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| Question | Answer |
| Principles of MI: Express empathy | - Attitude and acceptance - Reflective listening to make the patient feel understood and cared for - Understanding client's perspective; ambivalence is normal - Labelling is unnecessary Affirmation, Summarizing |
| MI principle Discrepancy | - Clarify important client goals - Explore (potential) consequences of current behavior - Create & amplify ambivalence --> Work with ambivalence --> Double sided reflection |
| MI principle Resistance | - Avoid it - If it arises, use another path to continue - Invite to take on other perspective (don't impose) - Value client as resource for finding solutions |
| MI principle Self-efficacy | - Belief in ability as important motivator for change - Client responsible for choosing and carrying out change - Range of alternative responses --> Hope - Affirmations |
| MI Skills and Tools | Open-ended questions: 50-70% Affirmation: min 1x Reflective listening: 2:1 --> Understood right? --> Highlight ambivalence --> steer client toward problem awareness and concern --> Reinforce change statement Summarizing: 1-2x --> Understood right? --> Preparing client to move on --> Validate patient's feelings --> Show understanding and normalize |
| Methods of MI | - Ask: Permission, Open and closed questions - Tell: Information, Advice, Feedback - Listen: Appreciate, Reflect, Summarize |
| Stage of Change: Precontemplation | No awareness of the problem, No concern Ignoring concerned others No intention to change |
| Stage of Change: Contemplation | Awareness of problem No commitment to change Considering change Seeing pros and cons Constant inner debate |
| Stage of Change: Preparation | Intent on taking action Decision how to change Be/get ready (May take long) |
| Step of change: Action | Actively modifying behavior Need help to set realistic goals, coping skills and identify high-risk situations |
| Stage of change: Maintenanace | Sustained change New behavior replaces old behavior Maintaining it |
| Stage of Change: Relapse | Falling back into old behavior patterns Part of recovery process Usually few attempts needed |
| MI and SDT | Structure: Positive feedback, realistic goals, clear and neutral information about consequences of behavior, Self-efficacy support Autonomy support: Explore options, no coercion, client decides what and how to change, Roll with resistance, encourage change talk Involvement: Empathy and understanding, avoid judgement/blame, Explore client's concerns |
| MI & SDT | - Both based on the assumption that humans have an innate tendency toward growth and psychological integration - MI provides social-environmental factors facilitating needs suggested by SDT - Caution with discrepancy! --> Fulfill all three needs, autonomy and choice, partnership |
| Methods to facilitate confidence talk | - Looking back at prior successes - Confidence ruler - Evocative questions - Personal strength and support - Reframing |
| Methods to facilitate change talk | - Rulers - Looking back-/forward - Evocative questions (simple and complex reflections) - Clarifying - Querying extremes - Exploring goals and values |
| Client-centered approach | - Impetus for change from the client's intrinsic motives and goals - Client voices reasons for change - partnership - freedom of choice |
| Directive approach | - Reinforcing self-motivating statements & affirmations - Aim: Guiding client toward resolution of ambivalence & inconsistencies in behavior in order to build motivation toward change in particular direction |
| MI spirit | - Motivation to change elicited by client - Readiness for change not client characteristic but product of interpersonal interaction - Partnership - No direct persuasion - Counselling style quiet & eliciting |
| MI therapist | - Understanding client's perspective - Monitoring client's readiness for change and not jumping ahead - Acceptance and non judging - Affirming client's freedom of choice - Eliciting and reinforcing self-motivating statements |
| Boundary conditions | - Counsellor has to be open - Enough time - Counsellor has to be competent - Complementary for other interventions |
| Parameters of effectiveness | - Supportive relationship - Evocation of change talk - Collaboration, Evokation, Autonomy, exploration |
| Processes of MI (Martinez et al., 2017) | Engaging: Rapport, OARS Evoking: Change Talk: DARN CAT Planning: Summarize change talk and change plan: Goal, options for change, deciding on a plan, committing to the plan |
| Amico et al., 2008 | Brief MI intervention with high-risk teens for alcohol & drug use MI vs. usual care --> Less Marijuana use, lower intention to use, less perceived prevalence of mari use, fewer friends who use |
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