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Lecture 23

PSYC 471 Lecture 23: 23 PSYC 471 April 6th 2017

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McGill University
PSYC 471
Richard Koestner

23 PSYC 471 April 6 2017 Motivational interviewing (MI) and Behaviour (B) change among adolescents (with a focus on Anorexia-Restrictive Form)  MI designed to deal with resistant clients  Autonomy support very important  Anorexia: thought of as a compulsion, what’s autonomous and what’s controlled is particularly important  Family Based Treatment is main treatment  Flaw: didn’t include MI  It’s been integrated  McGill Eating Disorder Experts: Howard Steiger and Sarah Racine  Backfiring anti-obesity campaigns  “Obesity epidemic” led schools to start training kids about healthy eating really early  Healthy eating education programs can lead to anorexia  E.g. School program that challenged kids to increase physical activities and eat healthy lunches (e.g. they would inspect kids’ lunches), public weighings  One boy (Globe story) developed eating disorder, became phobic of high calorie foods  Eating disorders hard to id and treat MI introduction:  Founders: Dr. William Miller and Dr. Stephen Rollnick  Patient-centred, directive counseling style that builds on intrinsic motivation to facilitate change in health-related behaviours  Koestner’s comments:  Patient-centred and directive seem at odds with each other  Empathic, patient guided conversation/action vs. directed by therapist  Empathic guidance  More autonomous motivation than intrinsic motivation Clip:  Instead of getting an idea into a person it’s about getting something out of the person…  Series of open questions  Following client with reflective listening  Respecting person’s freedom to chose (autonomy) reflecting and encouraging person’s desire to change  Koestner’s comments:  It’s helped people with addictions  Changed the field  “We tend to pathologize ambivalence”—but ambivalence is the human state… especially about change… MI puts ambivalence at the centre MI theory: Stages of Change Model  Precontemplation: not considering change—give them info, encourage them to explore  Contemplation: considering change—pros and cons  Preparation: planning—use implementation plan  Action: [this is where therapists often try to jump in… without considering patient’s stage of readiness]—support action, focus on their commitment  Maintenance: very important to consciously focus on maintaining change  Termination or relapse Advantages:  Recognizes that we’re ambivalent… and there are individual differences in this  Suitable for mandated treatments: for court referral, school referral etc.
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