interviewing test for the 8 hour tour: pre post

Fazzio Consulting Professional Development April, 2019 Motivational Interviewing of 4

MotivationalInterviewingTestforthe8HourTour:

PrePost

Name: Agency:

Date: Score:

Instructions: Read each question carefully and circle the letter corresponding to the response you believe to be correct. Each item has only one correct response. Do NOT circle more than one response to any test item. Multiple marks or indiscernible responses will be marked as incorrect. This is a closed book test. Motivational Core Skills 1. Motivational Interviewing is only used with clients.

a. True

b. False

2. Motivational Interviewing uses active listening as a beginning point.

a. True

b. False

3. Developing discrepancies are keys to change.

a. True

b. False

4. Reflections help with the discord of clients.

a. True

b. False

5. Affirmations evoke sustain talk.

a. True

b. False

6. Which of the following statements correctly identifies the “C” in the acronym C.O.A.R.S.?

a. Collect information.

b. Communicate clearly.

c. Closed‐ended question.

7. Which of the following statements correctly identifies the “O” in the acronym C.O.A.R.S.?

a. Oral communication.

b. Open‐ended question.

c. Offer advice.

Motivational Interviewing Pre Post

Name: Date:

Fazzio Consulting Motivational Interviewing April, 2019 of 4

8. Which of the following statements correctly identifies the “A” in the acronym C.O.A.R.S.?

a. Affirmations.

b. Ask permission.

c. Amplified ambivalence.

9. Which of the following statements correctly identifies the “R” in the acronym C.O.A.R.S.?

a. Remorse.

b. Reflections.

c. Recorded response.

10. Which of the following statements correctly identifies the “S” in the acronym C.O.A.R.S.?

a. Supports self‐efficacy.

b. Simple question.

c. Summarizations.

11. Which of the following statements correctly identifies the acronym D.E.A.R.S.?

a. Discord, empowerment, ability, roll with resistance, support self‐efficacy.

b. Develop discrepancy, express empathy, amplify ambivalence, roll with resistance, support self‐efficacy.

c. Develop diplomacy, even the score, ask a question, reflection, support sustained ambivalence.

Core MI Knowledge Scale

Mark the correct MI mechanics (A ‐ E) for each response below.

A. Closed‐end question

B. Open‐end question

C. Affirmation

D. Reflection

E. Summarizations

12. “How many times have you been here to talk with someone?” ☐ A ☐ B ☐ C ☐ D ☐ E

13. “Thank you for being here on time today, Brenda.” ☐ A ☐ B ☐ C ☐ D ☐ E

14. “Describe for me what happened next?” ☐ A ☐ B ☐ C ☐ D ☐ E

15. “So, if I have this right, you didn’t feel you were at fault.” ☐ A ☐ B ☐ C ☐ D ☐ E

16. “Were you there at the time?" ☐ A ☐ B ☐ C ☐ D ☐ E

17. “You got in the car, said hello to a friend, and jumped back out.” ☐ A ☐ B ☐ C ☐ D ☐ E

18. “Tell me about the situation you were in?” ☐ A ☐ B ☐ C ☐ D ☐ E

19. “That must have been hard for you staying away from those addictive friends.” ☐ A ☐ B ☐ C ☐ D ☐ E

20. “So you’re stressed out and you’re running out of patience about that.” ☐ A ☐ B ☐ C ☐ D ☐ E

21. “You felt nervous, so you just didn't pay.” ☐ A ☐ B ☐ C ☐ D ☐ E


Name: Date:


Stages of Change Model

22. Pre‐Contemplation is denial.

a. True

b. False

23. Active listening is a part of stages of change.

a. True

b. False

24. Contemplation without ambivalence will not work.

a. True

b. False

25. Maintenance is 0‐6 months.

a. True

b. False

26. Action and maintenance are the goals.

a. True

b. False

27. Ready, willing, and ability are major catalysts for change.

a. True

b. False

28. Preparation is a stage when the client is taking care of bussiness.

a. True

b. False

29. There are four types of pre‐contemplation.

a. True

b. False

30. Relapse is normal for most people.

a. True

b. False

31. Some people stay stuck in different stages of change.

a. True

b. False


Name: Date:


Application of Skills Knowledge

Word Bank for questions 32 ‐ 35

Engagement

Courage

Partnership

Compassion

Evocation

Reflection

Acceptance

Responsivity

Pre‐Contemplation

Using the word bank above, what are the 4 items used with the new SPIRIT of MI?

32.

33.

34.

35.

