Chapter 16: Motivational Interviewing Flashcards
Motivational Interviewing (MI)
A client-centered coaching style that helps clients resolve ambivalence and elicit behavior change.
Ambivalence
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.
Proximal Rewards
Rewards that are immediate – for example, the pleasure of eating high-sugar, high-fat foods.
Distal Rewards
Rewards that are far away, such as a loss of 30 pounds.
Motivational Phase
The build-up of mental energy that drives the desire to behave in certain ways – behavior often needs plans.
Planning Phase
Point where individuals decide how they will turn their motivation into behavior.
Motivation
The collective reasons that drive a person to take action.
Self-Determination Theory (SDT)
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.
Amotivation
A state in which a person is not motivated to behave.
Extrinsic Motivation
When a behavior is done for any reason outside of inherent pleasure.
Intrinsic Motivation
Behavior that is directed by personal (internal) satisfaction such as personal enjoyment as well as striving for self-determination and competence.
Controlled Motives
Those with motives who feel outside or internal pressure to do certain behaviors.
Autonomous Motives
Behaviors that are enacted with a sense of volition and choice – autonomously motivated people want to do the behavior.
External Regulation
Behavior performed to achieve some external reward or to avoid punishment – it is reflective of complying with other people’s demands.
Introjected Regulation
Behavior performed to avoid negative feelings (i.e., shame or guilt) or to enhance positive feelings (i.e., ego).
Identified Regulation
Behavior performed because it is valued and personally important.
Integrated Regulation
Behavior performed because it is fully congruent with a person’s values and needs.
Unconditional Positive Regard (UPR)
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.
Autonomy
The feeling of freedom from external influences or control – the individual is perceived to be the source of their own behavior.
Change Talk
When the client voices the benefits of change and disadvantages of staying the same.
Self-Regulation
An individual’s ability to modify their behavior.
Value Exploration
Clients discover why the goal is important to them. They then create specific behavior-oriented goals based on what their values are.
Value Prioritization
When values are prioritized, behaviors are linked with the client’s personal sense of a desired identity.
Reflective Listening
Listening that clarifies and expresses an understanding of a person’s own experiences and goals.
Fundamental Attribution Error
When a person’s behavior is attributed to “the way they are” rather than to external factors.
Unconditional Positive Regard
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.
Self-Efficacy
A person’s confidence that they can successfully execute behaviors required to produce outcomes.
Affirmation
A positive statement about a client’s character that acknowledges their efforts.
Transtheoretical Model (TTM)
Behavioral change model that demonstrates progression through stages until the change becomes part of the everyday lifestyle.
What are some key characteristics a Nutrition Coach might exhibit when using Motivational Interviewing with a client?
They are collaborative, Empathetic, Communicates with their client’s goal(s) in mind
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
Within the motivation continuum, what are some examples of motivations that would be considered controlled motives?
“My employer told me, so I need to…”
“I should make better eating choices.”
Within the motivation continuum, what are some examples of motivations that would be considered controlled motives?
Feeling guilty
When providing nutrition coaching to your clients, it is imperative to use Motivational Interviewing strategies to help clients discover their own reason for change. These motivational interviewing strategies involve what following actions?
Express empathy
Discrepancy identification
Support self-efficacy
Avoid arguments
Client resistance adjustment
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.
Contemplation
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.
Preparation
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.
Action
Revise plans as needed.
Foster strong self-efficacy.
Harness social support.
Create and follow through on plans.
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 allows for empathetic listening to occur?
The Nutrition Coach respects and accepts the client.
Which of the following is defined as the seemingly paradoxical state where a client wants to change but also does not want to change?
Ambivalence
Which of the following is consistent with motivational interviewing?
Supporting self-efficacy
Discrepancies drive behavior change most of the time. That being said, which example of a discrepancy would likely be the most demotivating rather than motivating?
A client who weighs 220 pounds and wants to weigh 140 pounds
Which construct is the least subject to change?
Values
How many basic psychological needs are there in self-determination theory?
3
Which of the following terms refers to a client who eats healthy food because eating food is connected to their identity?
Integrated regulation
In motivational interviewing, ambivalence is seen as which of the following?
A normal part of the change process
When a coach argues that a client’s behavior needs to change, the client may respond by doing which of the following?
Defending their behavior
How many motivational interviewing strategies are there?
5
Self-efficacy is mediated by how many sources?
4
Which of the following is taken away if a Nutrition Coach tells a client what to do and does not ask for their opinion?
Autonomy
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
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
Clients should feel as if their own unique change experience is truly understood by the coach. Doing which of the following can accomplish this?
Expressing empathy
