Motivational Interviewing and Risk Management

Seeds of Change Consulting provides training, supervision, and consultation with a focus on providing individually tailored, strength-based treatment to clients. All services include an examination of the idea of “resistance”, the subsequent clinical challenges arising from this discord, and how to strategically address these challenges through the use of Motivational Interviewing and other forms of strength-based assessment and treatment.

Seeds of Change Consulting teaches concrete skills so service providers can experience a sustained increase in strength-based assessment and treatment, resulting in improved client outcomes.

Director of Seeds of Change Consulting-Sarah Solis LCSW

Sarah Solis - Motivational Interviewing and Strength-Based Assessment

Director of Seeds of Change Consulting, Sarah Solis LCSW, has 15 years of experience providing care to clients impacted by trauma. She is currently employed as a Clinical Case Manager at the Department of Veterans Affairs. Sarah has worked in corrections, community mental health outpatient and day treatment programs, medical social work, and community-based services for children and families. Sarah has experience providing direct service, clinical supervision, and worked as a program manager for many years.

Sarah believes treatment is a gift to the healer as well as the healing. Each individual or family brings an incredible life story and personal wisdom.Throughout the treatment process, Sarah ensures that an individual or family’s voice is heard and respected. The majority of her experience has been working with underserved and marginalized populations. Cultural humility and responsiveness is an important element in her work. She participates in monthly cultural humility work groups and facilitates multiple social justice focused trainings .

Sarah has completed the Motivational Interviewing Network of Trainers (MINT) training program and remains an active member.

Philosophy

Most service providers enter their prospective fields with the intent to facilitate change for their clients in a strength-based manner. Barriers to seeing this intent through include:

  • The service provider’s experience and internalization of a historical or current deficit-based work-place culture
  • The mandate to collaborate with individuals or agency partners that utilize a deficit-based approach, and the service provider’s internalization of this view of the client
  • Federal, state, or county service provision rules that reinforce deficit-based treatment
  • And, of course, the service provider’s lived experience and, at times, the application of this lived experience as the only context to understand the client (transference/counter-transference)

Seeds of Change Consulting normalizes the service provider’s experience of these impediments and assists in the learning of a more strength-based and effective approach.

Services

Trainings 

Half-Day Motivational Interviewing Training – This 4-hour training provides attendees with a basic understanding of Motivational Interviewing. Attendees will learn how to assess a client’s current motivation to change a particular behavior and then learn how to use Motivational Interviewing Open-Ended Questions, Affirmations, Reflections, and Summaries (OARS) to further enhance or consolidate the client’s level of motivation.

Full-Day Motivational Interviewing Training – This 6-hour training (7 hours total, with a 1/2 hour lunch break and two 15 minute breaks) provides attendees with a broad understanding of the foundational concepts of Motivational Interviewing. Attendees will learn how to assess a client’s communication around change and use Open-Ended Questions, Affirmations, Reflections, and Summaries (O.A.R.S) evoke or enhance change talk.  Attendees will discuss the four processes of Motivational Interviewing and identify concrete tools that can be used during each process. The training will culminate with the creation of sustainable change plans. The goal of the training is to enhance the attendees’ ability to collaboratively work with clients to increase or consolidate motivation to address identified problem areas.

Two-Day Motivational Interviewing Training – This two-day training provides a total of 12 hours of interactive learning, covering the basic tenets and techniques delivered in the Full-Day Motivational Interviewing Training. There will be additional workshop time to put these new skills into practice, with fellow attendees, under the trainer’s guidance and direction.

Three-Day Motivational Interviewing Training – This three-day training provides a total of 18 hours of interactive learning, covering the basic tenets, and an introduction to intermediate level Motivational Interviewing skills. Attendees engage in multiple break-out group activities and process the learning experience after each activity.

“Motivational Interviewing: Applying MI Skills in Telehealth Contacts”-Attendees will review foundational Motivational Interviewing skills/concepts in this 3-hour training and discuss how to apply these skills in various telehealth modalities. Learning domains will include the Spirit of Motivational Interviewing, O.A.R.S (open-ended questions, affirmations, reflections, and summaries) and values work. Training will include large group discussion and small group breakout.

“Motivational Interviewing and Adolescence: Nurturing Independence” –This 6-hour training will focus on the nuanced application of Motivational Interviewing fundamentals when working with adolescent clients. Attendees will learn about the Spirit of Motivational Interviewing, the four processes, OARS (open-ended questions, affirmations, reflections, and summaries), and the different forms of communication (change talk, sustain talk, discord). Attendees will apply these concepts with the practice of adolescent-friendly Motivational Interviewing interventions that nurture agency and independence. The training will conclude with a discussion around how to increase caregiver (family, school staff, other adults) support around the adolescent’s treatment focus. The training will include large group discussion, breakout groups, and practice with concrete MI exercises.

