Motivational Interviewing

Question	Answer
Who said the key ingredient to change is motivation?	Miller & Rollnick (2002)
Ambivalence	feeling two ways about something; pros and cons exist in behaviour change
The righting reflex	therapist's impulse to use information to persuade and increase patient motivation to change
Efficacy of the righting reflex	doesn't usually work; provokes resistance and defensive responding
decisional balance	the balance between the costs of change and the benefits, leading up to a decision
the spirit of motivational interviewing - three concepts	ACE, A - autonomy, C - collaboration, E - evocation
ACE - autonomy	change arises from within the client, it is their responsibility to change, their perspective, direction and choice of when and how
ACE - collaboration	Client enacts change, therapist supports change. Change is not imposed, or directed. Decision-making is a joint process.
ACE - evocation	evoke pre-existing motives, goals, values, and resources from within the client. Connect behaviour change to client concerns.
Primary aim of MI	enhance intrinsic motivation
Primary method of MI	communication
four principles of MI	1. express empathy, 2. develop discrepancy, 3. roll with resistance, 4. support self-efficacy
Why is it important to normalise ambivalence?	Provides relief, validation and understanding for client. Enables an examination of the pros and cons.
How can a therapist develop discrepancy?	amplify the conflict between a client's stated goals and values and their present behaviour.
If a client shows resistance, what might this signal to the therapist?	That it may be time to try something different.
Motivation interviewing strategies: miscroskills O.A.R.S.	O - openness, A - affirming, R - reflecting, S - summarising
O.A.R.S. - Openness	encourages client speech, ask open-ended questions, prompts
O.A.R.S. - affirming	affirm and validate the client so they feel supported through the process of therapy
O.A.R.S. - reflecting	reflect cautiously back to the client on the meaning of what they have been saying, guess at meaning.."maybe...or you seem a little upset..."
O.A.R.S. - summarising	link the material together to reinforce discussion and demonstrate understanding
Motivation interviewing strategies: the importance ruler	ask clients to rate the importance of an issue on a scale (1-10) it helps to build understanding and explore client motivations. What would it take to increase that to...?
Motivation interviewing strategies: elicit change talk	resolve ambivalence by discussing pros and cons
Motivation interviewing strategies: elaborate reasons for change	ask client for specific examples
Motivation interviewing strategies: querying extremes	when little desire to change is evident ask "what is the worst thing that might happen if you continue....?"
Motivation interviewing strategies: looking forward	help client envision a future without the problem
Motivation interviewing strategies: building self efficacy	identify past successes and personal strengths
Motivation interviewing strategies: change plan worksheet	a plan of action with goals and reason for change. Listing social supports, possible obstacles, and what success will look like
MI - What is the name of the program Paxton et al developed for adults with binge eating problems?	Set your body free.
In a 2008 study of the efficacy of MI for binge eating disorders (Cassin et al.), which treatment condition was more effective?	Group therapy plus a self-help manual was more effect than a self-help manual alone.
What areas has MI been effectively applied? S______a____, and h____ b______.	substance abuse and health behaviours (dental, diabetes, diet and exercise, blood cholesterol, blood pressure, binge eating disorder)

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Motivational Interviewing

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	Created by batten.shelley over 10 years ago