. MI strategies to increase readiness to change
Slide 5.1
35
Section 3
Role-play
group activity 1. Define goal for change 2. Assess level of motivation to change (importance and confidence) 3. Confirm stage of change 4. Use at least one of the strategies for change: good/not so good reasons, reviewing successes, looking forward, summary of where to next
Slide 5.2
Discussion about role-plays
Slide 5.3
Key successes Challenges
36
Section 3
Summary of Module A training
Slide 5.4
Motivation to change High ambivalence to change Assess the importance to change behaviour in next week Assess the confidence to change behaviour in next week Readiness to change Five stages of change Strategies to support change Understand the young persons perspective Work with the young persons goals Looking forward Reinforce any positive change
37
Section 3
Homework for Module A
Slide 5.5
1. Identify two specific existing or new clients with whom you will use MI skills at the next session 2. Identify a colleague to whom you are going to explain MI skills 3. Identify a buddy in your work group that you can discuss your progress with the MI skills Make a time in the coming week to meet or telephone Discuss your successes and challenges in using MI with the young person
Homework for Module A continued ...
Slide 5.6
Questions to answer with your colleague Did you use reflective listening and paraphrasing? Did you assess the importance and confidence of the young person to change the chosen behaviour? Could you identify the young persons stage of change for a specific behaviour? Did you seek to confirm your assessment of the stages of change with the young person? Did you manage your urge to offer solutions too early or unrequested?
38
Section 3
Introduction to Module B
Welcome to the second half-day MI and BCT training session
Slide 6.1
Review of training from previous half-day training (Module A) Reflections on the successes and challenges of implementing the MI skills.
Stages of change
Not everyone is ready to change! 1. 2. 3. 4. 5. Pre-contemplation Contemplation Preparation Action Maintenance
Slide 6.2
39
Section 3
Processes of change
Covert and overt activities Ten common processes Change is best achieved by appropriate matching of processes with the stage of change Two general categories of processes Experiential processes Behavioural processes
Slide 6.3
40
Section 3
Experiential processes of change
Slide 6.4
1. Consciousness Raising (increasing awareness) I recall information people had given me on

how to stop smoking
2. Dramatic Relief (emotional arousal) I react emotionally to warnings about smoking cigarettes 3. Environmental Re-evaluation (social reappraisal)
I consider the view that smoking can be harmful to the environment
Experiential processes of change

4. Social Liberation (environmental opportunities)
Slide 6.5
I find society changing in ways that make it easier for the non-smoker 5. Self Re-evaluation (self re-appraisal) My dependency on cigarettes makes me feel disappointed in myself
41
Section 3
Behavioural processes of change
Slide 6.6
6. Stimulus Control (re-engineering) I remove things from my home that remind me of smoking 7. Helping Relationship (supporting) I have someone who listens when I need to talk about my smoking
Behavioural processes of change

8. Counter Conditioning (substituting)
Slide 6.7
I find that doing other things with my hands is a good substitute for smoking 9. Reinforcement Management (rewarding) I reward myself when I dont smoke 10. Self Liberation (committing) I make commitments not to smoke
42
Section 3
Summary as guideline for processes sheet activity

Assessment of readiness to change Stages of change Importance and confidence Strategies to increase readiness to change Processes Good/not so good Looking forward Reviewing successes
Slide 7.1
Discussion on case study activity

Slide 7.2
43
Section 3
Behaviour change techniques

Goal setting Brainstorming Action plan
Slide 8.1
Goal setting
Slide 8.2
Identifying the goal for change Brainstorming for goals
44
Section 3
Brainstorming for goals

Principles:
Slide 8.3
There is usually not one but many possible courses of action I can tell you about what has worked for others You will be the best judge of what works for you Lets go through some on the options together
45
Section 3
General goals to specific goals

Goal Strategy Target Lose weight
Slide 8.4
Example of general goals to specific goals

General goal Lose weight Strategy Eat less food Specific goals
Slide 8.5
Cut out fried potatoes No red meat during the week No full-fat milk Fruit once a day Baked potatoes or rice instead of chips Fruit instead of pudding 3/7 days Walk to work Arrange sport or dancing once a week Use the stairs
Start eating new foods Replace certain foods Get more exercise
(Rollnick, Mason, & Butler, 2000: Health Behaviour Change)
46
Section 3
Goal setting: action plan

