Part 1 - What Is MI Flashcards
Define: Motivational Interviewing
Motivational interviewing is a collaborative conversation style for strengthening a person’s own motivation and commitment to change.
Where does MI fall on the spectrum of “directing” to “following”?
Middle as a “guiding” style
Sometimes following a client’s lead. Sometimes leading the discussion.
What is the overall goal of a MI conversation?
In particular, MI is about arranging conversations so that people talk themselves into change, based on their own values and interests.
What is the righting reflex?
The righting reflex involves acting based on the belief that you must convince or persuade the person to do the right thing.
How do clients typically respond to the righting reflex?
People tend to feel bad in response to the righting reflex, and causing people to feel bad doesn’t help them to change.
They may shut down, or become defiant in order to preserve their autonomy.
Why is it so easy to slip into the “righting reflex”?
The “righting reflex” stems from the desire to fix what seems wrong with people and to set them promptly on a better course.
What tends to happen when you try to argue for change?
Argue for one side and the ambivalent person is likely to take up and defend the opposite.
And since causing someone to verbalize one side of an issue tends to move the person’s balance of opinion in that direction - the client is actually LESS likely to change when YOU argue for change.
What 2 types of talk are you likely to hear from an ambivalent person?
Change talk (desire/reasons to change)
And
Sustain talk (desire/reasons not to)
Is it odd for clients to have ambivalent thoughts about making changes in their best interest?
Not at all. Ambivalence is normal. People considering change see both reasons to change and reasons not to.
Ex. “Smoking is bad for my health, but helps me relax after a stressful day.”
How might you tell if the interaction will be successful?
If the CLIENT, not the counselor, is the main one voicing the reasons for change.
What are the 4 key elements of the spirit of MI?
PACE
Partnership
Acceptance
Compassion
Evocation
Describe the MI element of partnership.
Partnership is a working collaboration between the client and counselor.
You are working together not against one another.
What is a good metaphor for the Partnership element of MI?
MI is more like dancing and less like wrestling.
You are moving and working with each other, not against each other.
Describe the MI element of acceptance.
Why is it important?
Recognizing that the client is a valuable unique individual, and seeking to understand their perspective, knowing that they have the freedom to choose to change or not.
When a client is treated without that mindset, they feel defensive and are less able to change.
What is the paradox of autonomy?
When you tell someone they can’t do something, they are more likely to.
When you acknowledge their autonomy to choose, they are less defensive and more likely to change.
Describe the MI element of compassion.
Why is it important?
To actively promote the other’s welfare, to give priority to the other’s needs.
Our services are, after all, for our clients’ benefit and not primarily for our own.
Describe the MI element of evocation.
Why is it important?
Ambivalent clients already have pro-change voices on their internal committee, with their own positive motivations for change.
Your task, then, is to evoke and strengthen these change motivations that are already present.
These are likely to be more persuasive than whatever arguments you might be able to provide.
What were the 2 original phases of MI?
1) Build motivation
2) Consolidate commitment
What are the 4 phases of MI?
1) Engage
2) Focus
3) Evoke
4) Plan
Define the “engage” process.
We define engaging as: the process of establishing a mutually trusting and respectful helping relationship
Define the “focus” process.
Focusing is the process by which you develop and maintain a specific direction in the conversation about change.
Agreeing on an agenda
Define the “evoke” process
Evoking involves eliciting the client’s own motivations for change, and it has always been at the heart of MI.
Most simply put, evoking is having the person voice the arguments FOR change.
Define the “planning” process. (MI)
Planning encompasses both developing commitment to change and formulating a specific plan of action.
What are the 5 key communication skills of MI?
1) Open questions
2) Affirming
3) Reflecting
4) Summarizing
5) Giving information/advice with permission
The 5 underlying principles of MI (Miller Video):
1) Empathic listening (listen to understand THEIR perspective)
2) Developing discrepancy
3) Avoiding argument
4) Roll with resistance
5) Support self-efficacy (give them hope)
