Motivational Interviewing Conference in Cardiff

Have just come raring back from the 2012 Cardiff Motivational Interviewing Conference.... and I’m feeling very motivated!

Bill Miller led the day with Steve Rollnick, a rare opportunity to work with both the founders of Motivational Interviewing together. 

It has been a while since I’ve had an opportunity of seeing Steve speak again but it was the first chance I’d ever had to work directly with Bill. 

Apart from reviewing old ground, participants also got a glimpse of some of the new ideas which will be fully expressed in their new edition of Motivational Interviewing that's coming out this summer.

Keep your eyes peeled for it. 

In the meantime, if you're looking for MI training either as an individual or in-house, get in touch with us and we can guarantee we'll offer you a stimulating and practical experience that will definitely change your practice.

http://www.skillsdevelopment.co.uk/seminars.php?courseid=5


Best Wishes

Paul

Debate on Motivational Tools - Feedback

What do you usually do with your unmotivated clients? Discharge them? View them as resistant and work with them accordingly? Hope your supervisor got some ideas?
What do you do if you’re a supervisor and are at a loss?

The fact of the matter is that we could always do with some new ideas and tips on how to approach our most difficult clients.

Our recent delegate debate on motivational techniques produced some fascinating discussions about the topic and I would like to share them with you. Please read the comments to this post and feel free to contribute to this discussion by commenting yourself.

The issue of motivation is extremely interesting and multi-dimensional - that is why our training courses on Motivational Interviewing are always very engaging and lively. They are currently run in Manchester and London and until tomorrow you can book them with 30% discount. If you would like to learn more about this training follow the link:
http://www.skillsdevelopment.co.uk/seminars.php?courseid=5

I hope you will find this post an interesting read and look forward to continuing this discussion with you at one of our training courses.

Take care
Paul

Motivation and Good Health

Another big NHS story to hit the news recently is the idea of the NHS providing incentives to motivate patients to become healthy.

An interesting idea in theory, as there is evidence that incentives do encourage people to continue behaviours - so if your goal is to quit smoking the the NHS rewards you, by whatever means, you are more likely to stick at it. In this example, the short term rewards for quitting is just as great (if not better than!) the long term reward (good health.)

But this idea hasn't come without controversy.

The first barrier is whether incentives are actually effective - or would the NHS just be throwing money away? So far, the results seem mixed - some hits and some misses. Unfortunately there is very little evidence at this point in time to suggest that even the positive evidence will last long term, especially after incentives are removed.

Unsurprisingly, in my mind at least anyway, a large percentage of the public is actually against NHS incentives, which struck me as rather amusing as the percentage of overweight and obese people in the UK is over 50% (or so my quick google for statistics told me.) Read into that what you will - there's no direct link between the two points, I honestly just found that interesting.

.. But people just don't feel incentives are fair.

And perhaps this is what it comes down to - fairness. It's not fair that people ruin their own health then are paid by the taxpayer to improve their health. The public seems to have no problem with surgery, e.g. for heart or lung problems, after the event - we don't seem to want people dead! - but it's not viewed as fair to help people before the absolutely need it.

I don't know which way to think - it's just an interesting point of note.

The thinkers at the NHS may have been along the right lines - motivation, it can be argued, is the number one reason people change their behaviour. I mean, why would you change your behaviour if you weren't motivated to do so - right? So their heart was in the right place.

But perhaps their are other motivations that can be used in the stead of taxpayers money? Smokers, for example, save a huge amount of money by simply not buying cigarettes! If smoker 'Frank' enjoys playing sports, what's going to motivate him more than being able to breath properly when he's running around the pitch?!

Motivation may be the key to helping people improve their on health - but maybe financial incentives are not the way to about it?

Looking to help motivate people yourself? - For more information on Motivation, have a look on our website www.skillsdevelopment.co.uk and check out our course "Motivational Interviewing and Beyond."

How can people be motivated to make better health choices?

The National Institute for Clinical Excellence (Nice) is considering ways to persuade people to take better care of their health, due to the considerable impact that unhealthy habits are having on the NHS.

The NICE study examined a series of proposals, including one in Kent which pays dieters up to £425 for losing weight and another in Scotland which gives pregnant women shopping vouchers worth up to £650 for quitting smoking.

According to the proposals being considered by the health watchdog for England and Wales - people could be given cash incentives to encourage them to give up smoking or to lose weight.

• Can cash incentives motivate people to make better health choices?
• Are there better ways to encourage people to take care of their health or we are now at our last resort – hard cash?
• Would offering money as an incentive to improve health be cost-effective for the NHS or would the money be better spent elsewhere?
• Is it the right way forward?