36. What is the correct MI code for this statement? “Tell me about your day today?”

a. Reflection.

b. Open‐ended question.

c. Closed‐ended question

37. Which of the following would be the first thing to do when a client is in pre‐contemplation?

a. Tell them about it.

b. Call it a day.

c. Develop discrepancies.

38. Which of the following are the most important when using MI?

a. Facial expressions and active listening

b. MI mechanics and stages of change wheel

c. a and b

39. When relapse occurs, the correct approach is to:

a. Talk about what happened.

b. Increase consequences.

c. Give the client a hug and tell them it is okay.

40. S.M.A.R.T. goals are used for what reason?

a. To increase sanctions.

b. As a guide to deal with issues.

c. As a way to show you care about the client.

MI Matrix Handout

Fazzio Consulting Professional Development February, 2019 Motivational Interviewing Training Page 1

MI Master Matrix

1. The "SPIRIT" of MI: 2. "Active Listening" 6. The "Stages of Change" Model: 18. The 4 Processes:

‐‐Collaboration ‐‐Partnership Relapse ‐‐2 to 6 times, average ‐‐Engaging

‐‐Evocation ‐‐Acceptance 3. ‐‐R Resist the Righting Reflex ‐‐Focusing

‐‐Autonomy ‐‐Compassion ‐‐U Understand your client Maintenance Precontemplation ‐‐Evoking

‐‐Evocation ‐‐L Listen to your client ‐‐6 months to ‐‐No problem recognition ‐‐Planning

4. Target Area/s ‐‐E Empower your client forever 17. The 4 R's of Precontemplation:

7. The 3 catalyst for Action: ‐‐Reluctant

5. Instant Assessments: ‐‐Ready Contemplation ‐‐Rationalizing

‐‐Facial Expressions = 55% communications ‐‐Willing ‐‐Problem Recognition ‐‐Resigned

‐‐Tone of Voice = 38% communications ‐‐Ability ‐‐Ambivalence ‐‐Rebellious

‐‐Words = 7% communications Action

‐‐Body = Testosterone and Cortisol ‐‐Problem Recognition 19. The "Objective": Preparation/Determination Backwards Talk VS. Forward Talk

Other Skills of Communications: ‐‐Procrastination "Sustain Talk" VS. "Change Talk"

8. Principles of Effective Interventions: 10. DERS: 11. MI Mechanics, COARS: 12. "70%‐‐30% Split"

‐‐Risk Principle ‐‐Develop Discrepancies ‐‐Closed Ended Questions 20. The "7 Dimensions of Change Talk":

‐‐Need Principle ‐‐Express Empathy ‐‐Open Ended Questions 13. The "10 Second Rule" ‐‐Desire to change

‐‐Responsivity Principle ‐‐Roll with Resistance ‐‐Affirmations 14. "Empathy": ‐‐Ability to change

‐‐Support Self‐Efficacies ‐‐Reflections "Lightweight" and "Heavyweight" ‐‐Reason to change

9. Evidence Based Practices: ‐‐Summarizations 15. 3 Types: ‐‐Need to change

‐‐Assessment tool to help identify target area/s 22. SMARTER Goals: ‐‐Simple sided ‐‐Commitment to change

‐‐Intrinsic motivation ‐‐Small/Specific 16. 3 or more Reflections ‐‐Amplified/Complex ‐‐Actions towards the change

‐‐Match needs to target area/s ‐‐Measurable ‐‐Double Sided ‐‐Taking steps for change

‐‐Skill train with direct practice ‐‐Attainable

‐‐Support the positive ‐‐Realistic 23. More tools for MI: 21. "5 Dimensions of Sustain Talk":

‐‐Always measure outcomes ‐‐Timely ‐‐Importance/Confidence Ruler ‐‐Desire for the status quo

‐‐Expectations ‐‐Querying Extremes ‐‐Inability to change

‐‐Roles ‐‐Looking Forward/Looking Back ‐‐Reason for the status quo

‐‐Evocative Questions ‐‐Need for the status quo

‐‐Decisional Balance ‐‐Commitment not to change

‐‐Goals and Values

‐‐Elaborating

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PROFESSIONALDEVELOPMENTMotivational Interviewing

An 8 Hour Presentation

April, 2019

Andy Fazzio

Fazzio Consulting

1503 Egger Ave

Round Rock, TX, 78664

541 990‐3011

PROFESSIONAL DEVELOPMENT Participant Guide

Fazzio Consulting Professional Development March, 2019 MI An 8 Hour Tour Page 3 of 14

