Chapter 16: Motivational Interviewing Flashcards
A client-centered coaching style that helps clients resolve ambivalence and elicit behavior change.
It is a client-centered approach for enhancing intrinsic motivation.
Motivational Interviewing (MI)
The state of having mixed feelings about change – a client with ambivalence wants to change and at the same time does not want to change.
Ambivalence
Rewards that are immediate – for example, the pleasure of eating high-sugar, high-fat foods.
Proximal Rewards
Rewards that are far away, such as a loss of 30 pounds.
Distal Rewards
The build-up of mental energy that drives the desire to behave in certain ways – behavior often needs plans.
Motivational Phase
Point where individuals decide how they will turn their motivation into behavior.
Planning Phase
What is the underlying purpose of using Motivational Interviewing as a strategy to help a client change their behavior?
Effective motivational interviewing helps clients discover their own reasons for change,
A motivational theory that describes individuals psychological needs for growth – self-determination theory also describes different types of motivational regulation and considers these regulations anywhere on a continuum of motivation.
Self-Determination Theory (SDT)
A state in which a person is not motivated to behave.
Amotivation
Behavior performed to achieve some external reward or to avoid punishment – it is reflective of complying with other people’s demands.
External Regulation
Behavior performed to avoid negative feelings (i.e., shame or guilt) or to enhance positive feelings (i.e., ego).
Introjected Regulation
Behavior performed because it is valued and personally important.
Identified Regulation
Behavior performed because it is fully congruent with a person’s values and needs.
Integrated Regulation
The support of a client regardless of what they say or do – it is the belief that the client is trying their best despite perceived destructive behaviors.
Unconditional Positive Regard (UPR)
The feeling of freedom from external influences or control – the individual is perceived to be the source of their own behavior.
Autonomy
When the client voices the benefits of change and disadvantages of staying the same.
Change Talk
Clients discover why the goal is important to them. They then create specific behavior-oriented goals based on what their values are.
Value exploration
When values are prioritized, behaviors are linked with the client’s personal sense of a desired identity.
Value Prioritization
Within the motivation continuum, what are some examples of motivations that would be considered controlled motives? Check all that apply.
Feeling guilty
Five Strategies of Motivational Interviewing
Express empathy through reflective listening.
Help clients identify discrepancies between their values or goals and their behavior.
Support self-efficacy.
Avoid arguments.
Adjust to client resistance.
Listening that clarifies and expresses an understanding of a person’s own experiences and goals.
Reflective Listening
When a person’s behavior is attributed to “the way they are” rather than to external factors.
Fundamental Attribution Error
The support of a client regardless of what they say or do – it is the belief that the client is trying their best despite perceived destructive behaviors.
Unconditional Positive Regard
People’s ideal version of themselves
ideal comparator
A person’s confidence that they can successfully execute behaviors required to produce outcomes.
Self-Efficacy
Behavioral change model that demonstrates progression through stages until the change becomes part of the everyday lifestyle.
Transtheoretical Model (TTM)
Precontemplators and Resistance to Change
Precontemplator 1
Reluctant precontemplators: These clients lack proper knowledge or think the goal is too far away. They may not recognize the consequences of their current behaviors. They may not want to risk the discomfort or challenge of changing.
Action: Empathetic listening and providing sensitive feedback
Precontemplator 2
Rebellious precontemplators: These clients have the information to know that their behaviors are problematic. They are, in fact, adamant about not changing.
Action: Ensure the client that no one can force them to make any changes and that you have no intention of making them do anything they do not want to do. Provide them with a variety of options to see if one is appealing.
Precontemplator 3
Resigned precontemplator: These clients may feel overwhelmed by the change process. Changing seems hopeless to them.
Action: Instill hope and explore barriers to changing.
Precontemplator 4
Rationalizing precontemplator: These clients do not feel as if they are in personal risk from their behavior.
Action: Empathy and reflective listening – Let the client talk about the pros of their behavior.
Precontemplation
Provide empathetic and reflective listening.
Do a value exploration to see how the client’s behaviors fit in with their values.
Build rapport.
Avoid arguments.
Begin with a small change and provide affirmation for each success.
Enhance self-efficacy.
Help clients resolve ambivalence and encourage change.
Have clients get bloodwork done to examine biomarkers of health. Relevant health information may encourage change.
Use decisional balance sheets.
Provide affirmations.
Continue to enhance self-efficacy.
Contemplation
Assess strength of commitment to change.
Help clients develop feasible plans.
Help clients make specific action plans that dictate when, where, how, and with whom a behavior will occur.
Preparation
Revise plans as needed.
Foster strong self-efficacy.
Harness social support.
Create and follow through on plans.
Action
Maintenance
Encourage clients to organize their environment so that temptations to relapse are minimal.
Strengthen commitment to the goal.
Identify relapses early.
Encourage clients to forgive relapses and return to their routine.
Harness social support.
Which of the following terms refers to a client who eats healthy food because eating food is connected to their identity?
Integrated regulation
A client is not sure that they can reduce their intake of snacks at work, but their Nutrition Coach reminds them that they felt the same way when they thought they could not reduce their alcohol intake. The coach is using which of the following to increase this client’s self-efficacy for the specific task of reducing snacks?
Verbal persuasion
Which of the following varies along a continuum and is reflective of the level to which a behavior is integrated into an individual’s values or identity?
Motivational regulation
Self-efficacy is mediated by how many sources?
4
A coach summarizes and restates what a client has just told them by saying, “This is the third time you have made a serious effort at losing weight in the last two years. The goal is personally important to you for health reasons, but you are also worried about staying committed to the goal over the long haul.” Which of the following is the coach expressing?
Accurate empathy
Which of the following is the theory that proposes that motivation lies on a continuum from amotivation, to extrinsic motivation, to intrinsic motivation?
Self-determination theory
Which of the following is defined as all of the brain processes used to energize and direct behavior?
Motivation
With which of the following does motivational interviewing start?
Collaboration
Which of the following is defined as being the source of one’s behavior?
Autonomy
How many basic psychological needs are there in self-determination theory?
3
Changing because of outside pressures is a controlled motive; however, changing because an individual wants to change is considered to be which one of the following?
Autonomous motive
Which of the following reframes the idea of failures as ineffective solutions?
A process mindset
