Motivational interviewing

Question 1

motivational interviewing is a method of causing __

Answer 1

motivational interviewing is a method of causing behavior change

Question 2

6 stages of behavior change

Answer 2

1. precontemplation
2. contemplation
3. preparation
4. action
5. maintenance
6. relapse

Question 3

precontemplation is __ about change

Answer 3

precontemplation is NOT yet THINKING about change

Question 4

contemplation is __ about change

Answer 4

contemplation is THINKING about change

Question 5

at what stage can you temporarily exit the stages of change circle

Answer 5

preparation

Question 6

relapse is __ and __

Answer 6

relapse is normal and common

Question 7

5 steps of contemplating change

Answer 7

1. Identifying the behavior: this is how I eat
2. Identifying a problem: eating this way is a problem
3. Desiring a change: I want to eat better
4. Feeling confident about a change: eating better will help me be healthier and feel better
5. Doing it!

Question 8

3 values of stages of change models

Answer 8

1. Sending a patient home even thinking about change is a huge step
2. Knowing where patients are stuck may help you narrow down the likely barriers
3. Framework that can be used to facilitate empathy

Question 9

the 4 spirits of MI

Answer 9

1. acceptance (autonomy and empathy)
2. collaboration
3. compassion
4. evocation

Question 10

MI: acceptance
if given a choice, more likely to __

Answer 10

MI: acceptance
if given a choice, more likely to make a change

Question 11

__ acceptance facilitates change

Answer 11

nonjudgmental acceptance facilitates change

Question 12

MI: acceptance
__ is normal

Answer 12

MI: acceptance
ambivalence (not knowing where you are) is normal

Question 13

MI: collaboration

Answer 13

being an equal partner

Question 14

MI: compassion

Answer 14

MI is not a magic bullet or trick

Question 15

MI: evocation

Answer 15

eliciting patient’s perspective as well as “change talk”

Question 16

change talk consists of the patient’s expression of their own __, __, __, and __ for behavior change

Answer 16

change talk consists of the patient’s expression of their own desires, ability, reasons, and need for behavior change

Question 17

sustain talk consists of the patient’s expression of their own __, __, and __ for behavior change

Answer 17

sustain talk consists of the patient’s expression of their own desires, reasons and need to stay the same, and inability for behavior change

Question 18

MI: where is the patient? what is their perspective?

Answer 18

empathy, use stages of change
collect info

Question 19

MI: what are the micro-skills needed?

Answer 19

Person centered guiding skills (OARS)
Giving information (includes suggestions, voicing your concerns, etc.)
“Rolling with resistance”

Question 20

MI: what is the overarching goal as a physician

Answer 20

Paying attention to, reflecting, eliciting, and reinforcing change talk: the reasons, desire, ability, need, etc. for behavior change
The more change-talk you hear from the patient, the more likely they are to want to change

Question 21

O in OARS

Answer 21

These are questions that invite the patient to say more than a yes, no, number or one word answer.

Question 22

A in OARS

Answer 22

These are statements that reinforce and convey recognition of the patient’s strengths, abilities, efforts, as well as past and current successes

Question 23

R in OARS

Answer 23

These are statements in which the provider repeats (exact words), rephrases (slight re-wording), or paraphrases (e.g., amplifying the thought or feeling, use of analogy, making inferences).

Question 24

S in OARS

Answer 24

These are statements in which the provider reviews patient’s stance on the behavior at the current moment and can be a useful tool to then elicit the “next steps” with a key question.

Question 25

“Eating healthier was very important to you back then and you made sure that nothing stopped you from doing so.”

which letter of OARS

Answer 25

Affirmations

Question 26

“How would you like for things to be different with your ____?”, “What concerns you about your____?”

which letter of OARS

Answer 26

Open-ended questions

Question 27

“You’ve done the hard work of eating healthier and losing some weight. You’ve felt really good about those changes, and recently you feel like you had a little setback. Getting to a healthy weight and feeling good about yourself is a priority for you and right now you’re not sure what to do. What would be most helpful for you right now?”

which letter of OARS

Answer 27

Reflections

Question 28

“You’ve done the hard work of eating healthier and losing some weight. You’ve felt really good about those changes, and recently you feel like you had a little setback. Getting to a healthy weight and feeling good about yourself is a priority for you and right now you’re not sure what to do. What would be most helpful for you right now?”

Answer 28

Summaries

Question 29

how to effectively give information

Answer 29

Provide information when asked
Ask for permission before giving (if the patient does not ask)
Provide small “chunks” of information while frequently getting feedback to assess the patient’s perspective on that information: the elicit-provide-elicit (EPE) model

Question 30

elicit-provide-elicit (EPE) model

Answer 30

elicit consent
provide small chunk of information
elicit confirmation of understanding

Question 31

when should you give information in a visit?

Answer 31

NOT first

Question 32

importance scale

Answer 32

how important is it for you right now to change?

Question 33

if patient is at a 6, ask (2 questions)

Answer 33

1. why is it a 6 and not a 3?
2. What would make you go from 6 to 9?

Question 34

confidence scale

Answer 34

if you decide to change, how confident are you that you will be able to?

Question 35

key questions for demonstrating the advantages of change

Answer 35

1. “How would you like for things to be different in the way you are feeling?”
2. “What would be the advantage of making this (or a) change?”
3. “I know that it is difficult to start making these kinds of changes. Let’s say you were able to, and your son got to a healthier weight. What would be the positive things you might see in his life? In your family?”
4. “How were you able to overcome this in the past?”

Question 36

key questions for demonstrating the disadvantages of the status quo

Answer 36

“What worries you about your current situation?”
“What makes you think that you need to do something about ______ (e.g., your smoking)?”
“In what ways does this concern you?”
“What do you think will happen if you donʼt change anything?”
“Putting aside what others are telling you to do, what are you saying to yourself, about what you think is best for you?”

Question 37

to elicit change talk you should use questions to point out the advantages of __ and the disadvantages of __

Answer 37

to elicit change talk you should use questions to point out the advantages of change and the disadvantages of the status quo

Question 38

MI can blend well with __

Answer 38

MI can blend well with CBT

Question 39

Cognitive Behavioral Therapy (CBT) =

Answer 39

thoughts + feelings + behaviors