An action plan should include: WHAT I am going to do? HOW MUCH I am going to do? WHEN I am going to do it? HOW MANY days in the week I am going to do it?
Slide 8.6
For example, this week I will walk (what) around the block (how much) after school (when) three times (how many).
Action Plan Form

This week I will:
Slide 8.7
__________________________________ (what) __________________________________ (how much) __________________________________ (when) __________________________________ (how many times) How confident am I that I will achieve this? Circle a number (1 = not at all sure and 10 = certain) 1 2 3 4 5 6 7 8 9 10
47
Section 3
Demonstration of goal setting

Behaviour change strategies Goal setting
Slide 9.1
Assumption of an action stage of change but suitable for action around information gathering for preparation of contemplation stages of change
48
Section 3
Group activity
The young person will identify the goal for discussion (assumes action stage of change) Behaviour change strategies and goal setting
Slide 9.2
Group activity discussion
Slide 9.3
49
Section 3
Summary of training
Slide 9.4
Motivational Interviewing Communications: reflective listening, paraphrasing Importance & confidence of behaviour change: 110 scale Looking forward and previous successes Stages of readiness to change behaviour pre-contemplation, contemplation, preparation, action and maintenance
Summary of training
Slide 9.5
Processes of change Awareness raising, reflection of self and others on behaviour change Preparation and placing in action behaviours for change Monitoring, cues for action, control of temptations and social support Goal setting relevant to stage of readiness to change
50
Section 3
Homework for Module A
Slide 9.6
1. Identify two specific existing or new clients with whom you will use MI skills at the next session 2. Identify a colleague to whom you are going to explain MI skills 3. Identify a buddy in your work group that you can discuss your progress with the MI skills Make a time in the coming week to meet or telephone Discuss your successes and challenges in using MI with a young client
Homework for Module A continued ...
Slide 9.7
Questions to answer with your colleague: Did you use reflective listening and paraphrasing? Did you assess the importance and confidence of the young person to change the chosen behaviour? Could you identify the young persons stage of change for a specific behaviour? Did you seek to confirm your assessment of the stages of change with the young person? Did you manage your urge to offer solutions too early or unrequested?
51
Section 3
Practice Review workshop details
Slide 9.8
The headspace training program organises a two-hour follow-on session for participants. Aims of the follow-on workshop are to: Reinforce and extend the MI and BCT skills developed in Module A and Module B Build self-efficacy and capacity of professionals to use the MI and BCT skills with young people Give professionals an opportunity to identify the success and challenges of using MI and BCT skills with young people. Details of date and venue to be announced by facilitator.
Slide 9.9
Thank you for participating in the Motivational Interviewing and Behaviour Change Techniques workshop.
Any final comments?
52
Section 4
Module A & B worksheets
Section 4
Worksheet 1
Case study:
Adam
Adam is a 16-year-old male who has presented to you for help with his alcohol use. He does not want to attend the appointment but has done so at the recommendation of his school coordinator who has expressed concern with his performance. Adam enjoys going to school and aspires one day to be a business man. However, he has a reputation for being the class clown and disrupting classroom activities. Adams parents have recently separated and he has been nding it difcult to cope with the change. His parents are both well educated and have established careers. He is currently living with his mum and two older brothers. He doesnt really get along with his mum but has a good bond with his eldest brother, who has been worried about Adams moods being up and down. Adam goes to parties every weekend with his mates. They consume excessive amounts of alcohol and Adam often ends up drunk. Sometimes he passes out when he gets home and experiences memory loss. Adam nds that drinking alcohol makes him relax. When he is drunk he doesnt get as angry and gets along better with other people. He has begun having a drink every day to achieve this relaxed feeling, consuming about six cans of pre-mixed drinks during a single day. Adam is physically well-built and enjoys playing football on the weekends. He has the potential to play for his district team if he attends training more regularly and applies himself. This has been quite difcult for him lately as he has been feeling depressed. Adam knows that his drinking is unhealthy but doesnt see any way of changing it.
Notes:
54
Section 4
Worksheet 2
Motivational Interviewing techniques
