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					                                                                                 CCD – Motivational Interviewing
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                            DIVISION OF BEHAVIORAL HEALTH (DBH)
                              DBH APPROVED TRAINER PROGRAM
                                     CORE COMPETENCIES

                                MOTIVATIONAL INTERVIEWING

   DATE:                            January 1, 2009
   DESCRIPTION:                     CAC Level II Required Class: 2 days – 14 hours
   CLASS SIZE LIMITS:               Maximum: 16 students            Minimum: 6

    a. “Motivational interviewing is a directive, client-centered counseling style for eliciting
       behavior change by helping clients to explore and resolve ambivalence.” Thi s is the
       definition of Motivational Interviewing put forth by William Miller and Stephen Rollnick.
       This class will introduce the aspiring addiction counselor to the foundational evidence -
       based practice of motivational interviewing and motivational enhancement therapy.
       Motivational interviewing has been demonstrated to be a very useful tool in working with
       clients with substance use disorders and has great relevance in addictions counseling
       today. This approach utilizes empathy, exploration and encouragement to lead the client
       to define their own problems with substance use. It uses the Stages of Change model to
       determine client’s readiness for change.
    b. All required classes seek to enhance the ability of the counselor to offer treatment services in a
       manner that respects gender, race and ethnicity, sexual orientation, cultural, familial, systemic
       and socioeconomic diversity.

    a. Must be credentialed and in good standing as a CAC III or LAC in Colorado.
    b. Must have a minimum of a Masters degree in a behavioral health field.
    c. Must have at least three years experience providing training/education to adult learners.
    d. Must use DBH-approved core competencies in the development of the curriculum for each
       required class.
    e. Must submit an original application, meet all application requirements, and be approved by the
       Division of Behavioral Health. The application will include a statement of specific experience
       relating to the training class.
    f. Must submit a prepared PowerPoint presentation on a CD or flash drive. All other materials
       will be at the discretion of the trainer.
    g. Must administer an examination as a measurement of learning with a minimum passing score
       of 70%, results to be reported on the DBH Course Report form and submitted within two weeks
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     of class delivery. The examination will be in a multiple choice, true/false, or fill-in-the-blank
     format, or some combination of these.
  h. Must use course reports, evaluation instruments, and certificate formats as posted on the DBH

  a. There will be an emphasis on experiential learning in conjunction with academic material using
       dyads, triads and groups and other experiential methods to reinforce the tools presented.
  b.   Student participation is expected in group discussions and presentations of case studies.
  c.   Videotaping may be used in practicing the skills for motivational interviewing
  d.   Presentation of material will include use of a PowerPoint and may include other resources
       either printed or online for further study.
  e.   The PowerPoint presentation, agenda and examination must be updated once every two years
       and submitted to DBH for approval.
  f.   The trainer is responsible for passing or failing students. If a student fails the skills
       demonstration but passes the written exam, the student will be required to retake the class. If
       the student passes the skills demonstration but fails the written exam, trainer discretion may be
       used in offering a retest one time only.

  a.   Definition of motivational interviewing
  b.   The spirit of motivational interviewing as an interpersonal style
  c.   Attitudes and beliefs of counselor using MI
  d.   Principles of motivational interviewing
  e.   Research studies with motivational interviewing and role of Bill Miller at University of
       New Mexico and his cohorts in developing this therapeutic approach
  f.   Motivational enhancement therapy (MET)—the four-session adaptation of the check-up
       intervention using the motivational interviewing style
  g.   Brief motivational interviewing developed for use in a single session in primary care
       settings and now being used in the SBIRT (Screening & Brief Intervention and Referral to
       Treatment) grant
  h.   Important change elements in MI such as understanding motivation and ambivalence
  i.   Stages of change model developed by Prochaska and DiClemente
  j.   Elements that influence change in MI, “denial” and readiness to change
  k.   Role of resistance in using MI and differences from more confrontational approaches
  l.   Strategies to eliciting self-motivational statements from clients
  m.   Motivational interviewing skills and practice

  Upon completion of this training class, as measured by skill demonstration and examination, the
  participant will be able to:
  a. Verbalize a working knowledge of the roots and principles of MI framework
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  b. Identify the stages of change and how to determine readiness for change
  c. Assess and identify client’s readiness for change with the use of the SOCRATES
  d. Describe counselor tasks and interventions at each stage of change
  e. Demonstrate the ability to use the decisional balance worksheet with clients
  f. Demonstrate the use of change talk to include desire, ability, reasons, need statements and
     commitment language
  g. Demonstrate knowledge of the traps to avoid i.e. argument with client, aggressive
     confrontation, being the expert, labeling, blaming, trying to solve client’s problem for them
  h. Demonstrate the ability to utilize the MI skills to include the use of change talk, empathy,
     reflective listening, affirmation, summarization, and eliciting self- motivational statements

  a. SBIRT, Screening Brief Intervention and Referral to Treatment:
  b. Enhancing Motivation for Change in Substance Abuse Treatment, Treatment
       Improvement Protocol (TIP) 35: U. S. Dept of Health and Human Services, Substance
       Abuse and Mental Health Services Administration,
  c.   Motivational Interviewing: Preparing People for Change - Second Edition: William R.
       Miller and Stephen Rollnick (2002).
  d.   Motivation Interviewing: Preparing People to Change Addictive Behavior: William R.
       Miller and Stephen Rollnick (1992).
  e.   Videos: Motivational Interviewing Professional Training Series by William R. Miller and
       Stephen Rollnick.
  f.   Resolving Patient Ambivalence: A Five Session Motivational Interviewing Intervention:
       Ann E. Fields (2006).
  g.   Motivational Interviewing and Stages of Change: Integrating Best Practices for
       Substance Abuse Professionals: Kathleen M. Tomlin and Helen Richardson (2004).
  h.   Motivational Dialogue: Preparing Addiction Professionals for Motivational
       Interviewing Practice: edited by Gillian Tober and Duncan Raistrick (2007).
  i.   Substance Abuse Treatment and the Stages of Change: Selecting and Planning
       Interventions: Gerard J. Connors, Dennis M. Donovan, and Carlo C. DiClemente (2004).
  j.   Handbook of Motivational Counseling: Concepts, Approaches, and Assessment : W.
       Miles Cox and Eric Klinger (2003).
  k.   A Toolkit of Motivational Skills: Encouraging and Supporting Change in Individuals,
       Second Edition: Catherine Fuller and Phillip Taylor (2008).
  l.   The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy : James O.
       Prochaska and Carlo C. DiClemente (1994).

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