Half-Day “Oppression, Structural Violence, and Motivational Interviewing”-This 3-hour training is intended for providers that have received at least two full days of Motivational Interviewing training. The training focuses on the experience of marginalized groups and the means of tailoring Motivational Interviewing to capture a client’s experience of oppression. Trainees practice the facilitation of change plans that highlight the client’s means of remaining safe in oppressive treatment systems.

Full-Day “Oppression, Structural Violence, and Motivational Interviewing”This 7-hour training covers the concepts noted in the half-day training with the addition of more workshop time to put these new skills into practice with fellow attendees under the trainer’s guidance and direction.

“The Use of Motivational Interviewing to Call-In Oppressive Comments: Effectively Reducing Client Harm”-This 4-hour session will use the framework of Motivational Interviewing to help providers dismantle oppressive beliefs, held by professionals with whom our clients need to interact, and support the creation of community-building narratives. Attendees will explore the difference between calling-in and calling-out, the benefits and drawbacks to each, and a framework for deciding which to use. Attendees will practice the use of open-ended questions, affirmations, reflections, and summaries in the context of addressing harmful comments and opening discussions with clients about the level of advocacy that they desire. Space will be given to discuss increasing comfortability around “calling-in”.

Full-Day “Motivational Interviewing and Systems: The Identification of System Motivation to Evoke Client Desired Change”This 6-hour training examines the many systems with which the client interacts, and how to motivate the systems to be more conducive to client desired change. Systems include, but are not limited to, family, school, work, mental health and medical programs, probation/parole, and child welfare. Trainees will learn the basics of Motivational Interviewing and how to apply these skills when interacting with reluctant system players.

“Suicide Assessment and Prevention with Youth”This 6-hour training focuses on suicide risk factors, protective factors, assessment of risk severity, and safety planning. Attendees will familiarize themselves with general suicide risk and protective factors, also exploring factors that are specific to youth. Attendees will use this information to create a meaningful, dynamic safety plan that includes warning signs, formal and informal supports/contacts, supportive environments, and coping strategies. The training will include a brief discussion of suicide assessment tools available to agencies serving youth. Attendees will review the limits of confidentiality, framing these limits at the beginning of the treatment relationship, and how to initiate emergency services. The training will include large group discussion, breakout groups, and the use of vignettes.

“Telehealth Suicide Assessment and Prevention with Adolescents”-This 3-hour training will focus on suicide risk factors, protective factors, assessment of risk severity, and safety planning in the context of telehealth. Attendees will identify potential challenges when assessing suicidality by text, on the phone, and while using video platforms. The training will cover standardized and non-standardized suicide assessment tools and the means of titrating the use of these for telehealth. Attendees will then translate assessment information into a dynamic safety plan that includes warning signs, formal and informal supports/contacts, supportive environments, and coping strategies. Attendees will discuss how to address the limitations of confidentiality for the different telehealth modalities. The training will include large group discussion, breakout groups, and the use of vignettes.

Supervision

Clinical group and individual supervision.

Consultation
Agency consultation focuses on balancing agency contracts and/or grant requirements with a service population’s current needs. This includes assistance in documenting the use of Motivational Interviewing.

Tools

Seeds of Change Consulting trainings and supervision include the introduction and practice of concrete tools. Examples of tools include O.A.R.S (open-ended questions, affirmations, reflections, and summaries), agenda setting, Motivational Interviewing Goal and Value cards, motivation scaling, change plans, strength-based supervision tools, cultural assessment questions, and safety planning tools.

Skills

SOC customers will learn to identify:

  • Client reluctance,
  • The etiology of the reluctance,
  • Client resiliency factors,
  • Change talk,
  • Client family/community supports,
  • Issues of culture and socio-economic status and how these effect treatment,
  • And client-recognized change areas

SOC customers will learn to navigate:

  • Deficit-based systems with which the client interacts/depends on,
  • Program/agency mandates vs. the needs of clients,
  • Transference/counter-transference

SOC customers will learn to facilitate:

  • Client desired change
  • Client system change

Documentation

SOC customers will learn to document interventions in line with standards set forth by:

  • Medicaid (Medi-Cal)
  • Grant providers

SOC customers will learn to identify, collect, and monitor outcome data.