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Michael Sainsbury
“I’m in too much pain to work
         “I’m in too much pain to work
         – IIdon’t think IIcould ever go
          – don’t think could ever go
        back!”
         back!”



                                  “There’s no point searching for aa
                                   “There’s no point searching for
                                  job
                                   job
                                   – no one’s going to employ me!”
                                    – no one’s going to employ me!”



“I’m too scared to do anything
 “I’m too scared to do anything
– because IImight reinjure myself!”
 – because might reinjure myself!”




                                                                       2
“Afterall, when you seek advice from someone, it’s
  certainly not because you want them to give it. You just
  want them to be there while you talk to yourself.”

“People are more likely to be persuaded by the reasons
  they have themselves discovered, than by those that
  come into the minds of others.”

                                                         3
It’s not that the individual is ‘unmotivated’!

          What drives the individual?

What is it that motivates their behaviour?




                                                    4
Willingness to change

Ability to change

Readiness for change




                        5
Ambivalence


“I want to, but I don’t want to”
dilemma


Explore the individual’s feelings of ambivalence to
understand their motivations

For what is the injured worker motivated?



                                                      6
Motivational Interviewing

A worker-centred, directive method for enhancing
intrinsic motivation to change by exploring & resolving
ambivalence

A soft way of asking workers to take a hard look at
themselves




                                                      7
Develop Discrepancy

Express Empathy

Avoid Arguing

Roll with Resistance

Support Self-Efficacy


                        8
Develop Discrepancy




Motivation for change can occur when the worker
recognises the discrepancy between where they’re at &
where they want to be in their life

Explore ‘looking back’ & ‘looking forward’



                                                        9
Express Empathy


Reflective listening to understand & accept
the worker’s perspective
-without judging, criticising or blaming

When the worker feels understood
-more able to open up & share their experiences

Acceptance & respect facilitates a positive
working relationship
- builds self-esteem for promoting change
                                              10
Low Empathy     High Empathy

Low Control     High Control



Low Empathy    HIGH EMPATHY

High Control   LOW CONTROL




                               11
Avoid Arguments


Positive approach that avoids
direct confrontation & arguing

Don’t push for change




                                 12
Roll with Resistance




Avoid challenging the worker’s resistance to change
-‘roll with it’ or it may lead to strongly defending their
current position

Use the worker’s ‘momentum’ to further explore their
views

                                                             13
Support Self-Efficacy

Individual’s belief in their ability to succeed

Worker’s belief that change is possible is an
important motivator

Highlight changes the worker has previously made in their
lives to develop a belief that change is possible

Enhance the worker’s confidence in their capacity to cope
with obstacles & succeed in change

                                                            14
Stages of Change




                   15
16

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Building motivation for change as a platform for return to work

  • 2. “I’m in too much pain to work “I’m in too much pain to work – IIdon’t think IIcould ever go – don’t think could ever go back!” back!” “There’s no point searching for aa “There’s no point searching for job job – no one’s going to employ me!” – no one’s going to employ me!” “I’m too scared to do anything “I’m too scared to do anything – because IImight reinjure myself!” – because might reinjure myself!” 2
  • 3. “Afterall, when you seek advice from someone, it’s certainly not because you want them to give it. You just want them to be there while you talk to yourself.” “People are more likely to be persuaded by the reasons they have themselves discovered, than by those that come into the minds of others.” 3
  • 4. It’s not that the individual is ‘unmotivated’! What drives the individual? What is it that motivates their behaviour? 4
  • 5. Willingness to change Ability to change Readiness for change 5
  • 6. Ambivalence “I want to, but I don’t want to” dilemma Explore the individual’s feelings of ambivalence to understand their motivations For what is the injured worker motivated? 6
  • 7. Motivational Interviewing A worker-centred, directive method for enhancing intrinsic motivation to change by exploring & resolving ambivalence A soft way of asking workers to take a hard look at themselves 7
  • 8. Develop Discrepancy Express Empathy Avoid Arguing Roll with Resistance Support Self-Efficacy 8
  • 9. Develop Discrepancy Motivation for change can occur when the worker recognises the discrepancy between where they’re at & where they want to be in their life Explore ‘looking back’ & ‘looking forward’ 9
  • 10. Express Empathy Reflective listening to understand & accept the worker’s perspective -without judging, criticising or blaming When the worker feels understood -more able to open up & share their experiences Acceptance & respect facilitates a positive working relationship - builds self-esteem for promoting change 10
  • 11. Low Empathy High Empathy Low Control High Control Low Empathy HIGH EMPATHY High Control LOW CONTROL 11
  • 12. Avoid Arguments Positive approach that avoids direct confrontation & arguing Don’t push for change 12
  • 13. Roll with Resistance Avoid challenging the worker’s resistance to change -‘roll with it’ or it may lead to strongly defending their current position Use the worker’s ‘momentum’ to further explore their views 13
  • 14. Support Self-Efficacy Individual’s belief in their ability to succeed Worker’s belief that change is possible is an important motivator Highlight changes the worker has previously made in their lives to develop a belief that change is possible Enhance the worker’s confidence in their capacity to cope with obstacles & succeed in change 14
  • 16. 16