engaging

Question 1

engaging

Answer 1

process of establishing a mutually trusting and respectful helping relationship

relational foundation of MI

should always be engaging even after the engagement process is over

Question 2

Goal #1 of engaging

Answer 2

create a working alliance

Question 3

Goal #2 of engaging

Answer 3

have the client return
* people who are actively engaged are more likely to return and benefit from treatment regardless of the orientation of the provider

Question 4

sustain talk

Answer 4

when someone is supporting the status quo

doesn’t want to change

the more someone hears change talk, the more likely they are to get on board with it

same is true about sustain talk

Question 5

traps (7)

Answer 5

assessment trap
expert trap
premature focus trap
confrontation-denial trap
labelling trap
blaming trap
chat trap

Question 6

assessment trap / Question-answer trap
* how to avoid?

Answer 6

counsellor controls session by asking questions, while the client only responds

effects: teaches client to be passive

avoid by: using a pre-counselling questionnaire to gather information or save questions until after engagement
– use open questions
– no more than 3 questions in a row

Question 7

expert trap
* how to avoid?

Answer 7

when there is an uneven position between the client and counsellor and the counsellor is expected to provide all the answers

effects: teaches client to be passive
– builds expectations for a counsellor =-prescribed solution

avoid by: exchanging information in an empathetic, collaborative fashion
– better to ask them what they already know and how they think about it compared to just providing info

Question 8

premature focus trap

Answer 8

assuming you know what the client wants to discuss and focusing before engaging
** getting wrong focus could cause discord

effects: can create a power struggle for the discussion topic
– can create discord

avoid by: starting broad and by focusing on the person’s concerns (rather than your own)

Question 9

confrontation-denial trap

Answer 9

arguing for change, leaving the client in the opposite role

effects: can increase sustain talk and create discord

avoid by: offering empathy for the client’s situation

Question 10

labelling trap

Answer 10

the client is given a “diagnosis” that may stigmatize

effects: may provoke denial and hinder progress
– power struggle for control

avoid by: using reflections and reframing
– deemphasizing the label

Question 11

blaming trap

Answer 11

client feels blamed by others and themselves

effect: may create defensiveness

avoid by: reflecting and reframing the person’s concerns
– render blame irrelevant

Question 12

chat trap

Answer 12

off-topic chatting that has insufficient direction (small talk)

effects: hinders progress

avoid by: using relevant open questions
– devoting attention to client’s concerns

Question 13

process of communication

Answer 13

encoding: the speaker is trying to put into words what’s in their head
– can go wrong if someone doesn’t say what they meant

hearing: maybe you hear something not in the way that they meant it

decoding: determine and interpret what you think they meant

** lots of places where the communication process can break down
** reflective listening gets us out of this problem

Question 14

nonverbal listening

Answer 14

undivided attention
** nodding, eye contact, tone, sitting at same level, mirror their emotions (but not when angry)

– physical distance/seating
– open body language

Question 15

roadblocks to communication

Answer 15

traps are more about the counsellors interaction and roadblocks are more about responses to what the client is saying

ordering
warning
advising
persuading
criticizing
praising
shaming
analyzing
reassuring
questioning
withdrawing

Question 16

reflective listening

Answer 16

statements of understanding that are used to check for meaning (rather than relying on assumptions)

requires thinking reflectively

• requires inflection that turns down at the end

is directive

simple - repeats clients own words
more sophisticated - new words, unspoken feelings

Question 17

reflections

Answer 17

making statements not questions

words may be similar but the delivery and effect are different

creates momentum in the conversation

Question 18

MI microskills: oars

Answer 18

open questions

affirmations

reflecting

summarizing

Question 19

ask open questions

Answer 19

goal: to give client the opportunity to express themselves

their answer allows you to follow the clients lead

Question 20

affirming

Answer 20

providing client with statements of support, appreciation, respect

must be appropriate and sincere - will backfire if it’s fake

can use reframing to recast a weakness as a strength

Question 21

affirmations

Answer 21

communicate a value of the person

statement of thanks and appreciation

mirror of the client’s personal qualities and strengths

anchor to support self-efficacy

Question 22

praise

Answer 22

may be perceived by the client as “judging” their behaviour

assumes that people need to be told what is right and wrong

may seem patronizing

may suggest that the relationship is tentative, based on the counsellor’s approval

Question 23

summarizing

Answer 23

a special form of reflective listening that is used to recap session content and allow client to hear their own words for a 3rd time

be careful using “but”
– cancels out what has been said before

Question 24

3 types of summarizing

Answer 24

collecting: recalling series of interrelated items as they accumulate

linking: use to contrast or tie together what the person has said - use “and” not “but”

transitional: use to wrap-up or move from one phase of change to another

Question 25

exploring goals and values

Answer 25

asking the client what matters most to them can be a good way to continue building in the engaging phase

also useful in focusing and evoking

exploring and discussing the discrepancy between important goals and values and the client’s current behaviour