1. Listen, build rapport attitude of being respectful of the adolescents values and choices. 2. Acknowledge your agenda and the adolescents difculty or ambivalence to changing behaviour Motivational Interviewing involves collaboration. 3. Focus on a specic behaviour. 4. Assess importance and condence: (a) How important is it to you, from 1 to 10? (b) Why so high? (c) What would help you move higher? (d) How high would you have to be to change? (e) How condent are you about changing, from 1 to 10? (f) What would help you move higher? (g) How high would you have to be to change? 5. Work on importance (a) What are the good things about the behaviour? (b) What are some of the not so good things about it? (c) Share information about risks: dont push information, ask what they already know, whether they want to know more, allow the adolescent to make the links (d) Manage resistance: Shift focus, express empathy, emphasise the adolescents control, summarise their position (e) Summarise the pros and cons. 6. Build condence (a) Is there anything youve found helpful in previous attempts to change? (b) Is there anything you can learn from any problems you had last time you tried? (c) Do you know other people who have successfully changed? What worked for them? 7. Summarise both importance and condence with Where does that leave you now? (a) Im not interested in changing - As your psychologist/health professional I am concerned about (my agenda). If you want to discuss this again, Im here (b) I want to do it! - Talk about how (practical aspects/preparation stage of change/goal setting) (c) Ive got to think about it - Encourage reection/monitoring (processes relevant to contemplation stage of change/diary/pros and cons).
Reference
Litt, J., Ali, R., & Pols, R. (1993). Brief alcohol intervention in general practice: Motivational Interviewing techniques [video recording]. Flinders Media.
55
Section 4
Worksheet 3
Case study:
Sally
Sally is a 17-year-old female who is in the nal year of secondary school. She has presented to you at the recommendation of her parents after they caught her smoking cigarettes behind the garage before school. Sally is an only child and lives at home with her parents. Sally gets along with her parents quite well but feels they hold quite high expectations of her. Her parents want her to go to university to study Law but she feels that she cannot achieve a high enough university entrance score. Sally has been extremely anxious and stressed about her studies and her future. Sometimes she feels as though there is no point continuing her education, and that she is a failure. Most of Sallys friends do not intend to go to university so do not study and spend most of their weekends going to parties. She nds her friends dont understand the pressures in her life, or why she wont go out with them every weekend. One of Sallys friends introduced her to cigarettes, telling Sally they would help her to relax after school or whilst studying. All of her friends smoke and Sally thought that taking up smoking might eliminate her reputation for being a good girl. Sally nds smoking reduces her anxiety, helping her cope with the stresses of studying, and pressures from her parents. Sally now smokes at least one pack a day and feels she cant get by without them. On the rare occasion that she goes out on a weekend with her friends, she has experimented with marijuana. Whilst at the moment she reports that she does not use marijuana regularly, she does have easy access to it, and she could see herself using it to manage her stress. Sally recognises that she is not coping well and needs help with other ways of handling her stress, but she feels she has already tried everything, and it is useless.
Notes:
56
Section 4
Worksheet 4
Case study:
Adrian
Adrian is a 19-year-old male who presents to you because his girlfriend is concerned about his binge drinking habit. He doesnt really want to be at the appointment with you but his girlfriend is threatening to end their relationship unless he seeks some help. Adrian is an apprentice plumber and enjoys his work. His boss believes that Adrian is doing really well and is planning to continue employing him after he nishes the apprenticeship. Adrian is a keen soccer player who plays regularly in the district B team, with an occasional position in the A team. He has developed a good friendship group through soccer. Adrian goes to nightclubs every Friday night with his soccer mates, but does not take his girlfriend. He often gets into ghts with people at the clubs and gets kicked out. Adrian often feels quite hung over the next day and nds it hard to perform well at soccer. He has been cautioned by the police recently for drunken and disorderly behaviour. Adrian lives at home with his parents and ve brothers and sisters. His parents migrated from Italy before the children were born and still maintain conservative views on behaviour. Adrian reports that his drinking and aggressive behaviour is disgracing his family. His parents have threatened that if he comes home intoxicated next weekend he will be no longer be welcome in their home. Adrian thinks that his behaviour and drinking is pretty harmless. He recognises that some weekends he does go overboard, but he doesnt want to lose his family or girlfriend over his drinking.
Notes:
57
Homework sheet for Module A

