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Professional training for new Primary Care Network (PCN) link workers

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Recognition of Community Action Norfolk’s experience in the planning and delivery of Social Prescribing has led to us being commissioned by NHS Norfolk and Waveney Clinical Commissioning Group to deliver professional support and training to the new Primary Care Network Social Prescribing Service.

The CCG is rolling out a network of link workers across Norfolk and Waveney. The new posts are part of a complex system of other Social Prescribing services across the area, along with a wide range of other support offers. The idea is that each PCN will evolve the social prescribing service to best meet their local needs, whilst maintaining consistency with the overall specification.  So, whilst link workers will share many common elements, some variation will exist in practice between individual roles. In addition, link workers come from a variety of backgrounds with a range of skills and experience.  

The first training session – on Motivational Interviewing - was delivered on 3rd June 2020 and the next is scheduled for 10th June. 

Motivational Interviewing

What exactly is Motivational Interviewing then? It’s a person-centred counselling approach that focuses on personal goals and objectives and the aim is to help motivate the client to change. It’s meant to be more focused than non-directed counselling, more directed towards goals or positive outcomes. It is worth looking at MI in a little more detail, to help differentiate it from more open-ended counselling.

One definition states:

“Motivational Interviewing is a directive, client centred counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence.” 

It’s about helping people choose, make and maintain the changes that they want to make.

Firstly, Motivational Interviewing can be used to help a person become aware of exactly what they want to change, where before they didn’t know. Secondly, it can help the person develop the single-mindedness they need to make and maintain those changes comfortably. Often people attempt to make changes before they have resolved their uncertainty or ambivalence, which leaves them vulnerable to sliding back. feeling that they are hanging on by their fingertips, so to speak.

The training

The aims of the training workshop is that CCG link workers will be able to:

  • identify motivation, ambivalence, and readiness to change in clients
  • understand the principles and spirit of a directive, person-centred interviewing style
  • recognise appropriate situations in which these skills may be utilized and
  • use supplementary skills to elicit, orientate and amplify motivation

 

As the trainers say: ‘It’s not a bag of tricks for getting people to do what they don’t want to do. It is not something that one does to people….it is a way of being with and for people…that evokes natural change”.

However, trainers and practitioners who become too focused on matters of technique can lose sight of the spirit and style that are central to the MI approach. It’s important to remember:

  • that motivation to change comes from the client, and not imposed from without
  • it’s the client's task, not the counsellor's, to articulate and resolve his or her ambivalence
  • to understand the person's frame of reference, particularly via reflective listening is important
  • to monitor the client's degree of readiness to change and not generate resistance by jumping ahead of the client
  • to affirm the client's freedom of choice and self-direction

 

In the end MI is about over-riding inertia. Ultimately, it is the client that should be voicing the argument for change. There is no "right way" to change, and even if one plan for change doesn’t work, another can be tried. The point is that the client can be helped to develop a belief that he or she can make a change.