Motivational Strategies Flashcards
What is Motivational Interviewing?
A communication method that is a guiding style for evoking intrinsic motivation
Selectively eliciting and reinforcing one’s own desire to change
A spirit with which an interaction is approached
Indications for MI
Change is necessary
Reluctance or ambivalence towards change
Health Belief Model
Perceived threat, benefits, barriers, risk and self efficacy direct behavior
Drawbacks:
Giving information/advice is inadequate
Deemphasizes cultural, contextual, structural forces
Social Cognitive Theory
Reciprocal Determinism
Individuals and the environment interact and change each other
Introduces self-efficacy as a key component driving behavior
Self Determination Theory
Vitality and effective function are innate
Facilitated when 3 basic needs are met - Competence, Autonomy, Relatedness
Demotivating factors - Excessive control (punishment, extrinsic rewards), Non-optimal challenges, Lack of connectedness
Must understand “Why am i doing this?”
Expressed on a continuum of motivation - From impersonal (nonvaluing/incompetence) to Internal (interest/enjoyment)
Transtheoretical Model
The action of change itself is a continuum
Relapsing is normal
PT impact on contemplation or preparation stage mostly
Collaboration
Equal rather than hierarchical relationship
Focus on mutual understanding (You may disagree)
Patient does the heavy lifting
The patient is the expert in their own life
Acceptance
Unconditional positive regard (“Absolute worth”)
Prioritize patient autonomy
Provide continuous affirmation
Compassion
Express accurate empathy
Commitment to patient’s welfare
Prioritize the patient’s needs
Evocation
Ideas are elicited rather than imposed
Draw out the patient’s own: Ideas, Motivations and Strategies
Deemphasize deficits
Guiding Principles (RULE)
R - esist the righting reflex
U - nderstand the patient’s own motivations (Guide them toward verbalizing the why’s and how’s of change)
L - isten with empathy (Active listing, see through their eyes)
E - mpower the patient (Build self efficacy, provide affirmations, set up optimal challenges)
OARS
Open ended questions - Invites deeper conversation and helps therapist build an empathetic understanding
Affirmations - Feedback about strength and improvements, avoid overly-ingratiating or insincere statements
Reflections - Can be used to encourage change talk or develop discrepancies
Summaries - Requires careful listening and is used to reflect what the patient has said
Change Talk
Strategically listen
D: “I want to…”
A: “I know I can..”
R: “I would help…”
N: “I need to…”
C: “I’ve decided to…”
A: “I’m going to…”
T: “I am…”
Selectively respond to statements
Provoke change talk directly
Decisional Balance
Explore status quo behavior and target behavior
Goal is to draw out change talk
Importance/Confidence Ruler
0-10 scale: “How important is it/confident are
you…”
“Why is it a 3 and not a 1?”
“What would it take to get it to 6”
“What might you do to increase your confidence?”