Motivational Interviewing skills
An important aspect of the training in Motivational Interviewing is the determination of opportunities and supports to practice the skills outside the training session. If we want to be good at anything, we need to practice. Additionally, the reinforcement of skills learnt in the training cannot be left to chance. Strategies to reinforce your training: 1. Identify two specic existing or new clients with whom you will use MI skills at the next session 2. Identify a colleague to whom you are going to explain the skills of MI 3. Identify a buddy in your work group that you can discuss your progress with the MI skills - Make a time in the coming week to meet or telephone - Discuss your successes and challenges in using MI with an adolescent client.
Questions to answer with your colleague

Did you use reective listening and paraphrasing? Did you assess the importance and condence of the adolescent to change the chosen behaviour? Could you identify the adolescents stage of change for a specic behaviour? Did you seek to conrm your assessment of the stages of change with the adolescent? Did you manage your urge to offer solutions too early or unrequested?
58
Section 4
Worksheet 5
Readiness to Change stages and processes sheet
The following examples of discussion and intervention focus on a range of behaviour change goals including reduced alcohol and drug usage, increasing healthy eating, exercise and school/work attendance, positive social interactions, improved sleeping patterns and quitting smoking. STAGES OF CHANGE
Precontemplation
PROCESSES
SPECIFIC EXAMPLES
Processes in this stage need to encourage thinking about change, not doing change. Do not make a plan for action. Consciousness raising 1. Keeping a diary of their weekly sleeping patterns (e.g. bed time, wake time, sleep duration, sleep quality, etc.). 2. Recalling information about the desired amount of sleep per night for a person their age. 3. Discuss with the person the benets of exercise to help negative mood. 4. Evaluate the cost of drugs/alcohol and poor education outcomes over time versus the adoption of healthy and achievement oriented behaviours. 5. Budget the cost of a holiday with mates. 6. Recalling a time when energy levels were good and identify the behaviours from that time. Dramatic relief 1. Discuss that any reduction in substance abuse (marijuana, alcohol, nicotine, hard drugs) can help to feel more in control. 2. All things being equal, people without addictions are happier and healthier. 3. Reacting emotionally to the idea that they will miss out on success and good friends if they continue along the current life-path. 4. Discuss the consequences of continued drug habits even in terms of worst-case scenarios. 5. Reection of the emotions around being a person with a substance abuse problem. That is, how do you feel, how do people treat you and how could life be better? 6. Feeling disappointed that they will no longer be smoking and this may restrict shared activities such as catching up with work colleagues or friends when at the smoking spot. They can still go out with friends and enjoy themselves without going outside for a smoke. 7. Discuss that managing a substance abuse problem can be of value to them and not just for the practitioner or their family. 8. Substance abuse control gives the young person more power and exibility with their life choices. 9. It is safer for the person to know their blood alcohol levels. Environmental re-Evaluation 1. Discuss feeling disappointed that travelling, having a good job and other activities is not possible because they have a substance abuse problem. 2. Thinking that avoidance of physical exercise is hurting their partner and family by restricting the possibility of shared activities (picnics, beach trips, bush walking, etc). 3. Think about the avoidance of social activities that arise from being unable to commit to healthy food choices. 4. Consider the future impact your substance abuse problem is having on others the burden for family and friends.
59
Section 4
Worksheet 5 (continued)
STAGES OF CHANGE
Contemplation
PROCESSES
SPECIFIC EXAMPLES
Processes in this stage are focused on encouraging the contemplation to extend into preparation. Get them to try healthy behaviour changes in small amounts and then perhaps to build up. Self reevaluation 1. Discuss the benets of not drinking alcohol for themselves and their family (impact of alcohol long-term and quality of life). 2. Would their self-image be improved if they saw themselves as a less-drunk person at parties? 3. Evaluate and list the barriers of having a weekend without drugs or alcohol and determine things that can be changed easily and those that will take time. 4. Think about how a change in smoking can impact on other chronic problems you may experience such as asthma. 5. Would their self-image be improved if they had more control over their use of drugs and alcohol?
Preparation
Processes in this stage are focused on developing achievable goals or preparation to extend into action. Build on any previous healthy behaviours and encourage goal-focused strategies. Self-liberation 1. Discuss with the person the types of activities they are planning to start to help improve their mental health. 2. Discuss the benets of making goals and a plan. 3. List the types of activities they have found particularly enjoyable in the past (e.g. exercise, socialising, lms, etc.). 4. Discuss career options to assist in making a decision to attend school regularly. 5. Enrol in karate or group exercise classes. 6. To inform yourself of the wealth of opportunities available. 7. Sign a contract to eat healthily for a certain number of meals per week or snack on healthy alternatives. 8. Discuss the benets of making goals and a plan. Social liberation 1. Discuss the support available to have a substance-free weekend. 2. Identify the support available for avoiding depressed or anxious feelings. 3. Form a new group of friends. 4. Involve a family member in assisting you to make healthy choices.
Action
