HEALTH SCI 2250 UNIT 4 READINGS QUESTIONS WITH VERIFIED
ANSWERS
original definition of Motivational Interviewing (MI) - Answers - -R. Miller in 1983
-developed from his experience in the treatment of problem drinkers. Through clinical
experience and empirical research
What is MI now established as - Answers - an evidence-based practice in the treatment
of individuals with substance use disorders
what does MI focus on - Answers - exploring and resolving ambivalence and centers on
motivational processes within the individual that facilitate change
how is MI different - Answers - -does not impose change (that may be inconsistent with
the person's own values, beliefs or wishes)
-supports change in a manner congruent with the person's own values and concerns
Motivational Interviewing (2009) - Answers - a collaborative, person-centered form of
guiding to elicit and strengthen motivation for change
what is MI grounded on? - Answers - in a respectful stance with a focus on building
rapport in the initial stages of the counseling relationship
what is a central concept of MI - Answers - identification, examination, and resolution of
ambivalence about changing behavior
ambivalence - Answers - feeling two ways about behavior change
Motivational Interviewing include three essential elements - Answers - 1) MI is a
particular kind of conversation about change (counseling, therapy, consultation, method
of communication)
2) MI is collaborative (person-centered, partnership, honors autonomy, not expert-
recipient)
3) MI is evocative (seeks to call forth the person's own motivation and commitment)
Lay person's definition (What's it for?) - Answers - Motivational Interviewing is a
collaborative conversation to strengthen a person's own motivation for and commitment
to change.
,A pragmatic practitioner's definition (Why would I use it?) - Answers - Motivational
Interviewing is a person-centered counseling method for addressing the common
problem of ambivalence about change.
A technical therapeutic definition (How does it work?) - Answers - Motivational
Interviewing is a collaborative, goal-oriented method of communication with particular
attention to the language of change. It is designed to strengthen an individual's
motivation for and movement toward a specific goal by eliciting and exploring the
person's own arguments for change
The "Spirit" of Motivational Interviewing - Answers - MI is more than the use of a set of
technical interventions. It is characterized by a particular "spirit" or clinical "way of being"
which is the context or interpersonal relationship within which the techniques are
employed.
what are the three elements MI is based on - Answers - collaboration between the
therapist and the client
evoking or drawing out the client's ideas about change
emphasizing the autonomy of the client
Collaboration (vs. Confrontation) - Answers - -Collaboration is a partnership between
the therapist and the client
-grounded in the point of view and experiences of the client
-This contrasts with some other approaches to substance use disorders treatment,
which are based on the therapist assuming an "expert" role, at times confronting the
client and imposing their perspective on the client's substance use behavior and the
appropriate course of treatment and outcome.
in Collaboration (vs. Confrontation) what does collaboration build - Answers - -rapport
and facilitates trust in the helping relationship, which can be challenging in a more
hierarchical relationship.
-does not mean that the therapist automatically agrees with the client about the nature
of the problem or the changes that may be most appropriate
-Although they may see things differently, the therapeutic process is focused on mutual
understanding, not the therapist being right
Evocation (Drawing Out, Rather Than Imposing Ideas) - Answers - -therapist's drawing
out the individual's own thoughts and ideas, rather than imposing their opinions as
motivation and commitment to change is most powerful and durable when it comes from
the client
,No matter what reasons the therapist might offer to convince the client of the need to
change their behavior or how much they might want the person to do so
-lasting change is more likely to occur when the client discovers their own reasons and
determination to change. The therapist's job is to "draw out" the person's own
motivations and skills for change, not to tell them what to do or why they should do it
Autonomy (vs. Authority) - Answers - -true power for change rests within the client.
-up to the individual to follow through with making changes happen. This is empowering
to the individual, but also gives them responsibility for their actions.
-Counselors reinforce that there is no single "right way" to change and that there are
multiple ways that change can occur
-clients are encouraged to take the lead in developing a "menu of options' as to how to
achieve the desired change.
