Motivational interviewing

Question 1

What is motivational interviewing?

Answer 1

• Motivational Interviewing (MI) is a way of working with clients to assist them in accessing their motivation and confidence to change behaviour.
• MI is founded on the premise that lasting change is more likely when clients discover their own reasons to change.

Question 2

What are the 4 elements that capture the spirit of MI?

Answer 2

1. Partnership.
2. acceptance.
3. compassion.
4. evocation.

Question 3

What is partnership?

Answer 3

Do you recognize that your client knows themselves the best? Does the time that you spend together with your client reflect the client’s agenda or your own agenda? Is it a team effort?

Question 4

What is Acceptance?

Answer 4

Do you as the qualified exercise professional see that the client has worth? Do you express empathy? Do you affirm the client’s own strengths? Do you support the client in choosing what is best for themselves even if you know better?

Question 5

What is compassion?

Answer 5

Do you put the needs and wellbeing of your client first?

Question 6

What is evocation?

Answer 6

Do you focus on what your client is missing or lacking or do you align with the “MI perspective?; that there is a deep well of wisdom and experience within your client from which you can draw. Much of what is needed is already there, and it’s a matter of drawing it out, calling it forth”

Question 7

What are the key features of helping others with MI?

Answer 7

• Discover their own interest in considering and/or making a change in their life (e.g., diet, exercise).
• Express in their own words their desire for change (i.e., change-talk).
• Examine their ambivalence about change as a means to elicit and strengthen their change talk.
• Enhance their confidence in taking action and noticing that even small, incremental changes are important.
• Strengthen their commitment to change.
• Plan for and begin the process of change.

Question 8

Why do we use open-ended questions with MI?

Answer 8

to help a client find the power to change from within, the interviewer must draw out the client’s story, motivation for change, and prior history in attempting the change. A useful approach is expressing curiosity about the client’s experience and views using open-ended questions that cannot simply be answered with ‘yes’ or ‘no’.

Question 9

Why do we use active-listening techniques with MI?

Answer 9

• Active listening is essential to developing the insight required to facilitate clients’ exploration of motivation and options for change. The tools of active listening (i.e., affirmations, paraphrasing, summarizing, and reflection on meaning and feelings) can be used to accurately demonstrate an understanding of the information the client has shared.
• build a good rapport with the client.

Question 10

What were the recent changes made in MI to address a challenge in determining when and how to transition from building motivation and commitment to planning a course of action?

Answer 10

1. Exploring (i.e., drawing out the client’s story, building rapport, obtaining a behavioral history, and identifying what behaviors are to be discussed),
2. Guiding (i.e., steering the conversation toward the possibility of change by asking the client to consider life with and without change to help the client see the discrepancy between current actions and broader life goals and values), and
3. Choosing (i.e., once a commitment to making a change occurs, the conversation moves to a more pragmatic discussion of HOW to put the desired change into action) (Resnicow et al., 2012).

Question 11

What is brief action planning?

Answer 11

another tool available to help the qualified exercise professional is Brief Action Planning (BAP). Gutnick and colleagues (2014) define BAP as “a highly structured, stepped-care, self-management support technique… Composed of a series of 3 questions and 5 skills…”.

Question 12

What are the 6 components of Brief Action Planning?

Answer 12

1. delivery.
2. time.
3. use.
4. How was BAP developed?
5. Evidence supporting BAP?
6. How do you do BAP?

Question 13

What is the delivery feature?

Answer 13

Clinicians or other allied health professionals such as qualified exercise professionals can be trained to use and deliver BAP.

Question 14

What is the time feature?

Answer 14

BAP with a trained professional may take as little as 5 minutes, but it is also easily accomplished within a 20-30 minute consultation session.

Question 15

What is the use feature?

Answer 15

BAP is flexible in terms of when it can be used with clients. BAP may be used during an initial visit and/or during follow-up visits. BAP may be used once or more than once with a client.

Question 16

How was BAP developed?

Answer 16

BAP is based upon literature identifying the need to support the development of client self-efficacy as well as the creation of appropriate action plans. Further, BAP is also derived from MI, with a particular emphasis on the “spirit of MI”.

Question 17

Evidence supporting BAP?

Answer 17

BAP has been recently used in several studies to promote physical activity among individuals with osteoarthritis (Li et al., 2017), spinal cord injury (Gainforth et al., 2014). BAP has also been used in a primary care intervention focused on preventing chronic disease (e.g., Sopcak et al., 2016; 2017) which is also being examined in a public health setting (Paszat et al., 2017).

Question 18

How do you do BAP?

Answer 18

Gutnick et al.’s (2014) paper is a starting point for any qualified exercise professional looking to better understand BAP. Training opportunities, as well as freely available online resources, are available from the Centre for Collaboration, Motivation, and Innovation: https://centrecmi.ca

Question 19

What do The Brief Action Planning Flowchart and the Brief Action Planning Guide show?

Answer 19

It shows practitioners the key questions and skills associated with BAP. In keeping with the tenets of MI, client autonomy, and awareness of readiness to change are upheld, client confidence is explored, and any information provided is consistent with MI by way of asking permission.