Processes in this stage are focused on achieving the set goals. Develop possible strategies for managing the barriers to regular healthy behaviours. Stimulus control 1. Discuss associating physical activity with a specic daily activity (pairing the activities together). 2. Have a list of future outings that will be enjoyed as mood improves 3. Have friends who do not offer cigarettes to you. 4. Improve your personal hygiene and appearance (hair cut, clean clothes etc.). 5. Work on planning small time-limited exposure to high risk situations.
60
Section 4
Worksheet 5 (continued)
STAGES OF CHANGE PROCESSES Counterconditioning AIMS AND SPECIFIC EXAMPLES 1. Organise alternative social activities to replace high risk situations (e.g. work/school nights, weekends, holidays etc.). 2. Substitute sitting watching an afternoon program on TV with going for a run. 3. Have a number of different activities planned. 4. Drink water in place of having a cigarette. 5. Walk to meet friends to establish a healthy mindset before you are offered cigarettes. 6. Allow oneself a reward if goals are achieved (e.g. download music, new running shoes). 7. Substitute drinking a second can of beer with a glass of water. Helping Relationships 1. Participate in a sporting group to get support in developing an interest in new activities. 2. Arrange a health coach (could be a friend) to discuss the healthy living program (goals, barriers, motivational strategies, etc). 3. Arrange an exercise partner to whom they can compare progress. 4. Have regular reviews with your practitioners. 5. Develop relationships with new friends. 6. Recruit supportive family members to ride the roller-coaster with you, provide stability. Reinforcement Management 1. Encourage family and friends to acknowledge the improvements in health, behaviours and mood. 2. Identify the benets in health (energy, sleep etc) from being substance free. 3. Close friends and family might be aware of an improvement in mood since exercising and changing substance use behaviours. 4. Keep a diary of positive comments people are making about your choices or appearance changes. 5. Examine the benets of better health in terms of time management: less time sleeping, recovering from a hangover etc. 6. Give yourself health rewards. 7. Family and friends are not worrying about you so much.
Maintenance
Processes in this stage aim to reinforce the action stage of behaviour change. Reinforce behaviour change strategies that maintain healthy behaviours. Relapse prevention 1. Set up a system of visual reminders in the bedroom or on the mobile phone. 2. Give an example to young children that drug habits could have an impact on the childs future health. 3. Develop a plan if behaviours start to slide. 4. Construct a support system if new behaviours begin to diminish 5. Reect on the benets of the change on a regular basis. 6. Plan new and healthy adventures (e.g. holidays, study, work etc).
61
Section 4
Worksheet 6
Case study:
Eloise
Eloise is a 15-year-old female who lives in a small country town with her parents and older sister. She is not close to her sister but gets along well with her parents. Eloise does quite well at school and has been learning to play the guitar for the past four years. Eloise feels self-conscious about her appearance and very aware of how the other girls at school look and behave. She has been struggling with being overweight since she started secondary school. She has two classmates that she spends time with in class and during the breaks. She doesnt spend any time with them outside of school. Eloise has never had a boyfriend and feels attracted to another female student at her school. She has not told anyone as she believes that her friends and family will hate her if she comes out as being gay. Her sisters boyfriend has been supplying her with marijuana for the past six months as he felt sorry that she didnt have a social life. Eloise reported that the marijuana helped her to deal with the stress associated with her poor social life and sexuality. Eloise has recently been feeling depressed and unlike herself. Whilst the marijuana makes it easier for Eloise to cope with her sexuality, she is nding it harder to concentrate at school and feeling increasingly distant from her family. She is really unhappy and feels that she wants things to change.
Notes:
62
Section 4
Worksheet 7
Case study:
Rachel
Rachel is a 19-year-old female who has presented to you for help with her smoking at the suggestion of her partner. She has a nine-month old baby and is not coping with the stress of her new role as a parent. She nds that the babys ever-changing routine and demands for attention are wearing her out. Rachel dropped out of her nal year of high school when she found that she was pregnant. She began working as a receptionist at that time to earn money for when the baby arrived. Since the baby has arrived her work has allowed her to continue her employment one day a week. Her mother looks after the baby whilst she works. Rachel currently lives with her partner who is very supportive of her and the baby, however, he works long days and most of the time Rachel nds herself at home caring for the baby alone. Both Rachels parents are supportive, but they want Rachel to take responsibility for the baby herself and not rely on them for babysitting. Rachel began smoking as a 15-year-old and only quit when she learnt she was pregnant. The stress of caring for a child has led Rachel to take up smoking again to calm her nerves during the day. Her partner is concerned that Rachels smoking will harm the baby and has urged her to quit. Rachel agrees with her partners concerns but doesnt know how to cope without the cigarettes.
Notes:
63
Section 4
Worksheet 8
Action Plan Form
When writing my action plan, I like it to include: What I am going to do How much I am going to do When I am going to do it How many days in the week I am going to do it.
Goal
Chew gum instead of smoking. For example, this week I will chew gum (what) everyday (how much) when I feel tempted to smoke (when) for at least ten minutes or until the cravings reduce (how many). This week I will: (what) (how much) How condent am I that I will achieve this? Circle a number: 1 = not at all sure, 10 = certain 1 DAY Monday Tuesday Wednesday Thursday Friday Saturday Sunday 2 3 4 5 6 7 8 9 10 (when) (how many times)
TICK OFF
COMMENTS
Tips to help me achieve my goal

