Lesson 5: Motivational Interviewing - Focusing

Attention

 

This TEDEd has a lot to do with success in general and the importance of FOCUS in particular.

We can teach our clients (and ourselves) to FOCUS by orienting ourselves to long term goals and to short term concentration.

Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • Reflect on the relationship between goals and commitment to attaining a goal.
  • Demonstrate the use of the "three questions" and "five skills" that are outlined in the Focusing step of MI.

Teaching

Focusing

Read pages 13-18 in the CCNC Motivational Interviewing (MI) Resource Guide.

Ultimately our presence in a client's life is as a "change agent." This means we have the role of facilitating a change in a person's life (internal or external) so that they can attain their goals.

Change can be, however, very difficult.

The Focusing stage of MI allows us to help clients prioritize their goals and determine how motivated they are to engage in the change process.

The process is broken up into parts:

  • Agenda Mapping - This process provides a laundry list of the current issues/goals/problems.
  • Brief Action Planning (with S.M.A.R.T. Goals) - This is a tentative plan that addresses the most pressing issue.
  • Giving Information - Here you are sharing YOUR expertise. Keep in mind though, that the "Elicit/Provide/Elicit" model is important in that it allows you to NOT play the role of "having all the answers." You ultimately want your client to come up with ideas based on their experience and history.
  • Establishing the Patient Dilemma - This is where you use open ended questions to help create the vision of what they might like to see or do differently. (Remember, this is working toward a larger Treatment Plan...that is different than the Brief Action Plan that we put in place to address immediate needs.)

For this Lesson, and anticipating the Lab described below, let's look at the Brief Action Planning step. Ultimately this is not very different than the conversation we would have with a client when we are establishing long range goals. For convenience I have copied the graphic from our CCNC resource here.

This graphic outlines the process and steps you take to have a conversation with someone about their goals and plans to address their goals. The orange balloons identify skills such as the development of S.M.A.R.T Goals and the "Giving Information" step outlined above. Notice where you place these behaviors in the process! IF the client ALREADY has an idea, go with that one! If they are not sure, then you might offer ideas.

Too many times we may have a "solution in search of a problem" based on our own persona experience and knowledge. There will be a time for us to offer these up but unless the person has no idea as to how to approach accomplishing their goals, we don't have to yet offer advice.

Assessment

Lesson 5 Lab

You are going to complete your second Lab Assignment as part of this lesson. The goal is for you to demonstrate your ability to use Agenda Mapping, Brief Action Planning, Giving Information, and Establishing the Patient Dilemma as described in this lesson. To complete the assignment read the instructions the Lab Tab/Section in Blackboard.

Lesson 5 Discussion

Change is sometimes difficult, even when making that change will result in a better quality of life. Many people have goals that they never attain because they are fearful of the change and/or the expectations required of them to bring about this change or the expectations of them after the change.

Consider people in your life (possibly yourself!) and the relationship between having a goal and the actual motivation to achieve that goal. How is this relationship important in working with individuals with mental illness?