Motivational Interviewing Preparing People to Change Addictive Behavior

by Miller, William R.; Rollnick, Stephen

• ISBN13: 9780898624694
• ISBN10: 089862469X
• Edition: 1st
• Format: Paperback
• Copyright: 1992-03-01
• Publisher: The Guilford Press

Summary

Since the initial publication of this classic text, motivational interviewing (MI) has been used by countless clinicians in diverse settings. Theory and methods have evolved apace, reflecting new knowledge on the process of behavior change, a growing body of outcome research, and the development of new applications within and beyond the addictions field. Including 25 nearly all-new chapters, this revised and expanded second edition now brings MI practitioners and trainees fully up to date. William R. Miller and Stephen Rollnick explain how to work through ambivalence to facilitate change, present detailed guidelines for using their approach with a variety of clinical populations, and reflect on the process of learning MI. Chapters contributed by other leading experts then address such special topics as MI and the stages-of-change model; using the approach with groups, couples, and adolescents; and applications to general medical care, health promotion, and criminal justice settings.

Author Biography

William R. Miller is Professor of Psychology and Psychiatry at the University of New Mexico, and Director of the Research Division of UNM's Center on Alcoholism, Substance Abuse, and Addictions. He has published 17 books and more than 100 articles and chapters, focusing primarily on the treatment of alcohol problems and addictive behaviors. He has developed and evaluated a variety of innovative clinical strategies and, along with G. Alan Marlatt, designed a comprehensive set of structured clinical interviews for pre-treatment and follow-up assessment of alcohol problems. He has held numerous research grants, founded a private practice, served as a consultant to many organizations, and currently holds a 5-year Senior Career Research Scientist Award from the National Institute on Alcohol Abuse and Alcoholism.

Stephen Rollnick has worked in the addictions field over the past 16 years as a clinician, supervisor, trainer, and manager. His research interests cover the process and outcome of treatment and training. The author of a variety of papers and articles on these and other topics, he currently works as a Principal Clinical Psychologist in a general practice setting and is completing collaborative studies with the World Health Organization and the National Drug and Alcohol Research Centre in Sydney, Australia.

