Motivational Interviewing Annual Quiz

What is Motivational Interviewing?

It’s a directive, person centered counseling style that aims to help people explore and resolve their ambivalence about behavior change.  Ambivalence is the state of having mixed feelings or contradictory ideas about something or someone. It’s more a counseling style rather than a set of techniques and is not a method for tricking people in to doing things they don’t want to do. It’s also a way of interacting with people to assess their readiness to change and to help them move through different stages of change. It is the role of the person served to be able to state and resolve his or her own ambivalence to change. And, it’s a way to draw out from the person their own motivations for change by connecting it with something of intrinsic value (important to the person).

1. Motivational Interviewing is a ___________, DSP-directed method for enhancing _________ motivation to change by exploring and resolving ambivalence.

2. True or False: Motivational Interviewing is a method to trick a person into doing something they don’t want to do?

Stages of Change – Change Model

There are five stages of change: Pre-Contemplation, Contemplation, Preparation, Action, and Maintenance.

Pre-Contemplation:

*Not thinking of making a change.

*The person feels that things are fine.

*They do not see a problem.

Contemplation:

*Thinking about making a change.

*Wondering how I affect others.

*Maybe trying to make small changes.

Preparation:

*The person has a plan to change.

*May have ‘cut down’ or ‘doing less’.

*Can see the benefits of stopping the behavior.

Action:

-Have quit the behavior.

-The person is avoiding triggers.

-Asking other for support.

Maintenance:

-No use of the behavior in a long time.

-Accepting myself.

-Helping others who are still using or displaying the behavior (mentor, etc.).

4. I don’t need to change; I don’t think I really have a problem « is an example of Pre-Contemplation? True or False?

5. Look, I know it’s killing me. I want to stop drinking. I don’t think I can do it on my own, but if you can get me into detox or maybe inpatient stay, I think I could probably give it a try” is an example of Preparation? True or False?

6. “So, I poured out all my beers last week and I haven’t drank for like 3-4 days and I’m really ready to stop and I just want to get some support” is an example of Action? True or False?

Three Components of MI Spirit – ACE

A=Autonomy: Decision-making is left to the person.

C=Collaboration: Working in a partnership.

E=Evocation: Draw out ideas and solutions from the person.

The Spirit of MI

*Motivation to change is drawing out from the person, not from other people.

*It is the person’s task, not DSP’s, to communicate and resolve ambivalence.

*Telling someone what they need to do is not an effective method for resolving ambivalence.

*The DSP’s role is generally to be quiet and listen.

*The DSP’s role is only to help the person to examine and resolve ambivalence.

*Readiness to change is an ever changing struggle. A person may be ready one day and not the next.

*The therapeutic relationship is more like a partnership or collaboration than expert/recipient role (Think of it as a two-way conversation).

7.  It is the _____ task to communicate and resolve ambivalence. 

8.  The best way to view the therapeutic relationship is:

Principles of MI – REDS

R=Roll with Resistance.

E=Express Empathy.

D=Develop Discrepancy.

S=Support Self-Efficacy.

*Roll with Resistance:

Avoid arguing for change.

-Avoid power struggles.

-Resistance often stems from fear of change.

*Express Empathy:

-Acceptance helps change occur.

-Active listening is fundamental.

-Reflect at least 2 times for every question asked.

-Ambivalence is normal!

*Develop Discrepancy:

-The difference between the person’s core values and life goals and their behavior.

-Difference between where the person is now and where he/she would like to be in the future.

-Find out the person’s goal and values. Evaluate person’s served current state with regards to those goals and values. Emphasize the discrepancy between them.

-No discrepancy = no ambivalence.

-Ambivalence makes change possible.

*Support Self Efficacy:

-The person’s belief in possibility of change is an important motivator –SELF DETERMINATION.

-The person served, NOT DSP is responsible for choosing and carrying out change.

-The DSP’s own belief in the person’s ability to change becomes a self-fulfilling prophecy.

10. True or False: To help express empathy it’s important to reflect at least 2 times for each question asked?

11. True or False: It is the DSP’s responsibility to choose and carry out any type of change?

12. True or False: It is important to emphasize discrepancies to create ambivalence?

MI Skills – OARS

O=Open-Ended Questions.
A=Affirm/Support.
R=Reflective Listening.
S=Summarize.
*Open-Ended Questions:

-Open-ended questions are questions that result in more than yes/no responses and elicit very specific pieces of information. Often these questions begin with the following: “What,” “How,” or lead off with the request, “Tell me…” or “Describe…” You use open-ended questions to encourage an open conversation about the person’s view of his/her commitment to change. In brief, by using open-ended questions, you give the person a wide range for discussing a topic of importance to him/her.  They also show an interest in the person and provide both an expectation and an opportunity for a person to self-disclose.

*Affirm:

-This skill focuses on your expressions of confidence in the person’s ability to achieve his/her goals. You may affirm a person in a variety of ways: a) using compliments or praise, b) acknowledging the person’s abilities that might promote change, and c) recognizing effort or small steps taken by the person to change. By complimenting, positively reinforcing, and validating the person, you foster the belief in the person that there is hope for positive change and it builds rapport.  Can also be expressed with active listening such as nodding your head or making eye contact with the person.

*Reflective Listening:

-Reflective statements restate a person’s comments using language that accurately clarifies and captures the meaning of the person’s communications and conveys to the person your effort to understand the person’s point of view. You use this technique to encourage a person to explore or elaborate on a topic. These techniques include repeating exactly what the person just stated, rephrasing (slight rewording), or paraphrasing (e.g., amplifying thoughts or feelings, using analogy, making inferences).

-Listening reflectively is about being quiet and actively listening to the person, and then responding with a statement that reflects the essence of what the person said, or what you think the person meant.

*Summarize - Summaries serve several purposes:

-Communicate that you have tracked what the person said and that you have an understanding of the big picture.

- Help structure a session so that neither the person nor the DSP gets too far away from important issues and can help you link what a person just said to something he/she offered earlier.

- Provide an opportunity to emphasize certain elements of what the person has said. For example, providing summaries of the positive statements a client has made about change (change talk) gives the person another opportunity to hear what she or he has said in the context provided by DSP.

Summaries represent change talk statements (statements that people make that are in the direction of change) linked together by DSP reflection. After several minutes of using OARS, a summary could serve as a check to see if you are “getting” what the person is trying to relay.

13.  Which of the following questions are open-ended:

14.  Which of the following is an affirmation:

15.  Listening reflectively is about being ____ and actively listening to the person, and then responding with a statement that _____ the essence of what the person said, or what you think the person meant.