Motivational Interviewing

Question 1

Change model

Answer 1

Precontemplation-does not see the need for change; contemplation-aware of problem, ambivalent about course of action; preparation-consequences of behavior are too great, change is necessary, small steps toward specific changes but still overall poor health behaviors; action-specific plan for change and begins to pursue it; maintenance-continues to engage in behaviors that support his or her decision (for example assess warning signs and reminder to seek help); back and forth between stages, non-linear progress, trials and errors

Question 2

Motivational interviewing

Answer 2

Facilitate intrinsic motivation within the client in order to change behavior, assess stage of change and use techniques likely to move a person forward, help clients to explore and resolve ambivalence; goal oriented, client centered counseling, nonjudgmental, non confrontational, non-adversarial; more focused and more directive than traditional Rogerian client centered therapy

Question 3

Strategies and techniques

Answer 3

Asking permission to discuss behaviors, issues, changing-communicates respect for clients; Eliciting/evoking change talk-asking clients to give voice to the need or reasons for changing, tends to be associated with successful outcomes; Exploring importance and confidence-how clients view the importance of changing and the importance of their goals and the extent to which they feel change is possible; Open ended questions-allow for richer, deeper conversation, allow clients to tell their stories; Reflective listening-primary way of responding to clients and building empathy; Normalizing-communicate to clients that having difficulties while changing is not uncommon; Decisional balancing-asking clients to evaluate their current behaviors by looking at the good and less good things about their actions, help clients understand their ambivalence about changing; Columbo approach-have the client help the therapist to make sense of the clients discrepant or contradictory information via a curious inquiry; Statements supporting self efficacy-build self-confidence to change by asking clients to notice and explain changes they have made; Readiness to change ruler-used to assess a client’s readiness to change; Affirmations-genuine statements to recognize clients strengths, successes, and efforts to change; Advice/feedback-often clients have either a little information or have misinformation about their behaviors, provide accurate information after getting permission from client that they want more information; Summaries-link different things clients have said, good way to end the session, or to transition to the next topic; Therapeutic paradox-used later in treatment when clients are not making changes, unexpected contradictions that are used in an effort to get clients to argue for the importance of changing;