Fit my goal into my everyday lifestyle Create reminders to help me remember my goal Remove temptations Use a diary to monitor my progress (such as the table on the front of this page) Make a written agreement between me and someone else Change my habits bit by bit Copy someone else Imagine a pleasant scene Reward myself when I achieve my goal. I can choose to use more than one tip for each goal. Different goals may need different tips.
Reference
Kelly, J., Menzies, D., & Taylor, S. (2003). The Good Life Club: Methodology and study design a discussion. The Australian Journal of Primary Health, 9, 186191.
64
Section 4
Worksheet 9
Case study:
Katrina
Katrina is a 21-year-old female who has presented to you for help with her drug habit at the recommendation of her sister. Katrina lives at home with her mother and sister; her father was an alcoholic and the family no longer have contact with him. Katrina is close to her mother and sister. Katrina is currently unemployed as she was made redundant when the company in which she was working was downsized. She receives unemployment benets and spends a lot of her day at home watching TV. Prior to losing her job, Katrina would regularly go to nightclubs on weekends and spend time with her close friendship group. Whilst she didnt have a steady boyfriend, there were always boys interested in dating her. Katrina started smoking marijuana on a daily basis since being unemployed. Katrinas sister and her friends are concerned about her as she rarely leaves the house or socialises. Katrina feels depressed by her life and feels that her future is hopeless. Katrina recognises that she has a fairly low quality of life and doesnt want her friends to worry, but she doesnt know how to change things.
Notes:
65
Section 4
Worksheet 10
Case study:
Travis
Travis is a 20-year-old male who has presented to you because his girlfriend is anxious that he is becoming addicted to marijuana and wasting his life. Travis completed high school two years ago with moderate results. He is now concentrating on pursuing a football career full-time in a league-level training squad. Travis lives at home with his parents and younger sister. Travis is really close to his mum who has recently been diagnosed with cancer. He used binge drinking to cope with stressful events in his teen years, but is now using marijuana. Travis feels that smoking marijuana numbs his mind and stops him worrying about his mum. Travis has noticed that he has been feeling depressed but has not had any suicidal thoughts or experienced any psychotic episodes. Travis feels as though he is slipping back into the old coping patterns he used as a teenager and recognises he needs help. He just feels that there is no other way to deal with his mothers medical condition.
Notes:
66
Homework sheet for Module B

