Invited workshop: Motivational Interviewing in Neuropsychology Basic Principles and Methods

Motivational Interviewing in Neuropsychology

Basic Principles and Methods

By: Tad T. Gorske, Ph.D.

Neurological disorders constitute approximately 6% of the global burden of disease (WHO, 2006) requiring a need for rehabilitation strategies for restoration of functioning. Non-compliance with rehabilitation recommendations can compromise a successful recovery program. Non-compliance can be related to client motivational or disability factors in addition to family member’s difficulty coping and adapting to the responsibilities of a rehabilitation program (Suarez, 2011).  While the problem of poor compliance has been studied as a factor in managing patients with medical issues, physical disabilities, cognitive impairments, and other injuries; little has been written about teachable methods for enhancing motivation and increasing compliance with rehabilitation recommendations. The Health Behavioral Change (HBC) model which is based on Motivational Interviewing (MI) fills this important gap by giving healthcare professionals essential tools for discussing the importance of following rehabilitation recommendations in addition to other topics such as exercise, eating habits, medication compliance, smoking, and drinking (Rollnick, Mason, and Butler, 1999; Miller and Rollnick, 2002). The HBC model was originally designed for physicians and provides a concise framework that can be used for brief-time limited interventions. It has been used in various rehabilitation settings where a therapeutic and collaborative relationship is an essential component for enhancing patient participation and outcome attainment (Prigatano, 1999).

In this training participants will learn the background and principles of the HBC model and its application to rehabilitation.  The essential elements of the model will be reviewed in addition to the specific clinical skills necessary to conduct an HBC session.  Participants will receive practical skills to guide client(s) through the difficult task of change all the while maintaining an empathic and collaborative relationship, rolling with client resistance, and then gently guiding them through the process of collaborative goal development and attainment.

Learning Objectives

Participants will learn….

1. The background and conceptual foundations of the HBC model;
2. The core interpersonal skills for conducting an HBC session;
3. To identify a client’s stage of change and intervene appropriately;
4. To assess clients level of readiness for change and enhance change talk;
5. Collaborative ways to manage client resistance;
6. To explore and enhance levels of importance and confidence for making difficult behavior changes;
7. To give feedback and advice in a way that maintains collaboration and motivates change;
8. To enhance client readiness to transition to more active and directive treatment interventions.

Collaborative Therapeutic Neuropsychological Assessment

Invited workshop:

Collaborative Therapeutic Neuropsychological Assessment - Tad Gorske

One of the challenges Clinical Neuropsychology faces is to develop an assessment process that is relevant and responsive to patient’s needs. Neuropsychology has typically followed an “Information Gathering/Medical Model” of assessment guided by the premise that tests are used to isolate a disease process and initiate treatment. More recently, neuropsychologists have taken a holistic perspective of practice.  A holistic neuropsychological perspective reflects patient-centered care models which emphasize empowering patients and families to improve their health and well being. Patient centered care views illness from a biopsychosocial perspective and emphasizes an egalitarian relationship with a strong working alliance between patient and practitioner (Mead and Bower, 2000). Collaborative Therapeutic Neuropsychological Assessment (CTNA) is a patient centered method for conducting a neuropsychological assessment feedback session that enlists patients and family members as collaborators and empowers them to take charge of their cognitive health (Gorske and Smith, 2009).  Evidence suggests neuropsychologists are frequently providing feedback and that the process is viewed as a positive experience by practitioners, patients, and family members (Bennett-Levy, et al., 1994; Donofrio, Piatt, and DiCarlo, 1999; Smith, Wiggins, and Gorske, 2007). Furthermore, patient centered interventions can potentially enhance the working alliance between practitioner and client which has been shown to enhance neuropsychological rehabilitation outcomes (Shonberger, Humle, Zeeman, and Teasdale, 2006). While authors have stated the importance and provided recommendations for providing neuropsychological test feedback, no agreed upon model exists (Gass & Brown, 1992; Malla et al., 1997).  CTNA hopes to fill this gap by providing a framework and methods for giving feedback from neuropsychological test results in a way that is understandable, patient centered, and empowers patients to take an active role in treatment. This workshop will provide the following: a) conceptual foundations of the CTNA approach; b) methods for providing neuropsychological test feedback based on CTNA principles; c) case examples of CTNA sessions; and d) suggestions for further work and research on CTNA applications.  This workshop will not discuss basic methods of neuropsychological interviewing, assessment, and interpretation as it is assumed attendees will be well versed in these procedures.

Learning Objectives:

1.    Participants will understand the value of a holistic CTNA approach for enhancing patient care.

2.    Participants will learn principles and methods of CTNA and be able to incorporate them into practice.

3.    Participants will understand the applications of CTNA in the rehabilitation of different patient populations. 

Registration enquiries and student volunteers

Enquiries have started to come in about registration fees and the conference programme.

CCN Conferences have always aimed to provide a strong conference that is good value for money, and  members of the CCN pay a discounted rate. It is planned that the registration fee for the 3.5 day conference this year will include morning and afternoon teas, lunch on the first 3 days, welcome drinks, attendance to all sessions, and a practical 'Neuropsychology in Action' conference backpack and drink bottle (to facilitate your brain-enhancing walks around Launceston and Tasmania). There may be a small charge for attendance at workshops, but this will be decided when the programme composition is known.

