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3 Tips to Use MI in Group Therapy
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My blog for health care providers using MI about the process of change!

3 Tips to Use MI in Group Therapy

I am a group therapy champion! There is power in group work that individual therapy cannot offer at times. Groups allow individuals to tap into a sense of commonality and normalcy with others while struggling to make lifestyle changes. Group members have the opportunity to help others, which can decrease their own suffering. Group work also offers individuals an opportunity to receive corrective emotional experiences as they re-enact interpersonal styles or family dynamics within an atmosphere of safety and acceptance. I never hesitate to recommend my clients for group psychotherapy when I believe they may be good candidates for group work. 

Group work with a Motivational Interviewing style can be very powerful for clients, including for those who are reluctant or who are "resistant" to change. MI groups include components of interpersonal process groups, where relationships (the process of group cohesion, peer feedback and influence) guide the process of change. The MI group also has aspects of psychoeducation groups with a clear focus on the target behavior and related discussion. If you are considering use of MI for group therapy, here are 3 tips to get started!

1. Explore Ambivalence in the Group Screening Process: MI can be very helpful in exploring client ambivalence about joining a therapy group. Most clients are reluctant to join groups (even when group therapy is recommended with confidence), which can be frustrating for helpers. MI can be used to  convey understanding of the ambivalence and strategically soften the many arguments against group clients typically share using OARS.

Information about group therapy can be shared with permission and with emphasis on personal choice to adopt the information or not, in hopes of softening arguments against joining a group. Of course, the helper can work to identify any language toward joining group therapy and align this language with the client's overall treatment goals.

2. Use Screening and Normative Feedback to Develop Discrepancy: MI can be used to help clients develop discrepancy with regard to the target behavior. For example, in an Alcohol or Other Drug college campus group, individuals might answer questions about their alcohol use (quantity, frequency).

The helper might compare clients' answers to national data norms for that particular group and guide a conversation about where their reported use falls in alcohol-related risk categories (i.e., NIAAA). The helper can give other information in neutral, but strategic ways to increase motivation to change (i.e., the time it takes to eliminate alcohol from the body, the effects of alcohol use on athletic/academic performance, etc.). The helper can neutrally explore clients' reactions and listen for change talk. The MI group also offers an opportunity to explore myths and perceptions that affect alcohol use versus reality (i.e., group members' perceptions of alcohol use on campus and nationwide). 

3. Create Change Talk: Like in individual therapy, MI strategies can be used to create change language in the group setting. Importance and Confidence rulers can further guide a conversation about readiness to change behavior. The Value Card Sort can help group members identify salient values. The helper's strategic open questions can guide a conversation about how their behaviors fit with or do not align with their value system.

The helper can highlight commonalities in values within the group and in how the group members express their values in healthy and unhealthy ways.

This is just a start list of how MI can be useful in groups. I'm sure there are many readers here who apply MI in group work and I'd love to hear about how your strategies!

 




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