TABLEOFCONTENTS

SECTIONI:INTRODUCTIONTOMOTIVATIONALINTERVIEWING...............................................................3

SECTIONII:CHANGEANDWHATITMEANS..............................................................................................6

SECTIONIII:UNDERLININGSKILLSTHATSUPPORTMOTIVATIONALINTERVIEWING............................7

SECTIONIV:MIMECHANICS......................................................................................................................8

SECTIONV:TIMETOTRYITALLOUT.......................................................................................................11

GLOSSARY...................................................................................................................................................................12

INTRODUCTION

Motivational Interviewing (MI) is a client centered, evidence based program that allows effective pro‐social

communications between people. This training provides an introduction to the techniques that help to

enhance communications between everyone.

PERFORMANCEOBJECTIVES:

1. Explain what is, "Motivational Interviewing”.

2. Have the ability to observe and understand basic human behavior.

3. Demonstrate “Active Listening”.

4. Identify "Readiness to Change” in a client.

5. Understand how to begin the process of using MI.

6. Practice using MI and giving MI adherent feedback.

SECTIONI:DEFINITIONSOFMOTIVATIONALINTERVIEWING:

Defining MI

2002 2009

A client‐centered, directive method for

enhancing intrinsic motivation to change by

exploring and resolving ambivalence.

Miller and Rollnick

A collaborative, person‐centered form of guiding

to elicit and strengthen motivation for change.

Miller and Rollnick



The Spirit of MI (2002)

• collaboration

• evocation

• autonomy

The Spirit of MI (2009)

• partnership

• acceptance

• compassion

• evocation

Active Listening

The RULE

• resist the righting reflex

• understand client motivation(s)

• listen

• empower your clients

ACTIVITY:ACTIVELISTENINGWARMUP#1

Instructions: With a partner, interview each other using the question listed below. Determine who will be the

initial speaker and listener. Interview your partner by asking: “Tell me how it was for you growing up”? The

listener is free to take notes during this interview.

After one minute, stop the speaker and allow the listener time to reflect and summarize back what the

speaker said.

Switch roles and repeat the activity.

ACTIVITY:ACTIVELISTENINGWARMUP#2

Instructions: With a partner, interview each other using the question listed below. Determine who will be the

initial speaker and listener. Interview your partner by asking: “Tell me who was the most influential person

for you growing up and why?”

The listener is free to take notes during this interview.

After two minutes, stop the speaker and allow the listener time to reflect and summarize back what the

speaker said.

Switch roles and repeat the activity.

_________________________________________________________________________________________

_________________________________________________________________________________________

________________________________________________________________________________________



Targeted Area(s)

• cues to client’s attitude and behaviors

• clinical or interpersonal

• client‐centered

• usually more than one target area

Other Tools of Communication

• facial expressions

• tone of voice

• words

• body language

_________________________________________________________________________________________

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_________________________________________________________________________________________

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SECTIONIII:UNDERLININGSKILLSTHATSUPPORTMOTIVATIONALINTERVIEWING_________Communication Skills

Non‐confrontational Promotes positive outcomes

Other Skills

Effective interventions

risk principle

need principle

responsivity principle

Evidence‐based Practices

Assess risk/needs of the client

Enhance intrinsic motivation

Target the issue specifically

Skill training with directed practice

Support positive reinforcement

Measure outcomes

DEARS Principles

Develop discrepancies

• client goals/values and current behavior

• Expressing empathy

• understand meaning through reflective listening

Amplifying ambivalence

• “to‐ing and fro‐ing”

Rolling with resistance

• client is defiant

• client views situation differently

EMPATHETIC STYLE

− Communicates respect and

acceptance

− Encourages non‐judgmental

relationship

− Supportive and knowledgeable

consultant

− Sincerely compliments

− Listens

− Gently persuades

− Provides support



Supporting self‐efficacy

• Therapist

− recognize client’s strengths

− acknowledge client’s strengths

− believe in client’s capacity to

reach goals

• Client

− believe that change is their

responsibility

SECTIONIV:MOTIVATIONALINTERVIEWINGMECHANICS__________________________________________

Close‐ended Questions

Advantages

• use for specific situations only

• answers who, what, when, and where

Disadvantages

• therapist does most of the work

• too many questions

Open‐ended Questions

Advantages

• client‐centered

• client does most of the work

Disadvantages

• using too many stems

• may sound disingenuous

OPEN STEMS OPEN STEMS CLOSED STEMS CLOSED STEMS

How? Tell me? Is? When?

What? Explain? Are? Who?

How could? Say more? Do? Where

How would? For example… Did? How many?

