Week 5

Question 1

What is motivational interviewing?

Answer 1

An effective way of talking with people about change

Question 2

What are some difficult decisions that we face later in life?

Answer 2

• Medical decisions
• Retirement
• Living alone
• Accepting help

Question 3

What is lack of change/when change is hard, it is NOT as a result of…?

Answer 3

• Lack of information
• Laziness
• Oppositional personality
• Denial
• Resistance

Question 4

When change is hard, it is often because of ____

Answer 4

Ambivalence

Question 5

What is ambivalence?

Answer 5

Wanting and not wanting the change or wanting incompatible things at the same time

Question 6

What does ambivalence lead to, because it is uncomfortable?

Answer 6

Anxiety, which then leads to procrastination

Question 7

Procrastination is often mistaken for ___

Answer 7

Resistance

Question 8

How does motivational interviewing help with ambivalence?

Answer 8

• Can help resolve ambivalence and help elicit a person’s own motivation to change

Question 9

What are the underlying concepts of motivational interviewing?

Answer 9

• Partnership
• Acceptance
• Compassion
• Evocation

Question 10

What does the partnership component of motivational interviewing include?

Answer 10

Work collaboratively and avoid the expert role

Question 11

What does the acceptance component of motivational interviewing include?

Answer 11

Respecting the client’s autonomy, potential, strengths, and perspective

Question 12

What does the compassion component of motivational interviewing include?

Answer 12

Keep the client’s best interest in mind

Question 13

What does the evocation component of motivational interviewing include?

Answer 13

The best ideas come from the client

Question 14

What are the skills necessary to master for motivational interviewing?

Answer 14

• Open questions
• Affirmations
• Reflections
• Summaries

Question 15

What are affirmations?

Answer 15

Statements about anything positive noticed

Question 16

What do we use affirmations in motivational interviewing for?

Answer 16

To build a sense of self confidence or self efficacy

Question 17

What is reflective listening?

Answer 17

Understanding what the client is thinking and feeling then saying it back to the client. (most important)

Question 18

What do we use reflections for in motivational interviewing?

Answer 18

• To convey empathy and understanding.

- To be able to see things through our patient’s eyes

Question 19

What is a summary?

Answer 19

A long reflection of more than one client statement

Question 20

What is the most important use of summary in motivational interviewing?

Answer 20

It provides an opportunity for the provider to become strategic and guide the client towards healthy behavior change by selectively summarizing the client’s own reasons for change

Question 21

What are the processes of motivational interviewing in order?

Answer 21

• Engaging
• Focusing
• Evoking
• Planning

Question 22

What is engaging?

Answer 22

The process fo establishing a trusting mutually respectful relationship

Question 23

What are the things to avoid when engaging with a patient?

Answer 23

• Assessing too early
• Telling how to fix problem
• Power differential
• Labeling

Question 24

What are the things to do when engaging with a patient?

Answer 24

• Feeling welcome
• Feeling comfortable
• Feeling understood
• Exceeding expectations
• Having mutual goals
• Feeling hopeful

Question 25

What is focusing?

Answer 25

An ongoing process of seeking and maintaining direction

Question 26

What does focusing involve?

Answer 26

Setting an agenda or agreeing on an agenda while considering patient's and provider's goals and priorities, in an effort to create a clear direction for the goal plan

Question 27

How does a provider accomplish focusing?

Answer 27

With the use of the OARS skills. - Open questions - Affirmations - Reflections - Summaries

Question 28

What is evoking?

Answer 28

Eliciting a client's own motivation for change.

Question 29

What are we evoking in motivational interviewing?

Answer 29

Change talk

Question 30

What is change talk?

Answer 30

Client speech that favors movement in the direction of change

Question 31

What are some ways to encourage change talk?

Answer 31

Ask questions like: - Why do you want to make a change? - What are the reasons to change? - What would some of the benefits be? - How might you go about making a change? - What would be your 1st step?

Question 32

What is planning?

Answer 32

Developing a specific change plan that the client agrees to and is willing to implement

Question 33

What are the 10 strategies for evoking change talk?

Answer 33

1. Ask Evocative Questions 2. Explore Decisional Balance 3. Ask for Elaboration 4. Ask for Examples 5. Look Back 6. Look Forward 7. Query Extremes 8. Use Change Rulers: 9. Explore Goals and Values 10. Come Alongside

Question 34

What are the characteristics of "Ask Evocative Questions" for evoking change talk?

Answer 34

Ask open question, the answer to which is change talk.

Question 35

What are the characteristics of "Explore Decisional Balance" for evoking change talk?

Answer 35

Ask first for the good things about status quo, then ask for | the not-so-good things.

Question 36

What are the characteristics of "Ask for Elaboration" for evoking change talk?

Answer 36

When a change talk theme emerges, ask for more details. In what ways? Tell me more…? What does that look like?

Question 37

What are the characteristics of "Ask for Examples" for evoking change talk?

Answer 37

When a change talk theme emerges, ask for specific examples. When was the last time that happened? Give me an example. What else?

Question 38

What are the characteristics of "Look Back" for evoking change talk?

Answer 38

Ask about a time before the current concern emerged. How were things better, different?

Question 39

What are the characteristics of "Look forward" for evoking change talk?

Answer 39

Ask what may happen if things continue as they are (status quo). Try the miracle question: If you were 100% successful in making the changes you want, what would be different? How would you like your life to be five years from now?

Question 40

What are the characteristics of "Query Extremes" for evoking change talk?

Answer 40

What are the worst things that might happen if you don’t make this change? What are the best things that might happen if you do make this change?

Question 41

What are the characteristics of "Use Change Rulers" for evoking change talk?

Answer 41

Ask, “On a scale from zero to ten, how important is it to you to [target change] - where zero is not at all important, and ten is extremely important? Follow up: And why are you at ___and not _____ [lower number than they stated]? What might happen that could move you from ___ to [higher number]? Instead of “how important” (need), you could also ask how much you want (desire), or how confident you are that you could (ability), or how committed are you to (commitment). Asking “how ready are you?” tends to be confusing because it combines competing components of desire, ability, reasons and need.

Question 42

What are the characteristics of "Explore Goals and Values" for evoking change talk?

Answer 42

Ask what the person’s guiding values are. What do they want in life? Using a values card sort can be helpful here. If there is a “problem” behavior, ask how that behavior fits in with the person’s goals or values. Does it help realize a goal or value, interfere with it, or is it irrelevant?

Question 43

What are the characteristics of "Come Alongside" for evoking change talk?

Answer 43

Explicitly side with the negative (status quo) side of ambivalence. Perhaps _______ is so important to you that you won’t give it up, no matter what the cost.