Motivational Interviewing skills & behaviour change techniques
An important aspect of the training in Motivational Interviewing (MI) and Behaviour Change Techniques (BCT) is the determination of opportunities and supports to practice the skills outside the training session. If we want to be good at anything, we need to practice. Additionally, the reinforcement of skills learnt in the training cannot be left to chance. Strategies to reinforce your training: Identify two specic existing or new clients with whom you will use MI & BCT skills at the next session Identify a colleague to whom you are going to explain the skills of MI & BCT Identify a buddy in your work group that you can discuss your progress with the MI & BCT skills Make a time in the coming week to meet or telephone Discuss your successes and challenges in using MI & BCT with an adolescent client. Questions to answer with your colleague: Did you use reective listening and paraphrasing? Did you assess the importance and condence of the adolescent to change the chosen behaviour? Could you identify the adolescents stage of change for a specic behaviour? Did you seek to conrm your assessment of the stages of change with the adolescent? Did you manage your urge to offer solutions too early or unrequested? Did you use appropriate processes for the readiness to change? Did you use goal setting? Did you use an Action Plan form?
67
Section 5
Participant Evaluation Form
Section 5
Participant professional background Please specify headspace CYS location Date: Venue: NOT 1. HOW WOULD YOU RATE THE WORKSHOP IN ASSISTING YOU TO MEET THE FOLLOWING LEARNING OBJECTIVES? (a) An understanding of effective models of service delivery for young people with co-morbid mental health and substance use problems based on harm minimisation (b) An ability to appropriately use a range of effective interventions for young people with co-morbid mental health and substance use problems, including Motivational Interviewing and cognitive-behavioural treatments (c) An ability to introduce harm reduction strategies appropriately to young people who present with co-morbid mental health and substance use problems (d) An ability to use Motivational Interviewing appropriately, in order to resolve ambivalence about changing behaviours and engaging in treatment, improve the young persons intrinsic motivation to change and maintain low levels of treatment resistance (e) an understanding of relevant behaviour change models, procedures for assessing readiness to change and how to apply Motivational Interviewing principles with young people to prepare them for cognitive-behavioural treatment interventions (f) An understanding of the cognitive-behavioural model for treatment of cooccurring mental health and substance use problems (g) an understanding to undertake an assessment, construct a formulation and determine appropriate forms of cognitive-behavioural intervention for young people with co-occurring mental health and substance use problems (h) An ability to provide effective cognitive-behavioural interventions for cooccurring mental health and substance use problems in young people 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 MET =1 PARTIALLY MET =2 ENTIRELY MET =3
2. Please rate to what degree your learning needs were met? 1 Not met 2 Partially met 3 Entirely met
3. Please rate to what degree this activity is relevant to your practice: 1 Not relevant 2 Partially relevant 3 Entirely relevant
71
Section 5
4. Please rate the following statements according to what is true for you. NEITHER AGREE STRONGLY DISAGREE FACILITATOR The facilitator was prepared and delivered the workshop in a timely manner The facilitators style was engaging and interesting The facilitator was condent and knowledgeable in their presentation The facilitator was open to further questioning and provided quality feedback SLIDE PRESENTATION The number of slides was appropriate for the content The slide presentation was informative and interesting The slides presented matched the content of the discussion and/or activity APPROPRIATENESS OF CONTENT There was an appropriate balance between knowledge and skill development activities The case studies/role-plays were relevant and applicable to the content of the workshop The case studies/role-plays contributed further to my understanding of the topic discussed The content of the training was appropriate to my work place needs Notwithstanding my prior knowledge, the training material was useful and appropriate 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 =1 1 DISAGREE =2 2 NOR DISAGREE =3 3 AGREE =4 4 STRONGLY AGREE =5 5
72
Section 5
5. If you rated any of the above items in section 1 as Strongly Disagree or Disagree could you please explain why?
6. What changes would you suggest to improve the workshop?
7. Would you like to make any further comments?
Thank you for completing this form. Please hand the Evaluation Form in to the facilitator prior to leaving the workshop.
73
Section 6
Practice Review Workshop
Section 6
Practice Review Workshop
Refer participants to the following worksheets that form part of the MI & BCT workshop. These are found in Section 4 of the Participant Manual and include: Worksheet 2: Motivational Interviewing Techniques Worksheet 5: Readiness to Change Stages and Process Sheet Worksheet 8: Action Plan Form. Inform participants that they will be referring to the information contained in these worksheets as part of discussion throughout the workshop.
76
Section 6
Mini PowerPoint slides & notes pages
Motivational Interviewing & Behaviour Change Techniques

