Course Outline of Record

Item	Value
Curriculum Committee Approval Date	10/06/2021
Top Code	120100 - Health Occupations, General
Units	3 Total Units
Hours	90 Total Hours (Lecture Hours 36; Lab Hours 54)
Total Outside of Class Hours	0
Course Credit Status	Credit: Degree Applicable (D)
Material Fee	No
Basic Skills	Not Basic Skills (N)
Repeatable	No
Grading Policy	Standard Letter (S),  Pass/No Pass (B)

Course Description

This course will focus on motivational interviewing techniques for use by the Integrative Health Coach. Topics will include a discussion of the spirit of MI, MI techniques, empathy, and goal setting in relation to a client's/patient's health behavior change. MI is an important tool used to translate a clinician's treatment plan into behaviors that support a patient's motivations and life-goals. Transfer Credit: CSU.

Course Level Student Learning Outcome(s)

1. Apply motivational interviewing techniques to help clients/patients negotiate clear goals (focus) of treatment
2. Use the MI techniques of questions, reflections, and summaries to facilitate behavior change
3. Assess clients’ readiness for behavior change using MI techniques

Course Objectives

• 1. Explain the spirit of motivational interviewing.
• 2. Identify and recognize key components of motivational interviewing (MI)
• 3. Use person centered “OARS” skills to engage clients/patients in treatment
• 4. Negotiate clear goals (focus of treatment)
• 5. Evoke clients own motivations for change, using questions, reflections, and summaries selectively to facilitate change
• 6. Demonstrate the RULE principles as related to motivational interviewing in health care.
• 7. Form reflective listening responses as statements rather than questions
• 8. Recognizing aspects of client speech that indicate whether a session is headed in the right (wrong) direction
• 9. Use MI skills and strategies to increase client confidence
• 10. Avoid responses such as persuasion that elicit client resistance
• 11. Explain how different strategies are appropriate when a health coachs goal is remaining neutral
• 12. Apply the techniques of active listening, including expressing empathy, reflecting feelings, paraphrasing content and summarizing.

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Lecture Content

Introduction to Motivational Interviewing The areas that MI can help The Underlying Spirit of MI   Collaborative Evocative Honoring patient autonomy Ambivalence and what goes wrong with persuasion The Righting Reflex Comparing differences between MI and other types of counseling techniques The Four Processes of MI Engaging Focusing Evoking Planning Engaging- The Foundation of Motivational Interviewing Establishing a connection with client/patient Recognizing strengths  Encouraging autonomy Forming a therapeutic alliance OARS Open-ended questions vs. closed Affirmation Reflection or active listening Summary Other types of questions and how they can affect engagement Fact gathering Multiple choice Intake questions Empathy Carl Rogers Client-Centered Therapy Tradition Accurate Empathy Thomas Gordons 12 Roadblocks to Listening Giving advice Asking questions Sympathizing Agreeing Informing (giving patient information) Ordering Warning Persuading with Logic Judging/Criticizing Shaming Withdrawing, distracting, using humor Moralizing-preaching Body Language Curiosity and an Uncluttered Mind Reflection What is reflection. Benefits of using reflection Simple Reflections Importance of changes in voice tone Guessing Complex Reflections Reflecting underlying feeling Continuing the paragr aph Double-sided reflection  Reframing Sustained Reflection Pitfalls of reflection Focusing Affirmation Simple Affirmations Complex Affirmation  Summaries Neutrality Decisional Balance Focusing Defined Three types of focusing Simple focusing Multiple options Unclear focus Directional vs Directive Agenda Mapping Conflicting Agendas Asking for focus Evoking- harnessing the change for motivation Sustain Talk Change Talk Ambivalence Precatory Change Talk- DARE Desire Ability Reasons Need Encouraging Change Talk-CAT Commitment Activation Taking Steps Using an Importance Ruler Querying Extremes Looking Forward/Back Exploring Values Reframing Recognizing, Elicit, Respond Thinking one step ahead Responding to Change Talk Example or Elaborate Affirmations Reflections Summaries Responses that stop Change Talk Why dont people change. Implementing Motivational Interviewing into your Work  Importance and Confidence Confidence Talk and Ability Language Using Rating Scales  Increasing Clients Confidence Techniques Describing characteristics of successful change Strengths assessment Asking about past successes Personal value card set When clients lack confidence Resistance or Discord Freud Resistance Talk and Sustain Talk Discord statements or signals Effects of Discord/Sustain Talk on Health Coach How to repair client relationship if ruptured by discord Planning in Motivational Interviewing Planning Statements Mobilizing Recognizing CATS Recognizing “Doing Language” Checking the clients readiness Giving Advice Elicit- Provide Elicit Evoking for a Change Plan Stages of Planning Why-Harness their Intention What-Find the plan within How- Create the detail Mistakes in Creating Change Plans Client leaving Unrealistic goals Low goals Restraining clients enthusiasm Other Motivational Interviewing Topics Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Motivational Interviewing When is Motivational Interviewing Not Applicable. Traits of a Good Motivational Interviewer Empathic Genuine Expert Listening Skills Convey Hope Clear Direction Impact De-clutter your mind