You, as one of those professionals who work in the front line of helping people, are qualified better then anyone to answer these questions on the basis of your experience. Your opinion is invaluable and needs to be heard. We have created a simple poll were you can make your view known in two seconds: http://www.surveymonkey.com/s/5WWMS39

Please vote – we will make sure that your answers are known to those who make decisions on the matter.
Please feel free to send us your views on the matter as well as to post comments in the comments box of the poll or on our Psychology & Psychotherapy Blog.

This is an important topic closely linked to our training on Motivational Interviewing and Beyond (http://www.skillsdevelopment.co.uk/seminars.php?courseid=5) and we will definitely address this issue as part of our course discussion. However, we would like to give all of you the opportunity to express your opinion whether you are taking part in the course or not.

Looking forward to hearing from you.

The link between popularity, friends and drug consumption

"Our study highlights a correlation between popularity and consumption," says Jean-Sébastien Fallu, lead researcher and professor at the Université de Montréal's School of Psychoeducation. "The teenagers we studied were well-accepted, very sensitive to social codes, and understood the compromises that it takes to be popular."

The findings showed an increase in consumption, as the child got older regardless of their popularity level. However, the more popular a child and their friends were, the greater this consumption was.

"Teenagers don't consume to belong to the group or to increase their popularity level, they do it to remain well-liked," says Fallu. "It's more about keeping their status than increasing it."

Teenagers who aren't considered popular are more inclined to develop violent behaviors than consume alcohol or drugs.

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Is drug taking cool? Maybe it was just the area I grew up in, but popularity in my school wasn't measured in the amount of drugs consumed! This study highlights a motivation for drug consumption that maybe hadn't been considered previously.

But what are your thoughts? Is social popularity the cause of drug consumption in teens? Or is the level of popularity the result of the drug consumption? Is level of social status enough motivation for teenagers to consume drugs? Is this type of peer pressure overt or just expected?

Why is drug taking considered 'cool' behaviour? Is it just because rules are being broken? Or is there another reason?

Let us know what you think.

Link to Article

Is changing your lifestyle fun?

"According to the authors, approximately one in five U.S. citizens over the age of 12 admits to binge drinking at least once per month, and nearly 10 million people suffer from clinical eating disorders. These epidemics make it critical to examine what can be done to encourage people to regulate consumption.

In one study, the researchers asked participants to hold pieces of candy between their fingers, and put it in their mouths and then take it out. "The goal of this task was to let people perform tasks with the candy but not be able to actually eat the candy," the authors explain.

Once the participants completed the initial tasks they moved on to taking unrelated surveys. But the candy was left on their desks without instruction as to whether they could eat it or not. The researchers measured how much candy the participants consumed and measured how much self-control the participants usually exerted.

"We found that participants who are usually high in self-control perceived the initial candy task - which involved touching, but not eating Skittles and M&Ms - as an opportunity to have fun (they were playing with candy)," - "Participants who are usually low in self-control, however, perceived the initial candy task as an obligation to work."

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The study could also highlight people's motivation to change, those that see therapy and changing their lifestyle as work are likely to be less motivated to make the changes than those that view the changes to their lifestyle, and their therapy, as fun.

Wording of techniques or exercises could make the difference between an individual feeling like their therapy is all hard work and an individual feeling that therapy is fun!

Link to Article

With a little help from your friends you can live longer

"A circle of close friends and strong family ties can boost a person's health more than exercise, losing weight or quitting cigarettes and alcohol, psychologists say.

Sociable people seem to reap extra rewards from their relationships by feeling less stressed, taking better care of themselves and having less risky lifestyles than those who are more isolated, they claim.

A review of studies into the impact of relationships on health found that people had a 50% better survival rate if they belonged to a wider social group, be it friends, neighbours, relatives or a mix of these.

The striking impact of social connections on wellbeing has led researchers to call on GPs and health officials to take loneliness as seriously as other health risks, such as alcoholism and smoking.

"We take relationships for granted as humans," said Julianne Holt-Lunstad, a psychologist at Brigham Young University in Utah. "That constant interaction is not only beneficial psychologically but directly to our physical health."

Holt-Lunstad's team reviewed 148 studies that tracked the social interactions and health of 308,849 people over an average of 7.5 years. From these they worked out how death rates varied depending on how sociable a person was.

