Motivational Interviewing

Question 1

WHO Guidelines for Movement

Answer 1

150 minutes/week moderatre to vigorous cardiovascular, minimum of 10 minute bouts.
2x/week strength, whole body movements.
Mobility training

Question 2

National Center for Health Statistics on Exercise

Answer 2

Percent of adults age 18 and older who met the physical activity guidelines aerobic physical activity = 46.9%
Percent of adults age 18 and older who met the physical activity guidelines for both aerobic and muscle strengthening activity = 24.2%

Question 3

Ambivalence

Answer 3

The state of having mixed feelings to contradictory ideas about something.
Is normal, therefore needs to be explore but not challenged.
Resolving ambivalence can be the key to change.

Question 4

Stages of Change

Answer 4

Precontemplation
Contemplation
Preparation
Action
Maintenance
Relapse

Question 5

Precontemplation

Answer 5

Individuals are not yet considering change.
They may be unaware of the need for change or are resistant to it.
Characteristics = denial, lack of awareness, and defensiveness.
Interventions = raise awareness, provide information, and discuss risks and benefits.

Question 6

Contemplation

Answer 6

Individuals acknowledge the problem and start to think about the possibility of change, weighing the pros and cons.
Characteristics = ambivalence, consideration, and self-reflection.
Interventions = explore ambivalence, discuss pros and cons, and enhance motivation.

Question 7

Preparation

Answer 7

Individuals intend to take action soon and may begin to take small steps toward change.
Characteristics = planning, commitment, and gathering resources.
Interventions = assist with planning, set realistic goals, and provide support and encouragement.

Question 8

Action

Answer 8

Individuals actively take steps to change their behaviour.
Characteristics = implementation of new behaviours, effort, and visible change.
Intervention = provide support, monitor progress, and help overcome obstacles

Question 9

Maintenance

Answer 9

Individuals work to sustain the new behaviour and prevent relapse.
Characteristics = long-term behaviour change, consolidation, and resilience.
Intervention = reinforce positive behaviours, develop coping strategies, and maintain support systems.
Time to recognize barriers as well.

Question 10

Relapse

Answer 10

Sometimes included as a stage.
Individuals return to old behaviours after a period of change.
Characteristics = setback, frustration, and potential demoralization.
Interventions = normalize the relapse, reassess motivation and strategies, and encourage a return to the stages of change.

Question 11

Stages of Change in Motivational Interviewing

Answer 11

Tailoring interventions = MI practitioners use the stages of change model to tailor their interventions based on the client’s current stage, providing appropriate support and strategies.
Enhancing motivation = by understanding where a client is in the change process, practitioners can better address their specific needs, reduce ambivalence, and enhance motivation.
Promoting self-efficacy = the model helps clients recognize their progress and strengths, building confidence in their ability to change.

Question 12

How can we integrate the model of MI and stages of change?

Answer 12

Assessment = determine the client’s stage of change through open-ended questions and reflective listening.
-summarizing what patient says is really important and makes them feel heard
Intervention = apply MI techniques that align with the client’s stage, such as raising awareness in pre-contemplation or planning in preparation
Support = continuously support the client through each stage, acknowledging their efforts and helping them navigate challenges

Question 13

What is motivational interviewing?

Answer 13

Is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.

Question 14

What is the spirit of motivational interviewing?

Answer 14

MI is characterized by a collaborative, respectful, and compassionate approach.
The practitioner’s role is to guide rather than direct, creating a partnership with the client where they feel heard and supported.
-providing partnership, acceptance, compassion, and evocation

Question 15

Evocation

Answer 15

In motivational interviewing is used to draw out a person’s own motivations, desires, and reasons for change, rather than imposing ideas or solutions from the outside.
The goal is to help individuals explore and articulate their intrinsic motivations from making positive changes in their lives.
-this approach is especially powerful because it empowers individuals to recognize and act upon their own values and goals

Question 16

Components of Evocation

Answer 16

Eliciting change talk
Exploring values and goals
Connecting actions to outcomes
Empathetic listening
Avoiding the righting reflex

Question 17

Eliciting change talk

Answer 17

Encouraging the individual to talk about their own reasons for wanting to change.
Change talk includes statements that express desire, ability, reasons, or need to change.
Asking very open-ended questions and pausing for space gives patient opportunity to think and speak.