Lab Content

Motivational Interviewing practice RULE Resist righting reflex Understand and explore patients motivation Listen with empathy Empower the patient/hope and optimism OARS Open-ended questions Affirmations Reflective statements Summary Statement Asking, listening, information Motivation scale and rulers Roll with resistance Scenarios, observations, evaluation Patient profiles, evaluation of patients motivation, moving forward The Coaching Session First meeting Confidentiality Accountability Agreement on roles for coach and patient Checklist Welcome patient (rapport, relationship) Assess readiness for change Collaborate on an action plan Work through barriers Chart progress Develop strategies to overcome setbacks Evaluate progress, develop new goals, reframe Ending of the need for coaching

Method(s) of Instruction

• Lecture (02)
• DE Live Online Lecture (02S)
• DE Online Lecture (02X)
• Lab (04)
• DE Live Online Lab (04S)
• DE Online Lab (04X)

Instructional Techniques

Lecture, demonstration, role-playing, videos, lab, student practice, interactive exercises

Reading Assignments

Students will spend approximately 2 hours a week reading from the textbook, case studies, and other materials provided by the instructor.

Writing Assignments

Students will provide reflection paper along with critiques.  This will require approximately 1 hour of outside work per week.

Out-of-class Assignments

The students will spend approximately 1 hour a week reviewing sessions; practicing motivational interviewing with a partner; viewing MI sessions and providing critiques; completing other homework assignments

Demonstration of Critical Thinking

Students will participate in a variety of activities that require critical thinking, including role-playing and scenario evaluation.  They will be using information to build client profiles and them working with them to set behavior change goals.  Students will view MI sessions, make observations, critique methods, and make recommendations for improvement.

Required Writing, Problem Solving, Skills Demonstration

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Eligible Disciplines

Counseling: Masters degree in counseling, rehabilitation counseling, clinical psychology, counseling psychology, guidance counseling, educational counseling, social work, or career development, marriage and family therapy, or marriage, family and child counseling, OR the equivalent. (NOTE: A bachelors degree in one of the above listed degrees and a license as a Marriage and Family Therapist (MFT) is an alternative qualification for this discipline.) Masters degree required. Title 5, section 53410.1 Health: Masters degree in health science, health education, biology, nursing, physical education, kinesiology, exercise science, dietetics, or nutrition OR bachelors degree in any of the above AND masters degree in public health, or any biological science OR the equivalent. Masters degree required. Health care ancillaries (medical assisting, hospice worker, home care aide...: Any bachelors degree and two years of professional experience, or any associate degree and six years of professional experience. Health services director/ health services coordinator/ college nurse: Minimum qualifications for these faculty members specified in title 5, section 53411. Masters degree required. Title 5, section 53411. Nursing: Masters degree in nursing OR bachelors degree in nursing AND masters degree in health education or health science OR the equivalent OR the minimum qualifications as set by the Board of Registered Nursing, whichever is higher. Masters degree required. Nutritional science/dietetics: Masters degree in nutrition, dietetics, or dietetics and food administration OR bachelors degree in any of the above AND masters degree in chemistry, public health, or family and consumer studies/home economics OR the equivalent. (Note: A bachelors degree in nutrition, dietetics, or dietetics and food administration, and certification as a registered dietician, is an alternative qualification for this discipline.) Masters degree required. Title 5, section 53410.1

Textbooks Resources

1. Required Miller, W.R., Rollnick,S.. Motivational Interviewing: Helping People Change, 3 ed. The Guilford Press, 2012 Rationale: Seminal text written by originators of MI 2. Required Rosengren, D.B.. Building Motivational Interviewing Skills: A Practitioner Workbook, 2nd ed. The Guilford Press, 2017