headspace Practice Review Workshop
Slide 1
Aims of the Practice Review Workshop
Slide 2
Reinforce and extend the MI and BCT skills developed in Module A and Module B Build self-efficacy and capacity of professionals to use the MI and BCT skills with young people Give professionals an opportunity to identify the success and challenges of using MI and BCT skills with young people
headspace MI & BCT Participant Manuall
77
Section 6
Summary of training
Motivational Interviewing Communications: reflective listening, paraphrasing Importance & confidence of behaviour change: 110 scale Looking forward Previous successes Stages of readiness to change behaviour Pre-contemplation, contemplation, preparation, action, maintenance
Slide R1
Summary of training
Slide R2
Processes of change Awareness raising, reflection of self and others on behaviour change Preparation and placing in action behaviours for change Monitoring, cues for action, control of temptations, social support Goal setting Relevant to stage of readiness to change
78
Section 6
Homework from workshop

Slide R3
1. Identify two specific existing or new clients with whom you will use MI skills at the next session 2. Identify a colleague to whom you are going to explain MI skills 3. Identify a buddy in your work group that you can discuss your progress with the MI skills Make a time in the coming week to meet or telephone Discuss your successes and challenges in using MI with a young client
Homework from workshop
Slide R4
Questions to answer with your colleague Did you use reflective listening and paraphrasing? Did you assess the importance and confidence of the young person to change the chosen behaviour? Could you identify the young persons stage of change for a specific behaviour? Did you seek to confirm your assessment of the stages of change with the young person? Did you manage your urge to offer solutions too early or unrequested?
79
Section 6
Activity: Review of skill development

Each practitioner to report in turn on:
Slide R5
Key successes and challenges in using Motivational Interviewing and Behaviour Change Techniques with their clients Discussing the training with colleagues Adapting the skills within professional current practice Using skills within the organisational structure of the workplace
Additional topics for discussion

Future support for skill development
Slide R6
Opportunities and needs for further training
80
Section 6
Slide R7
Thank you for participating in the headspace Motivational Interviewing and Behaviour Change Techniques workshop Practice Review follow-up session
Any final comments?
81

MH - Motivational Interviewing Techniques

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National Youth Mental Health Foundation

Motivational Interviewing and Behaviour Change Techniques Participant Manual

Workshop evaluation Participant Evaluation Form Practice Review Workshop

headspace MI & BCT Participant Manual

The headspace model

headspace MI & BCT Participant Manual

How will headspace work?

The headspace biopsychosocial model of intervention

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

Target workshop audience

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

Motivational Interviewing & Behaviour Change Techniques

headspace MI & BCT Participant Manual

Aims of the MI & BCT workshop

headspace MI & BCT Participant Manual

How is MI & BCT training relevant to a CYS?

headspace MI & BCT Participant Manual

Program outline: Module A

Program outline: Module A

headspace MI & BCT Participant Manual

Program outline: Module B

1.151.45 1.452.30 2.302.50

Program outline: Module B

headspace MI & BCT Participant Manual

Case study: Adam da da am

headspace MI & BCT Participant Manual

Efficacy of Motivational Interviewing and Behaviour Change Techniques

Motivational Interviewing (MI)

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

Aims of Motivational Interviewing

Unhelpful (but common) assumptions

headspace MI & BCT Participant Manual

Assessment of motivation to change

Motivation = Importance + Confidence Importance do I want to change? Confidence can I change?

Assessment of importance and confidence

headspace MI & BCT Participant Manual

Method of motivation to change behaviours

headspace MI & BCT Participant Manual

Readiness to change model

Components of the readiness to change model

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

Outline of strategies for MI

MI strategies to increase readiness to change

headspace MI & BCT Participant Manual

headspace MI & BCT Participant Manual

Reviewing previous successes

Demonstration: large group activity

headspace MI & BCT Participant Manual

Discussion about role-plays

Key successes Challenges

headspace MI & BCT Participant Manual

Summary of Module A training

headspace MI & BCT Participant Manual