We will not be able to set the registration fees until we have finalised the conference program. However, for the 3.5 days of this year's program, we are confident that the early bird rate for CCN members will be less than the member rates for the APS2011 and College of Clinical Psychology conferences,  (early bird $695 plus >$100 for workshops at APS 2011, and $780 for CClin members at their conference in 2012).

We hope the early-bird  registration fee for CCN student members will be no more than $200 for the whole conference. This compares to $395 for student members of the College of Clinical Psychologists to attend their conference this year, and $310 for APS student members to attend the APS 2011 conference. The CCN student registration fee is heavily discounted, to encourage student participation and presentations which enrich the conference programme with contemporary research and developments in our field, and to facilitate broader student learning from engaging with the wider professional community.

Student volunteers
Students are very important to the CCN - you are the future of our profession! We want you to be involved with our professional community, and the annual conference is one forum where we value your input, through formal presentations and also as volunteers to help make the conference run smoothly.

Student volunteers will be needed at this year's conference, but unlike previous years, the conference is being held in a state without a postgrad neuropsychology program, which have usually supplied resident student volunteers. I've already received several email queries from interested students, which is fantastic! However, to be fair to everyone, we will need to have a formal volunteer selection process.

Before we can call for volunteers, our conference committee will need to consider how many volunteers we need, what we need them to do, and if we will offer them free registration at the conference, or a subsidised registration fee. We will also need to consider the selection criteria - e.g., should we set a cap on the number of students from each course, so that students from each course can have an opportunity to help out and to meet each other and develop a sense of camaraderie?

School holidays are about to start in Tasmania, so we will not be meeting as a committee to discuss these issues until after June 18th. Rest assured that we will be calling for student volunteers in July or August.

Launceston and the Tamar Valley

Two videos about Launceston, one contemporary, one from the National Film and Television Archive in 1966.

http://www.youtube.com/watch?v=g3Y1RauJmZU&feature=related

http://www.youtube.com/watch?v=mlklnP25_2A

The visitor can decide what has changed in 47 years...

CCN Student Conference Award

The CCN is pleased to offer a student prize to the value of $500 for this year's conference. See details at http://www.psychology.org.au/Content.aspx?ID=3910
There will also be prizes awarded for the best student platform and poster presentations at the conference, as mentioned in the Call for Submissions document.

Submissions portal is open

The call for submissions is available at https://events.psychology.org.au/ei/speakers/Clinical_Neuropsychology_Call_for_Submissions.pdf

We hope to have a full and stimulating conference programme for the discerning clinical neuropsychologist, including several different presentation formats which will allow translation of research evidence to clinical practice at an advanced level.

The online portal for submissions is at  https://events.psychology.org.au/ei/cm.esp?id=1285&pageid=_3FH0L6S7S

We are particularly interested in presentations addressing upcoming and controversial issues in clinical neuropsychology. 

Topics of interest, in alphabetical order, will be added to this post later this evening

Call for submissions - closing date 18 June

Watch this space for the formal call for submissions!

The final proofs have been approved, so we're just waiting for the APS to go live with the submission portal, and to release the final version of the submissions document (hopefully on Monday). The submissions will need to be made via the conference website, at www.groups.psychology.org.au/ccn/events-cpd/conferences

Launceston and the Tamar Valley look beautiful in the submissions document, and we hope that many of you will set aside time to attend the conference and visit this wonderful place.

The photos at the end of this post were taken on a Tamar River luncheon cruise just two weeks ago - a wonderful four-hour cruise up the Tamar, featuring heritage buildings, farmland, vineyards, and our wonderful bushland. There was abundant birdlife, including sea eagles, and even a young seal sleeping by a navigation marker.

In case the location isn't enough to tempt you, think of the programme that we hope to offer this year: clinical neuropsychology papers backed by the most recent research evidence, that put the science of our profession into action.

We're particularly interested in presentations that look at evidence for the efficacy of neuropsychological assessments and interventions (e.g., behaviour management, memory groups, and for patients with complex comorbidities (psychiatric, medical, substance abuse), and the role of neuropsychologists in the community (e.g., community reintegration and interventions), and in less common decision-making contexts like sexuality and testamentary capacity.

We'd be delighted to have a program that educates and informs us on infrequently covered issues like sexuality and brain impairment, informed consent, e-health, ethics, the new driving guidelines, DSM-V, and the new diagnostic guidelines for dementia.

As you'll see when you look at the submissions guidelines, there are several different presentation formats to choose from. So think about submitting a presentation, especially if you haven't done so before - there are over 500 members of the CCN with talents in many areas. Our conference is a chance for you to share your professional passion and expertise with your colleagues.

Finally, in a spirit of community service, we hope to offer a small number of public forums on the last day of the conference for people affected by conditions like TBI and dementia and their carers. There is a great hunger in the community for information about neurobehavioural conditions. If you enjoy educating consumers and other professionals about these areas, please let the committee know via email.