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Table 2 imPACT motivational interviewing sessions’ objectives, steps, visual aids, and sample content

From: Individuals motivated to participate in adherence, care and treatment (imPACT): development of a multi-component intervention to help HIV-infected recently incarcerated individuals link and adhere to HIV care

Face-to-Face In Prison imPACT Motivational Interviewing Sessions
Session/Step Maps/Visual Aids used in Step Examples of Sample Statements Provided to Counselor in the Guide for that Step
Session 1 Objectives
1. Build rapport with client
2. Explore general post-release expectations
3. Explore post-release expectations for ART adherence and treatment
4. Develop an action plan for time between Session 1 & 2
Step One: Introduction No Map The most important thing for you to know before we start is that this is a time for you to explore any concerns that you have about taking your HIV medicines or getting treatment, especially what these things will be like for you when you get released from prison.
Step Two: Discussing What Is Important To You. Map 1: “What is Important to You?” Map I’d like to spend some time learning a bit about you and about the things in life that matter to you. Looking at this worksheet called “What is Important to You” in different areas of your life, You are in the center. Let’s look at different areas starting with your Family and Friends.
Step Three: What Makes Me Tick A Matrix of Values with Pictorial Icons If it sounds alright with you, I’d like to go through a list of values that are important to some people—we call this list “What Makes Me Tick”.
Step Four: Exploration Of Choices And Values Map 2: Most Important Value Map Tell me about how [MOST IMPORTANT VALUE] influences your decisions now.
Response and Reflection
Step Five: Adherence & Hiv Treatment Assessment Map 2: Most Important Value Map Tell me a bit about how [MOST IMPORTANT VALUE] affects the decisions you make about your HIV treatment and staying healthy. Response and Reflection
Step Six: Explore Release Expectations Map 3: Managing Your Health Map I’m wondering what you think might help you stay healthy and take your medicine after you get out? [Use “MAP 3: MANAGING YOUR HEALTH MAP” to explore barriers and facilitators to post-release engagement in medical care and medication adherence.]
Step Seven: Making Plans Map 4: Before the Second Session Map If it’s OK, let’s think together and fill out this map (4) about some things you would like to do before your next session. What steps can you begin now to prepare for success after release? Of the ideas that we’ve talked about, what specific things do you feel ready to try?
Step Eight: Summarize Session No Map Thank you for sharing all of this information with me. I know that sometimes it’s not always easy to think about these things, and I appreciate you being so open. Now I have a better understanding about what you think your life might be like after you get out of prison, such as [summarize facilitators and barriers, referencing Managing Your Health Map].
Step Nine: Closure Map 4 We’ll be meeting again in about a month, and we’ll have more time to talk about how you’re feeling thinking about what your life might be like after you get out then.
Session 2 Objectives
1. Continue to build rapport with client
2. Review Session 1
3. Update progress on “Before Second Session Map”
4. Complete Link Coordinator Referral Form
5. Identify Support Person
6. Prepare for 1st Phone Counseling Session
Step One: Introduction Map 3: Managing Your Health Map The last time we met we spent some time talking about things that are important to you. You mentioned [VALUES CHOSEN IN SESSION 1] as things that you think about when you make decisions about your health. Let’s review the two Maps we created together …
Map 4: Before the Second Session Map
Step Two: Topic Selection A Matrix of HIV Care Related Topics with Pictorial Icons Again, these sessions are a time for you to talk openly without being judged, so what, if any, topic on the list would you like to talk about today? I’d like to understand a little more about what [SELECTED TOPIC] means to you in terms of your HIV treatment
Step Three: Assess Facilitators & Barriers Map 3: Managing Your Health I’d like to understand more about how you are feeling about [PROPOSED BEHAVIOR/TOPIC]. Let’s think about what it will be like for you after you are released: Do you think [PROPOSED BEHAVIOR] will be something you are able to do all, most, some or none of the time? [REFER TO MANAGING YOUR HEALTH MAP FROM SESSION I] What do you think may help you to [PROPOSED BEHAVIOR] after you get out? What do you think may get in the way? Reflection
Step Four: Identify Ideas Using Elicit-Provide-Elicit Map 5: Generating Ideas for Success 1. Elicit ideas: Have you had any previous experience trying to do [SELECTED BEHAVIOR]?
