Motivational Interview Flashcards
Where can we use motivational interviewing? (general)
Anywhere you want to bring change
Like in the chronic pain cycle
Name a few disciplines where we could use motivational interviewing?
Substance abuse (addiction services) Mental health Psychiatry Primary healthcare Nursing Supported employment Vocational rehabilitation Residential Housing Criminal justice Physical Therapy Occupational Therapy
What are the core principles of motivational interviewing?
Express empathy through reflective listening.
Develop discrepancy between clients’ goals or values and their current behavior.
Avoid argument and direct confrontation.
Adjust to client resistance rather than opposing it directly.
Support self-efficacy and optimism
What is the difference between empathy and sympathy?
Empathy: the ability to understand and share the feelings of another
Sympathy does not require the sharing of the same emotional state.
How do we develop the discrepancy between the present state and the possible goals?
Developing awareness of consequences helps clients examine their behavior.
A discrepancy between present behavior and important goals motivates change.
The client should present the arguments for change
What are some good questions to help develop the discrepancy between the present state and the possible goals?
This is where you are right now/ Are you happy where you are?
Where do you want to be?
With where you are right now, do you think you will be ale to do shopping, gardening, play outside with your kids?
What do you think we need to change?
Why do we need to avoid argument?
Arguments are counterproductive.
Defending breeds defensiveness.
Resistance is a signal to change strategies.
Labeling is unnecessary.
What are the 4 types of resistance?
Four types of resistance: Arguing,
Interrupting,
Denying,
Ignoring.
What are some reasons we should roll with the resistance of our patients?
Momentum can be used to good advantage.
New perspectives are invited but not imposed.
The patient is a valuable resource in finding solutions to problems.
Why is it important to promote self-efficacy?
Belief in the possibility of change is an important motivator.
The client is responsible for choosing and carrying out personal change.
There is hope in the range of alternative approaches available.
What are the Five Opening Strategies For Early Sessions?
Ask Open-Ended Questions Listen Reflectively Summarize Affirm Elicit Self-Motivational Statements
give some examples of open -ended questions:
Tell me what you like about your current lifestyle?
“What’s happened since we last met?”
“What makes you think it might be time for a change?”
“What brought you here today?”
“What happens when you behave that way?”
“Tell me more about when this first began.”
“What’s different for you this time?”
“What was that like for you?”
give some examples of reflective listening phrases
“It sounds like….”
“What I hear you saying…”
“So on the one hand it sounds like …. And, yet on the other hand….”
“It seems as if….”
“I get the sense that….”
“It feels as though….”
What is “normalizing” intended to Do?
Normalizing is intended to communicate to clients that having difficulties while changing is not uncommon, that they are not alone in their experience, or in their ambivalence about changing.
What is “normalizing” NOT intended to Do?
Normalizing is not intended to make clients feel comfortable with not changing; rather it is to help them understand that many people experience difficulty changing.
Give some Examples of Normalizing phrases:
“Many people report feeling like you do. They want to be able to exercise, but find it difficult.”
“That is not unusual, many people report having made several attempts at starting an exercise program before they succeed.”
“A lot of people are concerned about their pain preventing them from exercising”
What are “Affirmations” and how should we use them?
Affirmative responses or supportive statements by therapists verify and acknowledge clients’ behavior changes and attempts to change.
When providing an affirmation, therapists should avoid statements that sound overly ingratiating (e.g., “Wow, that’s incredible!” or “That’s great, I knew you could do it!”).
While affirmations help to increase clients’ confidence in their ability to change, they also need to sound genuine.
Give some examples of Example of Affirmative Statements
Your commitment really shows by doing your HEP consistently.
“You showed a lot of determination by doing that.”
“It’s clear that you’re really trying to change your lifestyle.”
“By the way you handled that situation, you showed a lot of strength and courage.”
“With all the obstacles you have right now, it’s impressive that you’ve been able to go to the gym consistently.”
Give some examples of Questions that would Elicit/Evoke Change Talk
“What would you like to see different about your current situation?”
“What makes you think you need to change?”
“What will happen if you don’t change?”
“What would be the good things about changing your lifestyle?”
“What would your life be like 3 years from now if you changed your lifestyle/habits?
what are some alternatives to “wear and tear, degeneration, joint restriction”?
When you do need to report on positive findings, use a minimizing language for the impairments.
Consider a phrase like common, age-related changes rather than degeneration or wear and tear. Use muscular control as opposed to instability
Is Motivational interviewing low cost and effective?
Low cost.
Effectiveness:
Large effects from brief motivational counseling have held up across a wide variety of real-life clinical settings.
Is Motivational interviewing compatible with health care delivery.
Motivational interviewing does not assume a long-term client-therapist relationship. Even a single session has been found to invoke behavior change, and motivational interviewing can be delivered within the context of larger health care delivery systems.
Why is it important to Emphasize client motivation?
Client motivation is a strong predictor of change, and this approach puts primary emphasis on first building client motivation for change. Thus, even if clients do not stay for a long course of treatment (as is often the case with substance abuse), they have been given something that is likely to help them within the first few sessions.
Does motivational interviewing Enhance adherence?
Motivational interviewing is also a sensible prelude to other health care interventions because it has been shown to increase adherence, which in turn improves treatment outcomes