How might? Why? (sometimes) Why?



Affirmations

Elicits information

• lightweight versus heavyweight

Reflections

Information gathered by active listening

Confirming for the client

Statement I hear the client say

Do not end in a “swoop”

Types of reflections

• simple‐sided

• complex

• double‐sided

Summarizations

3 or more reflections

You are listening and heard the client

Shows concern

Establishes responsivity

Lowers defensiveness

Promotes evocation

Collect information from client

Assures accuracy

Transition from topic to topic

Consolidate information

SWOOP

− Indicates an up tone at end

− May create a challenge

response

− May cause a reaction

− May cause defensiveness

− Turns a reflection into a

question.



Roadblocks to Listening

1. Ordering, directing

2. Warning, threatening

3. Giving advice, making suggestions,

providing solutions

4. Persuading with logic, arguing, lecturing

5. Moralizing, preaching

6. Judging, criticizing, blaming

7. Agreeing, approving, praising

8. Shaming, ridiculing, name‐calling

9. Interpreting, analyzing

10. Reasoning, sympathizing

11. Questioning, probing

12. Withdrawing, distracting, humoring,

changing the subject

SMARTER Goals

Small and specific

Measurable

Attainable

Realistic

Timely

Expectations

Roles

4 TYPES OF CLIENT PROFILES:

Low importance with low confidence

Low importance with high confidence

High importance with low confidence

High importance with high confidence

2012

Motivational interviewing is a form of collaborative conversation for strengthening a person’s own

motivation and commitment to change. It is a person‐centered counseling style for addressing the

common problem of ambivalence about change by paying 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 persons own reasons for change within an atmosphere of acceptance and compassion.

Miller and Rollnick, 2012


Fazzio Consulting Professional Development March, 2019 MI An 8 Hour Overview Page 11 of 14

SECTIONV:TIMETOTRYITALLOUT!

Practice makes perfect. You will only improve your skills if you practice.

ACTIVITY:MOTIVATIONALINTERVIEWING–YOURTURN

Instructions: In groups of three, choose who will be the practitioner, the client, and the coder. Participants will play each role

at least once in a series of rounds. Be prepared to debrief after each round.

Simple Coding Process

Close‐ended questions _______________________________________________

Open‐ended questions ______________________________________________________

Affirmations _______________________________________________________

Reflections _________________________________________________

Summarizations _________________________________________________

Practitioner Feedback

1. Positive first and always.

2. Ask how they feel they did?

3. Support and/or affirm.

4. Always open‐ended questions.

5. Reflective listening and affirmations to enhance discussions.

6. Help client win his (or her) own arguments.

7. Always end with something positive.



GLOSSARYAbility – A form of clien preparatory chang talk that reflects perceived personal capability of making a change; typical words

include can, could, and able.

Acceptance – I accept you for who you are, I honor the decisions you make, I am non judgmental of you and what’s going on

with you. (2009)

Affirmation – One of four aspects of acceptance as a component of MI spirit, by which the counselor accentuates the positive,

seeking and acknowledging a person’s strengths and efforts.

Ambivalence – The simultaneous presence of competing motivations for and against change.

Ampified Reflection – A response in which the intervieer reflects back the client’s content with greater intensity than the

client had expressed; one form of response to client sustain talk or discord.

Autonomy – The independence of, the freedom of, having the right of self government, self‐governing as an individual,

empowerment of ones self. (2002)

Change Ruler – A rating scale, usually 0‐10, used to assess aclient’s motivation for a particular change; see Confidence Ruler

and Importance Ruler.

Change Talk – Any client speech that favors movemnet toward a particular change goal.

Client‐Centered Counseling – A therapeutic approach introduced by psychologist Carl Rogers in which people explore their

own experience within a supportive, empathic, and accepting relationship.

Closed Question – A question that asks for yes/no, a short answer, or specific imformation.

Coaching – The process of helping someone to acquire a skill.

Collaboration – To work with one another, cooperation to cooperate willing. (2002)

Compassion – I have empathy and will do my best to understand. (2009)

Complex Reflection – And interview reflection that adds additional or different meaning beyond what the client has just said;

a guess as to what the client may have meant.

Confidence Ruler – A scale (typically 0‐10) on which clients are asked to rate their level of confidence in their ability to make a

particular change.

DARN – An acronym for four subtypes of client preparatory change talk: Desire, Ability, Reason, and Need.

Decisional Balance – A choice‐focused technique that can be used when counseling with neutrality, devoting equal

exploration to the pros and cons of change or of a specific plan.

