Motivational Interviewing

Question 1

What is motivational interviewing

Answer 1

way of working with individuals to assist them in accessing their motivation and confidence to change (client centred approach). Designed to facilitate autonomy and intrinsic motivation

Question 2

Why is motivational interviewing the most helpful?

Answer 2

client must come to the conclusion of change on their own for it to be most effective. They stand in their own way

Question 3

When is motivational interviewing most helpful? (3)

Answer 3

-motivation is low
-treatment engagement is a challenge
-there is difficulty in making changes

Question 4

define ambivalence

Answer 4

when we have positive & negative feelings towards a behaviour
ex. I’m stuck or I know, but…I don’t do or I want to, but…

Question 5

Explain the client centred approach

Answer 5

-make decisions that are based on what works best for the client, not based on what should work for them
-guide them to find their reason to change or not change
-put the client first

Question 6

3 steps of motivational interviewing

Answer 6

1.exploring
2.guiding
3.choosing

Question 7

Describe and give examples of exploring in motivational interviewing

Answer 7

-ask open ended questions
ex:
-what brings you here today?
-in what ways does…concern you?
-what would you like to see change?
-if things were better with your..(eating).. what would change?
-what have you already tried?what worked? what didn’t work?
-why?…

Question 8

5 reflection tactics

Answer 8

1. content reflections
   2.reflection on feeling
2. amplified negative reflections
   4.double sided reflections
3. action reflections

Question 9

explain reflection tactic (content reflections)

Answer 9

paraphrasing what the client has told you “If I have this right…”

Question 10

explain reflection tactic (reflection on feeling)

Answer 10

Demonstrate empathy and encourage the client to disclose other feelings
“I sense that…”

Question 11

Explain reflection tactic (amplified negative reflections)

Answer 11

exaggerate the clients perspective. Addresses resistance from the client stuck on yes, but…
“So, you see no benefit in getting more physically active?” “being sedentary is all positive to you?” “So you take medication so you can continue to smoke?”

Question 12

Explain reflection tactic (double sided reflection)

Answer 12

Acknowledge you heard the clients reasons for and against change-another form of paraphrasing
“on one hand you would like to become more physically active, but uou don’t want to give up time with your family to go to the gym?”

Question 13

Explain reflection tactic (action reflection)

Answer 13

-only for people taking action
-proposing possible solutions to the clients challenges
“sounds like you need to find ways to be more active WITH family…”
“would you consider biking to work or walking during your lunch hour?”

Question 14

Explain change talk

Answer 14

verbal signals of progress towards making commitment
“I want…“(desire)
“I need…“(Reasons
“I think…“(ability)
“I am going to start…“(commitment)

Question 15

How do you assess self-efficacy and 3 questions to ask the client

Answer 15

readiness ruler:
1. how confident are you in making this change today on a scale of 1-10
2. how important is this change to you on a scale of 1-10
3. why do you choose an 8/10 instead of a 2/20?

Question 16

speculate and be solution focused- what questions will you ask? and when will you ask them?

Answer 16

-I wonder what it would be like if you…
-I wonder if we could try…
-In the past when were you successful with this even just a little?
-How could we do more of that?

Ask these after listening to the client, after open ended questions and reflection

Question 17

How to plan the next steps (end of the conversation)

Answer 17

“so given all this what do you think you will do next?”
“Whats next for you?”

End the session by summerizing and planning the next steps

Question 18

what is the ‘righting reflex’?

Answer 18

temptation to set the client straight

Question 19

define empathy

Answer 19

being able to imagine yourself in others situations/shoes without pitty or judgement

Question 20

3 stratagies for handling resitance/ resistant clients

Answer 20

1. use the 5 reflection tactics
2. shifting focus (away from what seems to be stumbling blocks)
3. emphasizing personal choice and control

Question 21

Describe the OARS+I approach

Answer 21

O: Open ended questions “what..”, “how..” , “Tell me more about..”
A: affirmations- encourage and acknowledge clients success
R: reflections- restate what you heard the client say “It sounds like…because..”
S: summarizing- summerize the conversation “We talked about how…”
I: Information giving- only when the client is open to recieveing your advice

Question 21

MI practical checklist (5)

Answer 21

1. the client is doing most of the talking
2. majority of the questions are open ended
3. at least one reflective statement to follow up on each answer to open ended questions
4. coach asks permission before giving advice
5. conversation flows and feels like a dance

Question 22

sources of self efficacy (4)

Answer 22

1. mastery experiences
2. vicarious experiences
3. social persuasion
4. emotional/physiological states