Table of Contents

PART ONE. BACKGROUND	3	(48)
1. The Atmosphere of Change	3	(11)
Specifying Nonspecifics	4	(1)
Critical Conditions of Change	5	(1)
The Evolution of Confrontation	5	(9)
2. What Motivates People to Change?	14	(16)
Motivation as a State	14	(4)
Motivation as a Behavior Probability	18	(2)
Effective Motivational Approaches	20	(8)
Putting the Ingredients Together	28	(2)
3. Brief Intervention: More Pieces of the Puzzle	30	(6)
Self-Change	30	(1)
The Impact of Brief Interventions	31	(1)
Active Ingredients of Effective Brief Counseling	32	(3)
Motivation as an Interpersonal Interaction	35	(1)
4. Ambivalence: The Dilemma of Change	36	(15)
I Want To, but I Don't Want To	36	(1)
Encountering Ambivalence	37	(1)
Understanding Ambivalence	38	(8)
Working with Ambivalence	46	(5)
PART TWO. PRACTICE	51	(136)
5. Principles of Motivational Interviewing	51	(13)
What Is Motivational Interviewing?	52	(1)
Differences from Three Other Styles	53	(2)
Five Basic Principles	55	(7)
Summary	62	(2)
6. Phase I: Building Motivation for Change	64	(25)
About the First Session	64	(6)
Opening Structure	70	(1)
Five Early Strategies	71	(16)
Follow-Through Contact	87	(2)
7. Using Assessment Results	89	(11)
Presenting Assessment	89	(2)
Dimensions for Assessment	91	(4)
Assessment of Motivation	95	(1)
Personalized Feedback	96	(4)
8. Dealing with Resistance	100	(13)
The Therapist's Role in Resistance	100	(1)
Recognizing Resistance	101	(1)
Strategies for Handling Resistance	102	(8)
Handling Missed Appointments	110	(1)
The Drama of Change	111	(2)
9. Phase II: Strengthening Commitment to Change	113	(12)
Recognizing Readiness for Change	113	(1)
Phase II Hazards	114	(2)
Recapitulation	116	(1)
Key Questions	117	(1)
Information and Advice	118	(1)
Negotiating a Plan	119	(4)
Endgame	123	(2)
10. Typical and Difficult Situations	125	(14)
Working with Spouses	125	(4)
The Coerced Client	129	(2)
Broaching the Subject	131	(1)
Shortage of Time	132	(1)
Exploring Emotions	133	(2)
Life in Chaos	135	(2)
Sidetracking	137	(1)
Detoxification	137	(2)
11. A Practical Case Example	139	(19)
12. Teaching Motivational Interviewing	158	(29)
Some General Points	159	(3)
Laying the Foundation	162	(1)
Opening-Strategy Exercises	163	(14)
Middle-Game Exercises	177	(5)
Endgame Exercises	182	(5)
PART THREE. CLINICAL APPLICATIONS OF MOTIVATIONAL INTERVIEWING	187	(136)
Introduction	187	(4)
13. Motivational Interviewing and the Stages of Change	191	(12)
Carlo C. DiClemente
Precontemplation: Resistance and "the Four R's"	192	(2)
Contemplation: A Risk-Reward Analysis	194	(3)
Determination: Commitment to Action	197	(1)
Action: Implementing the Plan	198	(1)
Maintenance, Relapse, and Recycling	199	(1)
Summary	200	(1)
Suggested Readings	201	(2)
14. Brief Motivational Interviewing for Use by the Nonspecialist	203	(11)
Stephen Rollnick
Alison Bell
The Conduct of a Session	204	(1)
The Opening: Raising the Subject of Substance Use	205	(1)
Getting Going: Exploring Concerns and Options for Change	206	(2)
Ending the Session	208	(1)
Case Example	209	(4)
Conclusion	213	(1)
15. Motivational Interviewing: Perspectives from The Netherlands, with Particular Emphasis on Heroin-Dependent Clients	214	(11)
Henck P. J. G. van Bilsen
Understanding Motivation	214	(3)
Special Techniques	217	(3)
Motivational Interviewing with Heroin-Dependent Clients	220	(5)
16. Motivational Counseling with Alcoholic Couples	225	(11)
Allen Zweben
Rationale for Involving the Spouse	226	(1)
The Spouse's Role in Motivational Counseling: "Witness" versus Active Participant	227	(1)
Inviting the Spouse to Participate in Treatment	228	(1)
Assessing the Spousal Support System	228	(1)
Techniques for Spouse-Involved Motivational Counseling	229	(7)
17. Reinforcing Robust Resolutions: Motivation in Relapse Prevention with Severely Dependent Problem Drinkers	236	(12)
Steve Allsop
Bill Saunders
Some Background	236	(1)
The Clinical Context	237	(1)
The Program	237	(1)
The Meetings with Each Individual Patient	238	(7)
The Meetings with Two Patients	245	(1)
Self-Efficacy	246	(1)
Conclusions	247	(1)
Acknowledgments	247	(1)
18. Motivational Interviewing with Young People	248	(12)
Gillian Tober
Setting and Biographical Details	249	(1)
The Interview	250	(8)
Sequel	258	(1)
Discussion	258	(2)
19. Alcohol Use and Goal Hierarchies: Systematic Motivational Counseling for Alcoholics	260	(12)
W. Miles Cox
Eric Klinger
Joseph P. Blount
Motivational Model of Alcohol Use	261	(1)
Assessing Motivational Structure	262	(1)
The Counseling Technique	263	(8)
Conclusions	271	(1)
20. Dealing with Alcohol Problems in the Community	272	(7)
Tim Stockwell
Community Alcohol Teams	272	(1)
The Relevance of Motivational Principles to Community-Based Alcohol Work	273	(5)
Summary and Conclusions	278	(1)
21. Motivational Intervention with Heroin Users Attending a Methadone Clinic	279	(14)
Bill Saunders
Celia Wilkinson
Steve Allsop
The Nature of Our Research	280	(1)
The Good Things about Drug Use	281	(2)
The Less Good Things	283	(2)
Life Satisfaction	285	(1)
Problems or Concerns	286	(1)
Cost-Benefit Analyses	287	(1)
Emotional Reviews	288	(2)
Future Intentions	290	(1)
Concluding Comment	291	(1)
Acknowledgments	292	(1)
22. Motivational Interviewing for HIV Risk Reduction	293	(10)
Amanda Baker
Julie Dixon
Philosophical Framework for the Approach	293	(2)
Clinical Population	295	(1)
Aims of the Motivational Interview	295	(1)
Rapport	295	(1)
Interview Strategies	296	(4)
The Case of Kerry	300	(2)
Important Elements	302	(1)
23. Motivational Intervention in the Treatment of Sex Offenders	303	(11)
Randall J. Garland
Michael J. Dougher
Factors Undermining Treatment Motivation	304	(3)
Engaging the Sex Offender in Treatment	307	(3)
Motivation during Treatment	310	(3)
Conclusions	313	(1)
24. Motivational Interviewing and the Maintenance of Change	314	(9)
Rosemary Kent
Nearing the End of the Journey	314	(1)
Ambivalence about Moving On	314	(1)
Ambivalence and Premature Self-Efficacy	315	(5)
Differing Expectations	320	(1)
Conclusion	321	(2)
REFERENCES	323	(20)
INDEX	343