Question 18

Exploring Values and Goals

Answer 18

Asking questions that help the individual reflect on their values, long-term goals, and how their current behaviour aligns or conflicts with those.

Question 19

Connecting Actions to Outcomes

Answer 19

Helping the individual see the connection between their current behaviours and the outcomes they want to achieve, thereby evoking a sense of responsibility and empowerment.

Question 20

Empathetic Listening

Answer 20

Actively listening to the person’s responses and reflecting their thoughts back to them, which helps to clarify and reinforce their own motivations.

Question 21

Avoiding the Righting Reflex

Answer 21

Resisting the urge to correct or provide solutions, and instead focusing on drawing out the person’s own insights and motivations.

Question 22

What are the key principles of motivational interviewing?

Answer 22

Express empathy
Develop discrepancy
Role with resistance
Support self-efficacy

Question 23

Express Empathy

Answer 23

Use reflective listening to convey understanding of the client’s perspective and feelings.
Empathy is the ability to understand and share the feelings of another person.
-in communication, showing empathy involves acknowledging someone’s emotions and responding in a way that shows you care.

Question 24

Develop Discrepancy

Answer 24

Help clients recognize the gap between their current behaviours and their broader goals or values.
Cognitive dissonance = holding conflicting beliefs/behaviours.

Question 25

Roll with Resistance

Answer 25

Avoid arguing and instead work with the client’s resistance to change, using it as an opportunity to further explore their motivations.
Rolling with resistance can help increase client rapport and trust.
Involves reframing.

Question 26

Reframing

Answer 26

Involves offering a different perspective on what the client has said, which can help them see their situation in a new light.
This can gently challenge the client’s resistance without being confrontational.

Question 27

Support Self-Efficacy

Answer 27

Encourage clients to believe in their ability to change and highlight past successes as evidence of their capability.
Empowering the client by emphasizing their control over their own decisions and actions can reduce assistance by reinforcing the idea that the client is in charge of their own change process.

Question 28

What are the core skills in motivation interviewing (MI)?

Answer 28

Open-ended questions
Affirmations
Reflective Listening
Summarizing

Question 29

Open-ended Questions

Answer 29

Encourage clients to talk about their thoughts and feelings in detail

Question 30

Affirmations

Answer 30

Recognize and acknowledge the client’s strengths and efforts

Question 31

Reflective Listening

Answer 31

Mirror what the client says to show understanding and prompt further discussion

Question 32

Summarizing

Answer 32

Recap what has been discussed to ensure clarity and reinforce what the client has said

Question 33

What are some applications of Motivational Interviewing?

Answer 33

Healthcare = MI is used to encourage patients to adopt healthier behaviours, such as quitting smoking, adhering to medication regimens, or losing weight.
Addiction treatment = it helps individuals explore their ambivalence about substance use and support their journey toward recovery.
Mental Health = MI techniques can assist in managing conditions like depression and anxiety by promoting positive behaviour changes.
Social services = it aids in addressing issues like domestic violence, homelessness, and criminal behaviour by fostering clients’ motivation to improve their circumstances

Question 34

What are some important things to consider with MI?

Answer 34

Listen and ask questions.
Do not ask more than 3 consecutive questions.
Avoid wordiness.
Avoid interrupting
Cooperate, do not force knowledge.
Use patient as consultant.
Be open, be direct.

Question 35

What are the rulers of motivational interviewing?

Answer 35

Conviction = perceiving the benefits of behaviour change.
Confidence = feeling capable of changing behaviour.

Question 36

How can we measure the rulers?

Answer 36

Measuring confidence and conviction can be done on a 10 point Likert Scale.
-0-3/10 LOW = patient receives no benefit or advantage; doubt works such as maybe or possibly.
-4-6/10 MODERATE = aware of the theoretical advantages of change
-7-10/10 HIGH = likely to make the change

Question 37

What is the rulers game plan?

Answer 37

Skeptical = increase conviction to 4-6/10 by improving perception of cognitive advantages then improve personal advantages to increase conviction to 7/10.
Frustrated = increase cofnidence by detecting obstacles and creating solutions.
Cynical = increase conviction so the patient feels motivated to change, then tackle barriers.
Pass to action = set the action plan.