Trauma-Informed Motivational Interviewing: A Foundational Approach to Engage and Treat Complex Clients

CPD

Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

Handouts

Speaker

Kristin Dempsey, EdD, LPCC, LMFT, MINT Certified Trainer Related seminars and products

---

Kristin Dempsey, EdD, LPCC, LMFT, MINT Certified Trainer, frequently trains diverse mental health and helping professionals in MI, trauma-informed care, crisis interventions, and various cognitive behavioral and behavioral therapy approaches. She specialized in working with individuals experiencing co-occurring mental health and substance use issues, trauma, and eating disorders, among other conditions. Kristin teaches from a strengths-based approach that explores values and meaning-building for clients, supervisees and clinicians alike.
 

Speaker Disclosures:
Financial: Kristin Dempsey maintains a private practice and has employment relationships with the Wright Institute and the San Francisco State University. She receives royalties as a published author. Kristin Dempsey receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Kristin Dempsey serves as the board president of California Associate of Licensed Professional Clinical Counselors.

Ali Hall, JD, MINT Certified Trainer Related seminars and products

---

Ali Hall, JD, MINT Certified Trainer, is a member of the Motivational Interviewing Network of Trainers (MINT), a MINT Certified Trainer, and an independent consultant and trainer. Ali currently serves on the MINT Board of Directors, focusing on professional skill development for MI practitioners and trainers. Ali served as a Lead Trainer for the International MINT Training for New Trainers (TNT) in Warsaw (2019), New Orleans (2018) and Berlin (2015). Ali has designed and facilitated more than 2500 Motivational Interviewing (MI) workshops for criminal justice, wraparound services, chronic disease and diabetes self-management educators, health care practitioners, health coaches, telephonic health service providers, social services providers, behavioral health clinicians, social workers, psychologists, and psychiatrists, and provides training for trainers in evidence-based practices. Ali regularly presents at national and regional conferences for wraparound, criminal justice, health care providers, public health leaders and key organizational administrators.

Ali regularly provides MI coding and evaluation training, coding services and skill development coaching, and provides consultation to systems for establishing communities of practice and for effective, sustainable MI implementation. Ali is the co-developer of the Motivational Interviewing Competency Assessment (MICA), a coding and coaching tool for MI skill improvement.

Ali regularly designs and evaluates MI interventions for funded research, including large national and international studies. Ali’s work with agencies includes creating skills development curricula for staff and materials for those served. Ali also regularly provides workshops in Dialectical Behavior Therapy (DBT), applications of Cognitive Behavior Therapy (CBT) and integration of MI and skill building evidence-based practices. Ali is the co-author of an MI skill-building manual and toolkit, to be released in late 2020 (published by PESI Behavioral Health Continuing Education). Ali also serves as a reviewer for the National Registry for Evidence-Based Practices and Programs (NREPP).

Ali spent her undergraduate years at Occidental College in Los Angeles and completed her graduate studies in organizational behavior at the School of Industrial and Labor Relations at Cornell University, as well as her J.D. at the Cornell University School of Law. In her spare time, Ali is a cold-water marathon swimmer, raising funds for under-resourced kid’s charities.

 

Speaker Disclosures:
Financial: Ali Hall receives compensation as an independent consultant and trainer and has an employment relationship with University of California-Davis. She is a member of MINT and is the co-developer of Motivational Interviewing Competency Assessment. She receives royalties as a published author. Ali Hall receives a speaking honorarium, recording, and book royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Ali Hall serves on the board of directors of MINT.

Objectives

1. Utilize the four components of the Spirit of MI to engage individuals in conversations about change.
2. Theorize each of the four process stages of motivational interviewing and state how each contributes to building motivation to change.
3. Practice dialogues that focus on change talk, validation and other motivational strategies.
4. Evaluate five tenets trauma-informed care to effectively use motivational interviewing with clients displaying symptoms of trauma.
5. Practice eight evidence-based micro skills and attitudes common to motivational interviewing that promote change across therapeutic modalities.
6. Demonstrate how each of the five motivational interviewing microskills can be used to address client trauma.
7. Create therapeutic responses addressing trauma using the five motivational interviewing microskills.
8. Formulate MI interventions that are sensitive to common co-occurring disorders including anxiety, depression, and bipolar disorder.
9. Apply MI strategies to assess for suicide and move clients toward stability.
10. Analyze role-play demonstration to enhance ability to apply MI strategies with challenging client problems.

Outline

• Ingredients
  • Four Processes
  • Microskills (common therapeutic factors) 
  • Exchanging Information
  • Language Types
  • Focus on change target
  • Elicitation and elaboration of change talk
• The Spirit of MI
  • Using PACE
  • How to create partnership
  • What “acceptance” sounds like
  • How to use “compassionate detachment”
  • OARS, DARN CAT & change talk
• Exercises & Techniques for Action
  • Sample questions to elicit & strengthen motivation
  • Personal reflection
  • Common responses to MI    
  • Counter client ambivalence 
  • How to use a strengths-based lens

• Why use a Trauma-Informed Approach?
  • The link between MI & Trauma care
  • What diagnosis misses
  • Bring the past into the present
  • Trauma basics – types, examples, ACES
  • What does a symptom really mean?
  • PTSD & the brain
• Trauma-Informed MI: How it Works
  • A “person-driven” approach
  • Build client autonomy and collaboration with client
  • The window of tolerance & optimal arousal for change
  • Reframe questions to avoid pathologizing client experience
  • Components of a trauma-informed care system
• Trauma-Informed MI Skills in Action
  • Righting Reflex and Roadblocks to Listening
  • Crosswalk between TI approach and MI
  • Spot clients “out of control” feelings
  • Building a safe environment 
  • Create self-advocacy & empowerment
  • Cultivate Post-traumatic growth

• Engage Your Trauma Clients More
  • Honour the client’s trauma reality
  • Create a trauma-narrative with open-ended questions
  • Use affirmations strengthen abilities & internal resources
  • Reduce trauma-induced confusion & overwhelm
  • Give clients choice & access to their own ideas for change – with client permission
• MI Techniques: Mirco Skills, Big Changes
  • Provide-Elicit-Provide
  • The communication process
  • The reflective listening process
  • Open-ended questions with traumatized clients
  • Sharing Information & Advising - What’s your role in legal advice?

• The Nature of Co-Occurring Disorders 
  • The expectation, not the exception
  • When it’s complex, keep it simple
  • 12 Steps to assessment
  • 10 Guidelines for developing a therapeutic alliance with COD folks
  • What you can do to reduce treatment barriers
  • Discord and repair conversations
  • Specific skills for Depression, Anxiety, Suicidal Ideation
  • Practice dialogues
• De-escalating Suicidal Clients with MI
  • Moving from Focusing to Engaging
  • Evoking strategies – You are Medicine
  • Putting change talk into Safety Planning
  • SHORES – Protective factors
  • Examples of MI used in crisis situations: Self-harming adolescents and individual impacted by natural disasters

• The role for MI
• Create a shared agenda
• Support autonomy and reduce discord
• The four processes of MI applied
• Effective responses with mandated clients
• Demonstration: Getting on the same team & repairing relationship

Target Audience

• Counselors
• Social Workers
• Psychologists
• Case Managers
• Addiction Counselors
• Therapists
• Marriage & Family Therapists
• Occupational Therapists
• Occupational Therapy Assistants
• Nurses
• Physicians
• Probation/Parole Officers
• Other Mental Health Professionals
• Other Rehab Professionals
• Other healthcare professionals