Chapter 10 Flashcards
What was the traditional belief about client motivation for change?
If clients weren’t sufficiently motivated for change, there was nothing you could do. ‘Come back when you’re ready to change’ was common advice.
What is now understood about client motivation?
Client motivation is not a stable trait but a dynamic process influenced by interpersonal interactions. It is part of the clinical task to enhance motivation for change.
What was an early clue that motivation was not a stable trait?
Studies in the 1950s and 1960s searched for a client dropout profile but found that the best predictor of dropout was the assigned counselor, not client personality traits.
How does the assigned counselor impact client outcomes?
Regardless of treatment type, the particular clinician can be the difference between getting better or worse, even when treatment is standardized.
What does the transtheoretical model’s stages of change explain?
It explains that clients start at different levels of readiness for change and need different kinds of help to progress.
What is ambivalence, and how does it relate to change?
Ambivalence is feeling two ways about something. It is normal when facing change, such as managing a health condition or substance use disorder.
How do people typically respond when confronted about their ambivalence?
They often argue against change, reinforcing their commitment to the status quo and making change less likely.
What is the decisional balance approach?
It involves helping clients voice all the pros and cons of each alternative they are considering.
Why is decisional balance not recommended for ambivalent clients?
It tends to decrease commitment to change unless the perceived benefits of change already outweigh the disadvantages.
What is Motivational Interviewing (MI)?
A collaborative, evocative counseling style that strengthens clients’ own motivations and commitment to change.
What are the four themes of MI spirit?
Collaboration, evocation, acceptance, and compassion.
What are the four processes of MI?
Engaging, focusing, evoking, and planning.
How does MI view ‘resistance’?
It differentiates between sustain talk (status quo) and discord (tension in the alliance), both of which are influenced by counselor style.
What is Motivational Enhancement Therapy (MET)?
A combination of MI with assessment feedback to help clients understand their behaviors and risks.
How has MI been shown to work effectively?
Studies have shown MI significantly improves outcomes for substance use disorders, particularly in more severe cases.
How can MI be combined with other treatments?
It is often combined with contingency management and other therapies to enhance motivation and adherence.