four Principles of Motivational Interviewing - Answers - Express Empathy
Support Self-Efficacy
Roll with Resistance
Develop Discrepancy
Express Empathy - Answers - -Empathy involves seeing the world through the client's
eyes, thinking about things as the client thinks about them, feeling things as the client
feels them, sharing in the client's experiences
-This approach provides the basis for clients to be heard and understood, and in turn,
clients are more likely to honestly share their experiences in depth
-process of expressing empathy relies on the client's experiencing the counselor as able
to see the world as they (the client) sees it
Support Self-Efficacy - Answers - -client's belief that change is possible (self-efficacy) is
needed to instill hope about making those difficult changes
-Clients often have previously tried and been unable to achieve or maintain the desired
change, creating doubt about their ability to succeed
-Motivational Interviewing, counselors support self-efficacy by focusing on previous
successes and highlighting skills and strengths that the client already has
what type of approach is MI (Support Self-Efficacy) - Answers - -strengths-based
approach that believes that clients have within themselves the capabilities to change
successfully
, Roll with Resistance - Answers - -counselors avoid eliciting resistance by not
confronting the client and when resistance occurs, they work to de-escalate and avoid a
negative interaction, instead "rolling with it."
-Actions and statements that demonstrate resistance remain unchallenged especially
early in the counseling relationship. By rolling with resistance, it disrupts any "struggle"
that may occur and the session does not resemble an argument or the client's playing
"devil's advocate" or "yes, but" to the counselor's suggestions.
-The MI value on having the client define the problem and develop their own solutions
leaves little for the client to resist
-frequently used metaphor is "dancing" rather than "wrestling" with the client
-In exploring client concerns, counselors invite clients to examine new points of view,
and are careful not to impose their own ways of thinking
-A key concept is that counselor's avoid the "righting reflex", a tendency born from
concern, to ensure that the client understands and agrees with the need to change and
to solve the problem for the client
when does resistance in treatment occur?
(Roll with Resistance) - Answers - -when then the client experiences a conflict between
their view of the "problem" or the "solution" and that of the clinician or when the client
experiences their freedom or autonomy being impinged upon
-These experiences are often based in the client's ambivalence about change.
Develop Discrepancy - Answers - -When clients recognize that their current behaviors
place them in conflict with their values or interfere with accomplishment of self-identified
goals, they are more likely to experience increased motivation to make important life
changes
-It is important that the counselor using MI does not use strategies to develop
discrepancy at the expense of the other principles, yet gradually help clients to become
aware of how current behaviors may lead them away from, rather than toward, their
important goals.
when does the motivation for change occur (Develop Discrepancy) - Answers - when
people perceive a mismatch between "where they are and where they want to be", and
a counselor practicing Motivational Interviewing works to develop this by helping clients
examine the discrepancies between their current circumstances/behavior and their
values and future goals.
ANSWERS
original definition of Motivational Interviewing (MI) - Answers - -R. Miller in 1983
-developed from his experience in the treatment of problem drinkers. Through clinical
experience and empirical research
What is MI now established as - Answers - an evidence-based practice in the treatment
of individuals with substance use disorders
what does MI focus on - Answers - exploring and resolving ambivalence and centers on
motivational processes within the individual that facilitate change
how is MI different - Answers - -does not impose change (that may be inconsistent with
the person's own values, beliefs or wishes)
-supports change in a manner congruent with the person's own values and concerns
Motivational Interviewing (2009) - Answers - a collaborative, person-centered form of
guiding to elicit and strengthen motivation for change
what is MI grounded on? - Answers - in a respectful stance with a focus on building
rapport in the initial stages of the counseling relationship
what is a central concept of MI - Answers - identification, examination, and resolution of
ambivalence about changing behavior
ambivalence - Answers - feeling two ways about behavior change
Motivational Interviewing include three essential elements - Answers - 1) MI is a
particular kind of conversation about change (counseling, therapy, consultation, method
of communication)
2) MI is collaborative (person-centered, partnership, honors autonomy, not expert-
recipient)
3) MI is evocative (seeks to call forth the person's own motivation and commitment)
Lay person's definition (What's it for?) - Answers - Motivational Interviewing is a
collaborative conversation to strengthen a person's own motivation for and commitment
to change.
,A pragmatic practitioner's definition (Why would I use it?) - Answers - Motivational
Interviewing is a person-centered counseling method for addressing the common
problem of ambivalence about change.
A technical therapeutic definition (How does it work?) - Answers - Motivational
Interviewing is a collaborative, goal-oriented method of communication with particular
attention to the language of change. It is designed to strengthen an individual's
motivation for and movement toward a specific goal by eliciting and exploring the
person's own arguments for change
The "Spirit" of Motivational Interviewing - Answers - MI is more than the use of a set of
technical interventions. It is characterized by a particular "spirit" or clinical "way of being"
which is the context or interpersonal relationship within which the techniques are
employed.
what are the three elements MI is based on - Answers - collaboration between the
therapist and the client
evoking or drawing out the client's ideas about change
emphasizing the autonomy of the client
Collaboration (vs. Confrontation) - Answers - -Collaboration is a partnership between
the therapist and the client
-grounded in the point of view and experiences of the client
-This contrasts with some other approaches to substance use disorders treatment,
which are based on the therapist assuming an "expert" role, at times confronting the
client and imposing their perspective on the client's substance use behavior and the
appropriate course of treatment and outcome.
in Collaboration (vs. Confrontation) what does collaboration build - Answers - -rapport
and facilitates trust in the helping relationship, which can be challenging in a more
hierarchical relationship.