Desire – A form of client preparatory change talk that reflects a preference for change; typical verbs include want, wish, and

like.

Directing – A natural communication style that involves telling, leading, providing advice, information, or instruction.

Direction – The extent to which an interviewer maintains in‐session momentum toward a change goal.



Discord – Interpersoanal behavior that reflects dissonance in the working relationship; sustain talk does not in itself constitute

discord; examples include arguing, interrupting, discounting, or ignoring.

Discrepancy – The distance between the status quo and one or more client change goals.

Double‐sided Reflection – And interviewer reflection that includes both client sustian talk and change talk, usually with

conjuction “and.”

Elaboration – An interviewer response to client change talk, asking for additional detail, clarification, or example.

Elicit‐provide‐elicit – An information exchange process that begins and ends with exploring the client’s own experience to

frame whatever information is being provided to the client.

Empathy – The extent to which an interviewer communicates accurate understanding of he client’s perspectives and

experience; most commonly manifested as reflection.

Evocation – One of four central components of the underlying spirit of MI by which the interviewer elicits the client’s own

perspectives and motivation.

Evocative Questions – Strategic open questions the natural answer to which is change talk.

Evoking – The third of four fundamental processes of MI, which involves eliciting the person’s own motivation for a particular

change.

Exploring Goals and Values – A strategy for evoking change talk by having people describe their most important life goals or

values.

Importance Ruler – A scale (typically 0‐10) on which clients are asked to rate the importance of making a particular change.

Integrity – To behave in a manner that is consistent with and fulfills one’s core values.

Intrinsic Motivation – The disposition and enactment of behavior for its consistency with personal goals and values.

Looking Back – A strategy for evoking client change talk, exploring a better time in the past.

Looking Forward – A strategy for evoking client change talk, exploring a possible better future that the client hopes for or

imagines. Or anticipating the furure consequences of not changing.

Motivational Interviewing – Lay definition: A collaborative conversation style for stengthening a person’s own motivation and

commintment to change.

Clinical definition: A person‐centered counseling style for addressing the common problem of ambivalence about change.

Technical definition: A collaborative, goal‐oriented style of communication with particular attention to the language of

change, designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the

person’s own reasons for change wihin an atmosphere of acceptance and compassion.

Need – A form of client preparatory change talk that expresses and imperative for change without specifying a particular

reason. Common verbs include need, have to, got to, must.

COARS – An acronym for five basic client‐centered communication skills: Closed question, Open question, Affirmation,

Reflection, and Summarization.



Open Question – A question that offers the client broad latitude and choice in how to respond; compared to Closed Question.

Partnership – One of four central components of the underlying spirit of MI by which the interviewer functions as a partner or

companion, collaborating with the client’s own expertise.

Planning – The fourth fundamental process of MI, which involves developing a specific change plan that the client is willing to

implement.

Querying Extremes – A strategy for evoking change talk by asking clients to imagine best consequences of change or worst

consequences of status quo.

Reason – A form of client preparatory change talk that describes a specific if‐then motive for change.

Reflective Listening – The skill of “active” listening whereby the counselor seeks to understand the client’s subjective

experience. Offering reflections as guesses about the person’s meaning.

Reflection – An interviewer statement intended to mirror meaning (explicit or implicit) of preceding client speech.

Resistance – A term previously used in MI, now deconstructed into its components; sustain talk and discord.

Righting Reflex – The natural desire of helper to set things right, to prevent harm and promote client welfare.

Self‐Efficacy – A client’s percieved ability to successfully achieve a particular goal or perform a paricular task; term introduced

by Albert Bandura.

Self‐Esteem – A client’s general level of percieved worth.

Simple Reflection – A reflection that contains little or no additional content beyond what the client has said.

Spirit – The underlying set of mind and heart within which MI is practiced, including partnership, acceptance, compassion, and

evocation.

Stages of Change – Within the transtheoretical model of change, a sequence of steps through which people pass in the change

process: precontemplation, contemplation, preparation, action, maintenance, and relapse.

Status Quo – The current state of affairs without change.

Summary – A reflection that draws together content from three or more prior client statements.

Sustain Talk – Any client speech that favors status quo rather than movement toward a change goal.

Taking Steps – A form of client mobilizing change talk that describes an action or step already taken toward change.

Transtheoretical Model – a complex model of change develped by James Prochaska and Carlo DiClemente, one part of which

describes stages of change.

Values – A person’s vvore goals or standards that provide meaning and direction in life.

interviewing test for the 8 hour tour: pre post

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