Podcast
Questions and Answers
Which of the following best describes the 'Guiding' process in motivational interviewing?
Which of the following best describes the 'Guiding' process in motivational interviewing?
- Uncovering the patient's inherent reasons and desires for change.
- Pinpointing specific areas where behavioral modifications would be advantageous. (correct)
- Establishing a strong rapport and trust with the patient.
- Formulating a concrete action plan to enact behavioral changes.
Which of the following reflects the purpose of affirmations in motivational interviewing?
Which of the following reflects the purpose of affirmations in motivational interviewing?
- Providing specific feedback on areas where the patient needs to improve.
- Directly advising patients on the best course of action for their health.
- Establishing a collaborative and respectful environment by acknowledging the patient's strengths and commitments. (correct)
- Challenging the patient's negative beliefs to promote a more positive outlook.
A health coach asks a patient, 'What are some things that are most important to you in your daily life?' This is an example of what kind of question?
A health coach asks a patient, 'What are some things that are most important to you in your daily life?' This is an example of what kind of question?
- An open question, encouraging the patient to elaborate. (correct)
- A leading question, guiding the patient towards a particular answer.
- A closed question, as it seeks specific information.
- A rhetorical question, not requiring a direct response.
Why are open questions preferred over closed questions in motivational interviewing?
Why are open questions preferred over closed questions in motivational interviewing?
Which of the following is a characteristic of closed questions?
Which of the following is a characteristic of closed questions?
During a motivational interviewing session, a practitioner says, 'So, it sounds like you're feeling unsure about making these changes, but you're also hopeful that it could improve your health. Is that right?' This is an example of which MI skill?
During a motivational interviewing session, a practitioner says, 'So, it sounds like you're feeling unsure about making these changes, but you're also hopeful that it could improve your health. Is that right?' This is an example of which MI skill?
What is the primary goal of 'evoking' in the context of motivational interviewing?
What is the primary goal of 'evoking' in the context of motivational interviewing?
A patient states, 'I don't think I can ever stick to a diet.' How might a practitioner using motivational interviewing respond, incorporating an affirmation?
A patient states, 'I don't think I can ever stick to a diet.' How might a practitioner using motivational interviewing respond, incorporating an affirmation?
Which of the following statements best describes the core principle of motivational interviewing in diabetes management?
Which of the following statements best describes the core principle of motivational interviewing in diabetes management?
A diabetes patient expresses frustration with checking their blood sugar multiple times a day, stating, "It's just so time-consuming and I don't always see the point." Which response demonstrates a reflective listening technique?
A diabetes patient expresses frustration with checking their blood sugar multiple times a day, stating, "It's just so time-consuming and I don't always see the point." Which response demonstrates a reflective listening technique?
A patient with diabetes has made a small improvement in their diet but hasn't yet achieved their target A1c level. Which response would be an example of using affirmation in motivational interviewing?
A patient with diabetes has made a small improvement in their diet but hasn't yet achieved their target A1c level. Which response would be an example of using affirmation in motivational interviewing?
A patient who has recently been diagnosed with diabetes says, "I know I need to make changes, but it all feels so overwhelming. I don't even know where to start." How could you use an open-ended question to explore this further?
A patient who has recently been diagnosed with diabetes says, "I know I need to make changes, but it all feels so overwhelming. I don't even know where to start." How could you use an open-ended question to explore this further?
Which of the following is NOT a characteristic of motivational interviewing?
Which of the following is NOT a characteristic of motivational interviewing?
A patient with poorly controlled diabetes attends their appointment. They state 'I know my numbers are bad. I don't know why I even bother coming in here. Nothing changes.' Which of the following is the most appropriate response?
A patient with poorly controlled diabetes attends their appointment. They state 'I know my numbers are bad. I don't know why I even bother coming in here. Nothing changes.' Which of the following is the most appropriate response?
You have been working with a patient utilizing motivational interviewing techniques. At the end of the session, what would be the MOST effective way to ensure the patient feels heard an understood?
You have been working with a patient utilizing motivational interviewing techniques. At the end of the session, what would be the MOST effective way to ensure the patient feels heard an understood?
A patient says, "I hate exercising. It's boring and I never have time." Which of the following options is the BEST reponse?
A patient says, "I hate exercising. It's boring and I never have time." Which of the following options is the BEST reponse?
Which of the following is NOT a characteristic of reflective listening?
Which of the following is NOT a characteristic of reflective listening?
When using reflective listening with a patient, what type of talk should you primarily reflect back to them?
When using reflective listening with a patient, what type of talk should you primarily reflect back to them?
Which of the following best describes the primary purpose of reflective listening?
Which of the following best describes the primary purpose of reflective listening?
