Motivational Interviewing Flashcards
What is motivational interviewing
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
Why is motivational interviewing the most helpful?
client must come to the conclusion of change on their own for it to be most effective. They stand in their own way
When is motivational interviewing most helpful? (3)
-motivation is low
-treatment engagement is a challenge
-there is difficulty in making changes
define ambivalence
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…
Explain the client centred approach
-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
3 steps of motivational interviewing
1.exploring
2.guiding
3.choosing
Describe and give examples of exploring in motivational interviewing
-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?…
5 reflection tactics
- content reflections
2.reflection on feeling - amplified negative reflections
4.double sided reflections - action reflections
explain reflection tactic (content reflections)
paraphrasing what the client has told you “If I have this right…”
explain reflection tactic (reflection on feeling)
Demonstrate empathy and encourage the client to disclose other feelings
“I sense that…”
Explain reflection tactic (amplified negative reflections)
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?”
Explain reflection tactic (double sided reflection)
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?”
Explain reflection tactic (action reflection)
-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?”
Explain change talk
verbal signals of progress towards making commitment
“I want…“(desire)
“I need…“(Reasons
“I think…“(ability)
“I am going to start…“(commitment)
How do you assess self-efficacy and 3 questions to ask the client
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?
speculate and be solution focused- what questions will you ask? and when will you ask them?
-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
How to plan the next steps (end of the conversation)
“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
what is the ‘righting reflex’?
temptation to set the client straight
define empathy
being able to imagine yourself in others situations/shoes without pitty or judgement
3 stratagies for handling resitance/ resistant clients
- use the 5 reflection tactics
- shifting focus (away from what seems to be stumbling blocks)
- emphasizing personal choice and control
Describe the OARS+I approach
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
MI practical checklist (5)
- the client is doing most of the talking
- majority of the questions are open ended
- at least one reflective statement to follow up on each answer to open ended questions
- coach asks permission before giving advice
- conversation flows and feels like a dance
sources of self efficacy (4)
- mastery experiences
- vicarious experiences
- social persuasion
- emotional/physiological states