Being lonely and isolated was as bad for a person's health as smoking 15 cigarettes a day or being an alcoholic. It was as harmful as not exercising and twice as bad for the health as being obese. The study is reported in the journal Plos Medicine.

Holt-Lunstad said friends and family can improve health in numerous ways, from help in tough times to finding meaning in life. "When someone is connected to a group and feels responsibility to other people, that sense of purpose and meaning translates to taking better care of themselves and taking fewer risks."

Holt-Lunstad said there was no clear figure on how many relationships are enough to boost a person's health, but people fared better when they rarely felt lonely and were close to a group of friends, had good family contact and had someone they could rely on and confide in.

Writing in the journal, the authors point out that doctors, health educators and the media take the dangers of smoking, diet and exercise seriously, and urge them to add social relationships to the list.

A report by the Mental Health Foundation in May blamed technology and the pressures of modern life for widespread feelings of loneliness in all age groups across Britain. The survey of more than 2,200 adults found one in 10 people often felt lonely and one in three would like to move closer to their family.

Andrew McCulloch, of the Mental Health Foundation, said the latest study builds on work that links isolation to poor mental and physical health. "Trends such as increasing numbers of people living alone and the advent of new technologies, are changing the way in which we interact and are leading both the young and old to experience loneliness. It is important that individuals and policy-makers take notice of emerging evidence and of the potential health problems associated with loneliness."
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But with online social networking on the increase, does this help or hinder our mental and physical health? Although online social websites allow us to catch up with more people than ever, even on the other side of the globe, has this left us more isolated?

I guess anybody can ask questions.

No go forth and socialise! For your health!


Link to Article

Thinking of a Loved One Can Reduce Your Pain

The study, which asked whether simply looking at a photograph of your significant other can reduce pain, involved 25 women, mostly UCLA students, who had boyfriends with whom they had been in a good relationship for more than six months.

The women received moderately painful heat stimuli to their forearms while they went through a number of different conditions. In one set of conditions, they viewed photographs of their boyfriend, a stranger and a chair.

"When the women were just looking at pictures of their partner, they actually reported less pain to the heat stimuli than when they were looking at pictures of an object or pictures of a stranger," said study co-author Naomi Eisenberger, assistant professor of psychology and director of UCLA's Social and Affective Neuroscience Laboratory. "Thus, the mere reminder of one's partner through a simple photograph was capable of reducing pain."

"This changes our notion of how social support influences people," she added. "Typically, we think that in order for social support to make us feel good, it has to be the kind of support that is very responsive to our emotional needs. Here, however, we are seeing that just a photo of one's significant other can have the same effect."

In another set of conditions, each woman held the hand of her boyfriend, the hand of a male stranger and a squeeze ball. The study found that when women were holding their boyfriends' hands, they reported less physical pain than when they were holding a stranger's hand or a ball while receiving the same amount of heat stimulation.

"This study demonstrates how much of an impact our social ties can have on our experience and fits with other work emphasizing the importance of social support for physical and mental health," Eisenberger said.

One practical piece of advice the authors give is that the next time you are going through a stressful or painful experience, if you cannot bring a loved one with you, a photo may do.
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I read the above article today by chance and thought it was very interesting. As its effects seem to be that of reduced pain, it may work in other situations, as the article suggests, such as stress relief. This may also have a knock on effect to other states such as anger, anxiety, depression, self esteem and motivation -just to name a few!

Link to Article

CERTIFICATE IN RESOURCE BASED THERAPIES - FAQ

As you know in the autumn we are running our first 4 days course “CERTIFICATE IN RESOURCE BASED THERAPIES” approved by BPS Learning Centre for CPD. http://www.skillsdevelopment.co.uk/seminars.php?courseid=76

The course generates a lot of interest as it is a fresh and innovative approach to complex cases that builds on training courses that you have already attended with us in the past. We asked Paul Grantham to answer some of the questions about this course that frequently raised in your e-mails. That what he said:

Q1: SDS has just introduced a new training course – A Certificate in Resource Based Therapies. What is this course about and how is it different to everything you’ve been doing before?

PG: We thought it was time to bring together different strands from the training we have been providing over the last couple of years and develop a new course around them. The course is modular and based on three separate evidence based therapeutic approaches – Positive Psychology, Brief Solution Focused Therapy and Motivational Interviewing. The course is run over a four day period which can be worked through as a whole block or in a modular manner. The certificated course has also just been approved by The British Psychological Society Learning Centre and is accompanied by an optional assessed examination.

Q2: Why do you think there is a need for such a course if it is based on variety of therapeutic approaches that already exist? What are the advantages in bringing them together?

