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Manipulation own > Motivational Interview > Flashcards

Motivational Interview Flashcards

1
Q

3 central MI concepts

A
  1. Readiness
  2. Ambivalence
  3. Resistance
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2
Q

Readiness and its role in MI

A
  1. How ready is a person for a change
    - on what stage of change is a person
  2. Impacts the action that follows the MI-Intervention
    - Counselor must be sure about the stage of the client
    - influences which methods are used
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3
Q

Readiness measurements in MI

A

6 Stages of change
1. Pre-contemplation
2. contemplation
3. Preparation
4. Action
5. Maintenance
6. Relapse

Readiness Ruler

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4
Q

Readiness importance in MI

A
  • Readiness is in the client
  • The methods must be related to the level of readiness
  • Wrong assumed readiness by counselor can create resistance
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5
Q

Ambivalence

A
  • Feeling different ways about one’s own behavior
  • often contains discomfort
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6
Q

Ambivalence importance in MI

A
  1. Counselor helps the client discover ambivalence
  2. Main driver for the behavior change when discovered
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7
Q

Resistance in MI

A
  • Often the result of counselors’ behavior or previous experience of the client
    A client can be:
    1. reluctant to change
    2. suspicious of the counselor’s intentions and prejudice
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8
Q

Forms how a client shows resistance in a Motivational Interview

A
  1. Arguing
    - against expertise, the accuracy of the counselor
  2. Interrupting
    - the counselor in a defensive manner
  3. Denying
    - the own problems, responsibility, and cooperation
  4. Ignoring
    - the counselor advises
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9
Q

principles of MI

A
  1. Express empathy (EE)
  2. roll with resistance (RR)
  3. develop discrepancies (DD)
  4. support self-efficacy (SS)
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10
Q

Express Empathy

A

The first phase of building a trust
Techniques:
1. Reflective listening (rephrase to show understanding and interest)

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11
Q

How to Roll with resistance

A
  1. Avoid confrontations
  2. shift attention
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12
Q

Develop discrepancies

A
  1. Let the client set goals
  2. Ask the client about the perceived consequences of their own current behavior
  3. Cost and Benefits of change and no change
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13
Q

Support self-efficacy

A
  1. Support the confidence of the client in their own abilities to change
  2. Self-affirmation can be used to rise confidence
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14
Q

OARS

A

To advance in the stages of change
1. Open ended question
- elicits change talk in the client
2. Affirmation
- reduce resistance against topic
3. reflective listening
- build trust and reduce resistance against counselor
- highlighting ambivalence
4. Summarising
- strengthen autonomy, highlights clients change talk

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15
Q

Normalizing

A
  • difficulties with changing are not uncommon
  • lowers pressure to change
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16
Q

Levels of reflection

A
  1. Simple = repeating
  2. Complex = rephrasing
    • Affective - emphasised the emotional dimension
    • Values - emphasized beliefs & principles
    • Continuing the the clients argumentation
17
Q

Advice Giving

A

Only with permission
On goals or informations
Can also be hidden in reflective listening and summarizing

18
Q

Change Talk

A

Is about eliciting change talk by the client
The client makes statements like
- disadvantage of staying the same
- the advantages of change
- optimism about change
- the intention to change

19
Q

How to elicit change talk in the client

A
  1. asking evocative questions
    • disadvantage of status quo
    • advantage of change
    • optimism
    • change intention
  2. Using the “importance ruler”
  3. Exploring the decisional balance (4-field matrix)
    • consequences of changing and not changing
  4. Querying extremes
    • what would be the worst outcome if you continue
  5. Looking back
    • have there been successes in the past?
  6. Looking forward
    • where do you want to be?
20
Q

Limitations of MI

A
  1. Most useful for clients with low motivation
  2. Should not be used as a method alone
21
Q

Self-Determination Theory in MI

A
  1. Integrating SDT to differentiate between motivation types and their impact on behavior change
22
Q

SDT Autonomy and MI

A

The change in the hand has to come from the client
Own goals, own way, own answers to open questions
Develop discrepancies (let the client develop them)
Roll with resistance

23
Q

SDT Relatedness and MI

A

Counselor & client relationship
Express Empathy without blaming

24
Q

SDT Competence and MI

A

Support self-efficacy
giving professional feedback if client agrees

25
Q

Stage 1: Pre-contemplation

A
  1. are unaware of any problem related to their behavior
  2. are unconcerned about their behavior or even enjoy it
  3. unconcerned about consequences
    help could provide:
    - reducing resistance
    - help recognize, motivate
26
Q

Stage 2: Contemplation

A
  1. are sometimes worried about the difficulties the behavior is causing
  2. debating with themselves whether to not they have a problem
  3. consider changing
    help could provide:
    - reducing resistance
    - support the thoughts
27
Q

Stage 3: Determination/Preparation

A
  1. getting ready to make a change
    help could provide:
    - support self-efficacy, feedback on clients ideas on how to change
28
Q

Stage 4: Action

A
  1. changing process
    help could provide:
    - goal setting, support self-efficacy (competence), feedback on process
29
Q

Step 5: Maintenance

A
  1. change is made and maintained
    help could provide:
    - building resistance against temptations
30
Q

Relapse in the stages of change

A
  1. normalized process
  2. client learns from trying and relapsing
  3. the client usually does not go back to pre-contemplation
31
Q

What to avoid in MI

A

Question-answer trap
Confrontation-denial trap
Expert trap
Labeling trap
Premature focus trap
Blaming trap
Lack of time trap

32
Q

Traditional Approach in relation MI

A

Giving the client a solution that does not fit the client
Trying change by increasing bad feelings

33
Q

What can change the impact of MI (Behavior change methods) from person to person?

A
  1. Difficulty to build a Counselor-client relationship
    - same age vs. different age, cultural differences, sometimes better when the counselor is not a clinical expert
  2. social influences (social environment) either supportive or not
    - connected to role models, social determinants
  3. Experience of Counselors
  4. Anticipations of the person
    - e.g. self-efficacy = overestimation of MI as behavior change
    - Intervention effect = something was done so it has to have an effect
  5. Goal
    - what MI is supposed to affect is too strict and leaves no room for own goals
34
Q

What methods can be used to support MI?

A
  1. CBT and group therapy for maintaining the motivation and changing the behavior long term

Manipulation own (6 decks)

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