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Brandy Petrie, Ph.D. - 11/07/14
Terms in this set (20)
What are the uses of Motivational Interviewing?
1. Substance use disorders.
2. Smoking cessation.
3. Weight Loss.
4. Medication compliance.
5. Treatment engagement.
6. Prenatal behavior.
8. Diet Changes.
What is Motivational Interviewing?
1. Focuses on exploring and resolving ambivalence.
2. Centers on motivational processes within the individual that facilitate change.
3. Supports change in a manner that is congruent with the person's own values and concerns.
4. Focuses on building rapport.
5. Grounded by a respectful stance and non-judgmental attitude.
What is the spirit of motivational interviewing?
1. Clinical way of being focused on the interpersonal relationship with the patient.
2. Essential elements of the "spirit" of MI - collaboration, evocation, autonomy.
What are the characteristics of Collaboration in Motivational Interviewing?
1. Partnership between the practitioner and patient.
2. Based on the point of view and experience of the patient.
3. Builds rapport.
4. Facilitates trust.
What are the characteristics of Evocation in Motivational Interviewing?
1. Drawing out the patient's thoughts and ideas.
2. Commitment to change is most powerful when it comes from the patient.
3. Lasting change is more likely to occur when the patient decides for themselves their reasons for change.
What are the characteristics of Autonomy in Motivational Interviewing?
1. Recognizes the true power of change is within the patient.
2. De-emphasizes the practitioner as an authority figure.
3. Empowers the patient and places the responsibility for change on them.
4. There is no "right way" to change.
What are the principles of Motivational Interviewing?
1. Express empathy.
2. Support Self-efficacy.
3. Roll with resistance.
4. Develop discrepancy.
What are the characteristics of the Express Empathy principle of Motivational Interviewing?
1. Ability to understand and share another person's experience and feelings.
2. Increases the likelihood of the patient being open and honest.
What are the characteristics of the Support Self-Efficacy principle of Motivational Interviewing?
1. One's belief in oneself to be successful at a task.
2. Focus on previous successes.
3. Highlight skills and strengths they already possess.
What are the characteristics of the Roll with Resistance principle of Motivational Interviewing?
1. Resistance is normal and expected and stems from ambivalence.
2. Reduce the likelihood of getting resistance by not confronting the patient - Avoid the "righting reflex".
3. When it does occur, roll with the resistance by de-escalating the situation and avoiding negative interactions.
4. Don't challenge resistance, focus on having the patient define the problem and develop their own solutions, explore new points of view without imposing your own way of thinking.
What are the characteristics of the Develop Discrepancy principle of Motivational Interviewing?
1. Motivation for change occurs when people identify a mismatch between where they are and where they want to be.
2. Help the patient examine the discrepancies between their current behavior and their values and future goals in a way that is inline with the spirit and principles of MI.
3. Motivation increases the more the patient realizes their behavior conflicts with their values or interferes with their goals.
What are the four major characteristics to the structure of Motivational Interviewing?
1. Engaging - Establishing a helpful connection and working relationship.
2. Focusing - Developing and maintaining a specific direction in the conversation about change.
3. Evoking - Eliciting the patient's own motivation for change.
4. Planning - Developing a commitment to change and formulating a concrete plan of action.
What are the three types of MI skills and strategies?
1. OARS - Micro-counseling skills used to establish a therapeutic alliance and elicit discussions about change.
2. Informing and advising.
3. Evoking "change talk" - statements by the patient revealing consideration of, motivation for, or commitment to change.
What kind of Open-ended Questions should be given when using Motivational Interviewing?
1. Not easily answered with "yes" or "no" or a short, specific answer.
2. Invites elaboration and deeper thinking about an issue.
What kind of Affirmations should be given when using Motivational Interviewing?
1. Statements that recognize patients strengths.
2. Reframe behaviors and concerns into positive qualities.
3. Builds Rapport.
4. Supports self-efficacy.
5. Helps the patient view themselves in a more positive way and feel change is possible.
6. Must be congruent and genuine.
What kind of Reflections should be used when using Motivational Interviewing?
1. Reflective listening.
2. Two purposes - Expresses empathy, Guides patients towards change.
What kind of Sumaries should be given when using Motivational Interviewing?
1. Type of reflection where the practitioner recaps a specific exchange that just happened or the entire interaction.
2. Communicates interest and understanding.
3. Promote the development of discrepancy by attending to what is important and excluding or minimizing what is not.
4. May be used to shift attention or direction.
5. Highlight both sides of a patient's ambivalence about change.
What are the characteristics of Evoking Change Talk?
2. Prepatory change talk - Desire, Ability, Reason, and Need.
3. Implementing Change talk - Commitment, Activation, Taking Steps.
4. Most predictive of positive outcome.
What are the major questions strategies for evoking change talk?
1. Ask evocative questions - open ended questions.
2. Explore decisional balance - Ask the pros and cons of changing and staying the same.
3. Explore the good things/not-so-good things - ask about the positive and negative aspects of the target behavior.
4. Ask for elaboration or examples - when a change talk theme emerges, ask for more details.
5. Look back - Ask about a time before the target behavior emerged.
6. Look forward - Ask what may happen if things continue as they are (status quo), Ask what would be different if they make a change.
7. Query Extremes.
8. Use Change Rulers.
9. Explore goals and values - ask about the patients values and what they want in life, ask how the continuation of the target behaior fits in with their goals or values.
10. Come alongside - explicitly side with the negative side of ambivalence (status quo).
How do you negotiate a plan with a patient using Motivational Interviewing?
1. Allow the patient to consider their options before suggesting a plan.
2. If the patient has difficulty formulating a plan, make some suggestions.
3. Discuss potential obstacles and barriers.
4. Remember to not rush the patient, if patient is unable to make a decision it is not a failure, prepare yourself and patients for set-backs.
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