PG: The simple answer to this is that there is considerable overlap and shared theoretical underpinnings to the three approaches. Firstly, they are all evidence based, in other words there are good psychological experimental underpinnings to the theories, process and interventions. The need to demonstrate a strong evidence base to any psychotherapeutic approach is not going to go away and it is rightly a key touchstone for any therapy we might be using. However, CBT does not have a monopoly on psychotherapeutic effectiveness and these approaches happily live along side it. Secondly, all three approaches are resource based in assumption, in other words they focus on what the client already has which enables them to thrive, and looks at how to amplify it. Motivational Interviewing draws strongly on Roger's ideas regarding clients' intrinsic motivation and has placed client perceptions of benefits and negative consequences at the centre of its approach. Brief Solution, of course , lives by the mantra of "There's nothing wrong with you that what's right with you, couldn't fix" and Positive Psychology's focus on Strengths via the VIA again focuses on clients’ existing resources. Thirdly, as a result of the above, all three are outcome, thriving and future focused rather than causal, deficit and past focused. And this is still a relatively rare common feature in most psychotherapeutic approaches. Finally, all three utilise brief and practical interventions to facilitate change.

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Q6: On the practical side of things – four day courses might be quite expensive – are there ways to budget for this course without spending much straightaway?

PG: This course is modular. Hence although you can sign up for all four modules at once (and there is a fee reduction if you do this), you can sign up for individual modules as well. This allows delegates to spread the cost according to their budget. This, combined with the typically low fees that SDS charges in comparison with many other training providers makes this one of the most financially accessible psychotherapy courses currently available.

TO READ THE WHOLE INTERVIEW GO TO: http://www.skillsdevelopment.co.uk/images/appl_form/RBT%20Interview%20May%202010.pdf

If you are not sure what modules of the course you have already done – please feel free to contact me directly – I will check it in our records and let you know what modules you need to take up in order to complete the full course. You can contact me directly via our enquiry page: http://www.skillsdevelopment.co.uk/contact.html

Start your comment with “RBT Course Enquiry for JB” and I will reply to you ASAP.

A COUPLE OF REMINDERS:

Our seminar “ANGER THERAPY: HATRED, HOSTILITY & BITTERNESS” is running currently around the UK with great success. If you missed your opportunity to attend it now - it will run ONE DAY in London in September. The early bird discount of £24 is still available for that particular date. Book now to make sure that you receive a discount and reserve your place (some venues are almost fully booked now).

Don’t forget – you can enter a monthly draw with a top price of a free place on our one day courses by registering on http://www.skillsdevelopment.co.uk/contact.html . The winner of the May draw was Amanda Evans, with two runners-up who received their prizes.

If you register on www.psychotherapydvds.com you can participate in a monthly draw with a free psychotherapy DVD as your prize. Don’t forget to CONFIRM YOUR E-MAIL ADDRESS when register on this site. Otherwise your registration is not complete and you cannot enter the draw.

It only takes seconds to register!

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Best wishes

Julia Budnik

Change your life in 66 days ?

Phillippa Lally and her colleagues at UCL (Lally et al (2009) How are habits formed: Modelling habit formation in the real world European Journal of Social Psychology) has been involved in addressing a fascinating question that is pressing for any practitioner who is trying to help their client change - namely how long does it take - not only to make a change but to ensure it is well established...in other words has become a new "habit" in their lives which they do automatically without thinking.

The average time taken was 66 days, although the spread ranged between 18 and 254 days. Not surprisingly, establishing new behavioural health habits (like doing sit ups every morning) took longer.

The good news from this study is that missing a single day's practice isn't of crucial importance. However, the bad news is that if a typical period for establishing a change is over two months (AFTER the change is learnt) brief interventions that are withdrawn as soon as a change is initiated are likely to lead to high relapse levels.

Our services (and ourselves as professionals) are forever overly preoccupied with clients at a Action Stage (in the Cycle of Change) and pay insufficient attention to Maintenance. Interventions for weight loss for example are well evidenced, but the containing failure at the maintenance stage continues to create problems. The issue is even more pronounced within mental health, where the preoccupation with acute problems remain just that - acute. Even when the issue of relapse is examined (as in depression) and its prevention through the use of mindfulness skills, there is little that looks at how long it takes a client to regularly and automatically use such new skills.

Whatever field we work in, if we were to keep the figure of 66 days in mind more frequently, it might substantially increase our long term effectiveness with our client and avoid the "hit and run" mentality that is currently so common.

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