MOTIVATIONAL INTERVIEWING

Question 1

What is MI effective for treating?

Answer 1

SUD

Question 2

what is the assumption of MI relating to motivation?

Answer 2

developing and strengthening motivation -> increase their engagement in treatment -> increase symptom improvement

Question 3

What atmosphere do therapists have to create (3; CAC)?

Answer 3

• collaboration
• acceptance
• compassion
  which allows internal motivation to change to be elicited.

Question 4

What two underlying components are fundamental to MI?

Answer 4

Technical (interventions) and Relational (therapeutic alliance)

Question 5

Relational - what does OARS stand for?

Answer 5

OARS (open questions, affirmations, reflections and summary statements)

Question 6

why is OARS so important?

Answer 6

• increase change talk
• reduce sustain talk
• resolve ambivalence

Question 7

4 pillars of a MI therapist are

Answer 7

compassion, collaboration, acceptance, evocation

Question 8

What four major processes are used to guide the discussion?

Answer 8

engaging, focusing, evoking, planning

Question 9

What is engaging?

Answer 9

Connecting with the patient and establishing a therapeutic
alliance.
Therapists are also able to determine how motivated their clients are by the degree of ‘change’ and ‘sustain’ talk.

Question 10

What is focusing?

Answer 10

The therapist narrow’s the discussion so that a collaborative
decision is made about the target of motivational enhancement.

Question 11

What is Evoking?

Answer 11

Eliciting the patient’s own motivations and commitments for
change.

Question 12

What is Planning?

Answer 12

The therapist works with the client on creating a plan to
achieve the change.

Question 13

What are the types of signs of readiness that indicate an appropriate time to transition from evolving to planning?

Answer 13

• decreased discord and sustain talk
• decreased discussion about the problem
• resolve
• increased change talk
• questions about chance
• envisioning and experimenting

Question 14

What is important when engaging? (things to avoid and ask)

Answer 14

avoid traps, ask open-ended questions, reflective listening, affirmations, summary statements

Question 15

what are some traps during the engagement process

Answer 15

o Ax – asking too many questions that may lead the pt to become passive
o Expert – communicating that the T is the expert and has the answers/solutions -> ct becomes passive or defensive
o Premature focus – trying to solve the problem before a strong TA has been established; focusing on an issue before a pt is ready -> power struggle and discord
o Labelling – emphasising dx or other label might come across as stigmatising and judgemental -> creating discord
o Blaming – placing fault on pt -> defensiveness
o Chat – engaging in small-talk -> insufficient direction and dissatisfaction

Question 16

what are the types of reflective listening?

Answer 16

o Verbalising potential for change
o Simple reflection
o Complex reflection (paraphrasing) –

Question 17

what are affirmations?

Answer 17

• type of reflection that serves to highlight pts positive qualities important to the change process – not just recognition or praise
• Recognising effort, appreciate ct’s strengths, and using positive reframes
• Help create an atmosphere where pt believes they can change, creating hope/optimism

Question 18

what are summary statements?

Answer 18

o Type of reflection
o Brings together what pt has said at different points
o Let me summarise what you have said so far…

Question 19

What does focusing involve?

Answer 19

• Multiple areas of concern
• Tackling all areas -> overwhelm and hopelessness
• Focusing involves the process of establishing the direction for the session by prioritising behaviour change targets

Agenda mapping

Question 20

What is agenda mapping?

Answer 20

• Agenda mapping -> collaboratively lay out all the various topics that need exploring
  o Make issues clearer and more manageable
• When agenda mapping is done -> where would you like to start?
• Where the pt is unable, the T can assist (collaboratively)

Question 21

Recognising change-talk - DARN-CAT

Answer 21

• DARN-CAT uses to identify different types of change talk.
• DARN (desire, ability, reasons, and need) – described as preparatory language because it represents the arguments pts make that prepare them to change.

Question 22

Mobilising change talk

Answer 22

• Mobilising change talk is denoted by CAT (commitment, activation, and taking steps) – pt talking about ways in which they are mobilising their motivations to foster change
  o Commitment statements -> I will stop drinking – communicate a decision to make a change
  o Activation statements -> I am ready to do the necessary work to improve my life -> signal pts are almost at the point of action and are identifying steps as part of a plan for change
  o Statements signifying taking steps -> I am no longer hanging out w my drinking buddies -> indicate what the pt is doing to initiate change.

Question 23

What is the immobilised stage?

Answer 23

DARN

Question 24

(9) What are the strategies used to elicit reasons to change?

Answer 24

o Recognising change talk
o Using evocative questions
o Reflection
o Employing an importance/confidence ruler
o Using decisional balance approach
o Exchanging information
o Exploring goals and values
o Looking back and looking forward
o Querying extremes

Question 25

Elements of a plan where a particular behaviour change is initiated (6)

Answer 25

1. Clear identification of the targeted behaviour change
2. Specific steps that need to take place
3. Who else can support the pt in making and sustaining the change
4. How the pt will now their plan is working
5. What can get in the way of the pt’s plan and how to address it
6. What the pt will do if the plan doesn’t work