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Psych 360 > Motivational Interviewing > Flashcards

Motivational Interviewing Flashcards

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1
Q

What was developed by William Miller and Steven Rollnick?

A

motivational interviewing (MI)

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2
Q

what was first found out in MI?

A

observed that shame and confrontation did not bring about change

when confronted w/ shame, get defensive and people tend to turn away/not trust you

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3
Q

“Motivational interviewing is a ______________ for eliciting from patients their own ___________ for making behavior change” - Miller and Rollnick

A

skillful clinical style; good motivations

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4
Q

interviewing consists of strategic _____ and ______

A

questioning; listening

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5
Q

what type of questions are asked in MI?

A

open-ended and directive

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6
Q

change vs. sustained talk

A

change: when someone is speaking about focusing on how they could possibly change

sustained: focused on not changing/why they can’t change

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7
Q

motivation is a _______ state

A

fluctuating

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8
Q

3 critical components of motivation

A

ready
- how change is prioritized

willing
- how importance of change is perceived

able
- confidence for change

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9
Q

change occurs ________, change in treatment mirrors this

A

naturally

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10
Q

______ about change influence change and how we _______ change influences change

A

beliefs; talk about

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11
Q

goal of motivational interviewing is to

A

create and amplify discrepancy between present behavior and broader goals

resolve ambivalence for change

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12
Q

transtheoretical model

A

can be applied to other theories, helps measure the change process in phases of:

pre-contemplation
contemplation
preparation
action
maintenance

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13
Q

what can you do in the transtheoretical model?

A

exit and re-enter at any stage

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14
Q

transtheoretical model: pre-contemplation

A

someone is not thinking about changing at all

arguing with someone at this stage will not work, have to find common ground

ex) smoker not willing to think about quitting

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15
Q

transtheoretical model: contemplation

A

height of ambivalence

where most people are

get people more ready, willing and able

ex) “I don’t think I can do this”

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16
Q

transtheoretical model: preparation

A

have made concrete actions towards change but change hasn’t fully been made just yet

ex) smokers maybe stopped smoking in certain places and time (i.e. stopped smoking in their car or with their morning coffee)

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17
Q

transtheoretical model: action

A

quit day!

where a lot of people can mess up, goal is to try to prevent them from going back too far in process

you can mess up in this stage and stay in action with a good mindset

ex) day a smoker stops smoking cigarettes in any scenario

18
Q

transtheoretical model: maintenance

A

hard part has pasted while there is still work to be done in maintaining behavior change

complex process

ex) done with withdrawals

19
Q

methods of psychotherapy: what MI actually looks like

A

focuses on patient concerns
combines directive and non-directive approaches
is delivered with a spirit of collaboration and patient autonomy

20
Q

ambivalence/resistance in MI is _______, how do we think of patient and therapist interaction?

A

expected; “dance” not a “wrestle”

21
Q

principles of MI

A

express empathy
- acceptance, reflection, destigmatize
- letting patient know we understand/want to know what they are going through/we are here for them

develop discrepancy
- identify patient goals and arguments for change
- see what is getting in the way of goals

roll with resistance
- avoid arguing, resistance is not directly opposed
- dance, not wrestle

support self-efficacy
- patient and therapist belief in capacity for change; build small successes
- part of preparation, as goals are achieved, confidence increases

22
Q

self efficacy

A

belief you can accomplish thing you are attempting

23
Q

______ is seen as a function of importance (willingness) and confidence (ability)

A

readiness

24
Q

what assess importance and confidence

A

importance and confidence ruler

on a scale from 0 to 10 how important is it for you …

on a scale from 0 to 10 how confident are you that you can…

25
Q

what questions are asked when assessing importance and confidence ruler results to elicit change talk?

A

“why isn’t it lower?”

“what can we do to get it higher?”

26
Q

decisional balance in eliciting change talk

A

change and status quo x costs and benefits

27
Q

disadvantages of the status quo =

A

statements acknowledge a problem

28
Q

advantages of change =

A

statements emphasize reasons to change

29
Q

optimism for change =

A

statements that acknowledge change is possible

30
Q

intention to change =

A

statements that envision change happening

31
Q

OARS acronym for MI

A

Open-ended
Affirmations
Reflections
Summaries

32
Q

OARS help build …

A

self-efficacy

33
Q

OARS: open-ended questions in MI

A

require patient to provide information

cannot be answered with yes/no (produces unproductive answer)

ex) how is smoking a problem for you > is smoking a problem for you

34
Q

OARS: affirmations in MI

A

statements of understanding or appreciation
reframe failure as partial success or learning experience
notice patient’s strengths
statements of hope

35
Q

OARS: reflections in MI

A

reflective listening = careful listening follows by statement of what was heard

may include content or inferred meaning

give opportunity for patients to confirm or correct

36
Q

types of reflections in MI

A

simple
- direct statement/verbatim

paraphrase
- suggestion about meaning

reframe
- change perspective
- ex) “I can’t do it” to “you know what works vs. doesn’t”

amplified
- overstate what was heard
- have to jar someone, use at right time and not too often
- ex) doesn’t want to quit smoking for a surgery, say “Ok so you don’t want the surgery”

double-sided
- when stating both sides
- ex) saying one-hand: you were unsuccessful in quitting in the past but on the other hand: you kept trying
- help convert sustained to change talk

37
Q

OARS: summaries in MI

A

highlight both sides of ambivalence

transition to a new topic

wrap up session

example of how talking about change influences change!

38
Q

giving advice using elicit - provide - elicit

A

elicit patient’s buy in
- ask permission for conversation, topic, advice

provide
- provide advice or information

elicit patients reaction
- ask what they think about the information you provided

39
Q

elicit- provide - elicit technique is key for _________ and ________

A

collaboration; autonomy

40
Q

motivational enhancement

A

specific goal to educating patient

more goal-oriented

41
Q

mechanisms for MI

A

client change talk

perceived discrepancy

decisional balance

42
Q

cultural considerations for MI

A

requires
- creativity
- flexibility
- appreciation of cultural differences

Psych 360 (27 decks)

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