2. Provide more information: Would you like to talk about some of the ideas you saw in the video or other ideas I’ve heard that have worked for other people?
3. Elicit their reaction: Do any of these ideas sound like something you’d like to try?
Step Five: Rate Importance & Confidence Visual Analogue Ruler To help me understand exactly how [important this is to you/confident you are you can do this], on a scale from 0 to 10 with 0 being not at all [important/confident] and 10 being very [important/confident], how important is [PROPOSED BEHAVIOR] to you? Question down: Why an [stated number] and not a [number 2–4 less than stated number]? Question up: Why an [stated number] and not an [number 2–4 more than stated number]? What would it take for you to move from a [stated number] to a [number 2–4 more than stated number]?
Step Six: Explore Goal Setting Based On Readiness None Ready: It sounds like you may be ready to think about trying to take some/a small step(s) toward [PROPOSED BEHAVIOR] after you are released. Is that right?
Ready = Moderate/High In Importance And Confidence Not Ready: What would it take for you to be ready to take a small step towards [PROPOSED BEHAVIOR] between now and the next time I speak with you after you are released?
Not Ready = Very Low In Importance And Confidence
Possibly Ready: It sounds like you value moving towards [PROPOSED BEHAVIOR] but you are not quite ready. What would it take for you to get ready? OR What would it take for you to make this step between now and the next time I speak with you after you are released?
Possibly Ready = All Others
Step Seven: Exploring Advantages And Disadvantages None Can you tell me some things you might like about [PROPOSED BEHAVIOR]? What about some things you might not like about [PROPOSED BEHAVIOR]? Where does this leave you now? [Provide double-sided summary]
Step Eight: Link Coordinator Referral Form Referral Needs Assessment Form I will not share anything you’re not comfortable with. But if it’s okay with you, I’d like for us to work together to jot down some notes to share with the Link Coordinator.
Step Nine: Identifying Support Person None Tell me about the people you think will be in your life on the outside, and who might give you the support you need to meet your goals for being healthy.
Step Ten: Making Plans For Coping Matrix of Coping Strategies with Icons Thanks for working with me to come up with a plan for when you’re released from prison. One thing I’d like to talk about now, if it’s okay, is what might happen if your plan doesn’t work out.
Step Eleven: Closure
Phone MI Sessions after Prison Release
Session 3 Objectives
1. Reconnecting with participant
2. Inform participant about upcoming phone counseling sessions
3. Assess how participant has been dealing with release
4. Check in to see if participant has attended doctor’s appointments
5. Assess Release Plan with Link Coordinator
6. Prepare for next 2 week plan to initiate or maintain care and treatment
Step Examples of Sample Statements Provided to Counselor in the Guide for that Step
Step One: Introduction The last time we met we spent some time creating an action plan for after you were released. What do you remember about your action plan?
Step Two: Doctors Visit Now I would like to talk about your Doctor’s visit. How was your appointment with [NAME OF DOCTOR OR CLINIC]? How much do you feel you have what you need to stay healthy?
Step Three: Medication Adherence Finally, if it is ok with you I would like to check in to see how things are going for you with taking your meds?
Step Four: Closure Review session and any changes to action plan
Sessions 4–8
1. Reconnecting with client
2. Review previous session
3. Assess progress with adherence goals
4. Make Plans for Coping
5. Prepare for next 2 week plan to improve or continue adherence plan [not included in session 8)
6. Prepare for closure from the intervention/transition [sessions 7 and 8 only]
Step One: Greeting & Review Of Phone Session Protocol
Step Two: Review Previous Session
Step Three: Topic Selection
Step Four: Assess Facilitators & Barriers
Step Five: Identify Ideas to Overcome Barriers and Enhance Facilitators
Step Six: Rate Importance & Confidence to Use Ideas to Address selected Topic
Step Seven: Explore Goal Setting
Step Eight: Exploring Advantages And Disadvantages
Step Nine: Making Plans For Coping
Step Ten: Closure
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