-does not mean that the therapist automatically agrees with the client about the nature
of the problem or the changes that may be most appropriate
-Although they may see things differently, the therapeutic process is focused on mutual
understanding, not the therapist being right
Evocation (Drawing Out, Rather Than Imposing Ideas) - Answers - -therapist's drawing
out the individual's own thoughts and ideas, rather than imposing their opinions as
motivation and commitment to change is most powerful and durable when it comes from
the client
,No matter what reasons the therapist might offer to convince the client of the need to
change their behavior or how much they might want the person to do so
-lasting change is more likely to occur when the client discovers their own reasons and
determination to change. The therapist's job is to "draw out" the person's own
motivations and skills for change, not to tell them what to do or why they should do it
Autonomy (vs. Authority) - Answers - -true power for change rests within the client.
-up to the individual to follow through with making changes happen. This is empowering
to the individual, but also gives them responsibility for their actions.
-Counselors reinforce that there is no single "right way" to change and that there are
multiple ways that change can occur
-clients are encouraged to take the lead in developing a "menu of options' as to how to
achieve the desired change.
four Principles of Motivational Interviewing - Answers - Express Empathy
Support Self-Efficacy
Roll with Resistance
Develop Discrepancy
Express Empathy - Answers - -Empathy involves seeing the world through the client's
eyes, thinking about things as the client thinks about them, feeling things as the client
feels them, sharing in the client's experiences
-This approach provides the basis for clients to be heard and understood, and in turn,
clients are more likely to honestly share their experiences in depth
-process of expressing empathy relies on the client's experiencing the counselor as able
to see the world as they (the client) sees it
Support Self-Efficacy - Answers - -client's belief that change is possible (self-efficacy) is
needed to instill hope about making those difficult changes
-Clients often have previously tried and been unable to achieve or maintain the desired
change, creating doubt about their ability to succeed
-Motivational Interviewing, counselors support self-efficacy by focusing on previous
successes and highlighting skills and strengths that the client already has
what type of approach is MI (Support Self-Efficacy) - Answers - -strengths-based
approach that believes that clients have within themselves the capabilities to change
successfully
, Roll with Resistance - Answers - -counselors avoid eliciting resistance by not
confronting the client and when resistance occurs, they work to de-escalate and avoid a
negative interaction, instead "rolling with it."
-Actions and statements that demonstrate resistance remain unchallenged especially
early in the counseling relationship. By rolling with resistance, it disrupts any "struggle"
that may occur and the session does not resemble an argument or the client's playing
"devil's advocate" or "yes, but" to the counselor's suggestions.
-The MI value on having the client define the problem and develop their own solutions
leaves little for the client to resist
-frequently used metaphor is "dancing" rather than "wrestling" with the client
-In exploring client concerns, counselors invite clients to examine new points of view,
and are careful not to impose their own ways of thinking
-A key concept is that counselor's avoid the "righting reflex", a tendency born from
concern, to ensure that the client understands and agrees with the need to change and
to solve the problem for the client
when does resistance in treatment occur?
(Roll with Resistance) - Answers - -when then the client experiences a conflict between
their view of the "problem" or the "solution" and that of the clinician or when the client
experiences their freedom or autonomy being impinged upon
-These experiences are often based in the client's ambivalence about change.
Develop Discrepancy - Answers - -When clients recognize that their current behaviors
place them in conflict with their values or interfere with accomplishment of self-identified
goals, they are more likely to experience increased motivation to make important life
changes
-It is important that the counselor using MI does not use strategies to develop
discrepancy at the expense of the other principles, yet gradually help clients to become
aware of how current behaviors may lead them away from, rather than toward, their
important goals.
when does the motivation for change occur (Develop Discrepancy) - Answers - when
people perceive a mismatch between "where they are and where they want to be", and
a counselor practicing Motivational Interviewing works to develop this by helping clients
examine the discrepancies between their current circumstances/behavior and their
values and future goals.
