L4: Motivational Interviewing Flashcards
How can you prepare for an MI session?
- preparing your attitude: remember spirit of MI: Partnership, Acceptance, Compassion, Evocation, Respect
- preparing your mind: RULE: Resist urge to give advice & opinions, Understand their motivations & solutions, Listen empathetically to their perspectives, Empower clients hope & optimism
- preparing your space: no mental or physical distracitons present
What makes changing so difficult?
- demoralization
- takes a lot of effort & time so need that in ordeer to change
- resistance (which often arises out of fear)
- automatic cognitive processes
- environmental factors
-> behaviour has a function or a “special meaning”
-> briefly acknowledge the reasons for problem behaviour in the initial phase
What is Motivatoin?
- degree of willingness/readiness to change
- can vary over time
- can be influence (eg by the counselor)
- underlies the actual change of behaviour
3 components - will to change
- confidence in own ability to change
- readiness to change
What is ambivalence?
- Conflicting motivations
- “i want to change but i still find it too difficult”
-> ambivalence evokes discomfort & is often the start of change (=cognitive dissonance)
What is Motivtional Interviewing?
a client-cenetered, directive method for enhancing intrinsic motivatoin to change by exploring & resolving ambivalence
What works in MI?
- show empathy
- unconditional acceptance (of the person, not necessarily the behaviour)
- avoid discord/discussion
- roll w resistance, moving along (judo)
- affirmation
- develop disbalance (cognitive dissonance)
- exploring the other’s point of view
What doesn’t work in MI?
- convincing
- direct confrontation
- discussion
- tips & tricks
- stressing negative consequences usually doesn’t work
- assuming the expert role
- critizing
- shaming
- labelling
- giving unsolicited advice
- righting reflex: repair reflex/for your own good reflex you really want to find a solution for this client
When is giving advice fine?
- when a decision is already made
- someone asks for it explicitly
- the other does not have the right info
What are the 4 processes of MI?
- engaging
- focusing
- evocation
- planning
What are the stages of change?
- precontemplation (engaging)
- contemplation (focusing/evoking)
- preparation (focusing/evoking/planning)
- action
- maintenance
- relapse
- pre contemplation
What is “engaging” in MI?
- entering therapeutic alliance & agenda setting
- can take long or can be immediate
- provide feeling of safety & appr”ciation for attending
- techniques: comforting, asking for permission, giving options, talking about values
- “what is the reason you are here”
- specifics: OARS: Open questions, Affirmations, Reflections, Summaries
What is “focusing” in MI?
“which change are we talking about?”
- determining goal/direction (clients & counsellors)
- if focus is not up to client (cause doctors orders) then give them menu of options
- if focus is clear: spend time clarifying & prioritizing (“what do you expect from this talk”)
- use OARS
- collaborative agenda setting
What are some helpful questions for identifying target behaviour in focus stage?
- What kinds of changes do you want to make in your life?
- How would you like things to be different for you?
- What things in your life would you like to be different?
- What goals do you have for changing your behavior?
What is “evocation” in MI?
“why change?” -> essential stage of MI
1. explore & increase ambivalence (this causes discomfort but increases willingness to change)
2. evoke change talk
- the balance between change & sustain talk predicts change
- influenced by clinician
- increase of intrinsic motivation by evocation of change language
What is change talk vs sustain talk?
essential in evocation stage of MI
change talk:
- disadvantages of status quo
- advantages of change
- confidence about changing
- determination to change
- 5 types: DARN-C (all talk that talks about Desire, Ability, Reason, Need, Commitment to change)
sustain talk:
- advantages of status quo
- disadvantages of change
- negatives about change
- determination to not change
