Motivational Interviewing in Social Work Practice by Melinda Hohman

Author:Melinda Hohman [BEAN, RITA M]
Language: eng
Format: epub
ISBN: 9781609189716
Publisher: THE GUILFORD PRESS
Published: 0101-01-01T00:00:00+00:00

MI IN GROUP SETTINGS

Because the example of developing discrepancy that is given next is applied in a group setting, it is helpful to take a brief overview of MI in this context. Over the past decade or so, MI has been applied to group work with some good outcomes. As group therapy is so prevalent in substance use treatment, most of the applications have been adolescents, college students, or adults, all with alcohol or drug-related concerns, but it has been used in other settings as well. Often called group MI or GMI, group sessions may be manualized with specific topics and exercises, and groups may be offered once, twice, four, or up to 10 times, depending on the study (Engle, Macgowen, Wagner, & Amrheim, 2010; Foote et al., 1999; Ingersoll, Wagner, & Gharib, 2002; LaChance, Ewing, Bryan, & Hutchison, 2009; Lincourt, Kuettel, & Bombardier, 2002; Santa Ana, Wulfert, & Nietert, 2007; Velasquez, Maurer, Crouch, & DiClemente, 2001). MI groups can also be process-focused where they are not manualized and are unstructured (Wagner & Ingersoll, in press).

Due to the history of confrontational methods in substance use treatment, clients who participate in an MI-based group often expect a GMI intervention to be more of the same. Because it is difficult to attend to group processes and to reinforce a different way of interacting, those who want to use this format should be proficient in both group work and in MI in order to combine the two effectively (Wagner & Ingersoll, in press). One of the first tasks of the group leader is to indicate that the GMI is different from what clients may be expecting and to set the tone of the MI spirit of collaboration, autonomy support, and empathy. This is often done through modeling of MI interactions as well as by redirecting and reframing negative or confrontational comments or unsolicited advice that may arise from group members (Ingersoll et al., 2002; Velasquez, Stephens, & Ingersoll, 2006). Group members may be taught how to utilize simple reflective listening methods to further integrate MI into the group process (Rose & Chang, 2010; Velasquez et al., 2006).

Empathy is a key ingredient in GMI. Reflective listening that is used selectively helps to demonstrate this as well as reinforce change talk as it occurs in the group setting. While it is important to acknowledge sustain talk and the ambivalence that clients struggle with, those using GMI work to focus on positives as a way to move forward and not get stuck in the past. As indicated earlier, developing discrepancy is used in a framework of optimism—for group members to think about ways to improve lives and live more closely with their desired values and goals. It is a “taste” of possibilities that the future could hold (Wagner & Ingersoll, in press).

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