A patient says, "I know I should exercise more, but it's so hard to find the time." According to the principles of 'Change Talk', which element does this statement primarily represent?
A patient says, "I know I should exercise more, but it's so hard to find the time." According to the principles of 'Change Talk', which element does this statement primarily represent?
Which of the following is the most appropriate way to start a summary during a conversation with a patient?
Which of the following is the most appropriate way to start a summary during a conversation with a patient?
How can strategically summarizing points of discussion with a patient elicit 'change talk'?
How can strategically summarizing points of discussion with a patient elicit 'change talk'?
What is the main purpose of using summaries in a conversation?
What is the main purpose of using summaries in a conversation?
During a reflective listening session, a patient states, "I want to quit smoking, but I don't think I'm strong enough." Which two elements of 'Change Talk' are represented in this statement?
During a reflective listening session, a patient states, "I want to quit smoking, but I don't think I'm strong enough." Which two elements of 'Change Talk' are represented in this statement?
A client expresses uncertainty about initiating a healthy lifestyle change. Which question would be MOST effective in understanding their perspective, according to the principles described?
A client expresses uncertainty about initiating a healthy lifestyle change. Which question would be MOST effective in understanding their perspective, according to the principles described?
A patient rates the importance of attending physical therapy as a '2' out of 10. Following the principles outlined, what is the MOST appropriate next step for the healthcare provider?
A patient rates the importance of attending physical therapy as a '2' out of 10. Following the principles outlined, what is the MOST appropriate next step for the healthcare provider?
A client is hesitant to seek therapy. Using the principles of motivational interviewing, which approach would be LEAST effective?
A client is hesitant to seek therapy. Using the principles of motivational interviewing, which approach would be LEAST effective?
A patient states they are very confident they could start exercising, but they don't see the point. Which element of motivation is MOST lacking?
A patient states they are very confident they could start exercising, but they don't see the point. Which element of motivation is MOST lacking?
A patient expresses low confidence in their ability to adhere to a new medication schedule. What strategy would be MOST effective in boosting their confidence, according to the information?
A patient expresses low confidence in their ability to adhere to a new medication schedule. What strategy would be MOST effective in boosting their confidence, according to the information?
According to the principles, what is the relationship between importance, confidence, and readiness?
According to the principles, what is the relationship between importance, confidence, and readiness?
What question is designed to understand the benefits that the patient envisions in seeking a therapist?
What question is designed to understand the benefits that the patient envisions in seeking a therapist?
After a patient provides a number on the importance ruler, which follow-up question is designed to uncover potential motivators?
After a patient provides a number on the importance ruler, which follow-up question is designed to uncover potential motivators?
A clinician is trying to understand a patient's perspective on their alcohol consumption. Which question would be MOST effective in eliciting a detailed response about their motivations, fears, and past experiences?
A clinician is trying to understand a patient's perspective on their alcohol consumption. Which question would be MOST effective in eliciting a detailed response about their motivations, fears, and past experiences?
A doctor is working with Mr. Jones, a diabetic patient with an A1c of 9.8 and blood pressure of 150/94. The doctor wants to use open-ended questions to understand Mr. Jones's perspective. Which of the following is the MOST appropriate initial question?
A doctor is working with Mr. Jones, a diabetic patient with an A1c of 9.8 and blood pressure of 150/94. The doctor wants to use open-ended questions to understand Mr. Jones's perspective. Which of the following is the MOST appropriate initial question?
Which of the following affirmations would be MOST effective in supporting a patient who has made a recent positive change, such as adhering to a diet?
Which of the following affirmations would be MOST effective in supporting a patient who has made a recent positive change, such as adhering to a diet?
A patient states, "I keep trying to exercise, but I always end up quitting after a week." Which of the following responses demonstrates reflective listening?
A patient states, "I keep trying to exercise, but I always end up quitting after a week." Which of the following responses demonstrates reflective listening?
A patient is hesitant to discuss their struggles with substance abuse. How could you use affirmations to build rapport?
A patient is hesitant to discuss their struggles with substance abuse. How could you use affirmations to build rapport?
A patient says, "I feel overwhelmed by all the changes I need to make to manage my diabetes." As a healthcare provider, what is the MOST appropriate reflective listening response?
A patient says, "I feel overwhelmed by all the changes I need to make to manage my diabetes." As a healthcare provider, what is the MOST appropriate reflective listening response?
After discovering that Mr. Jones hasn't been monitoring his blood sugar consistently, which of the following questions is MOST likely to reveal his reasons?
After discovering that Mr. Jones hasn't been monitoring his blood sugar consistently, which of the following questions is MOST likely to reveal his reasons?
Which affirmation best acknowledges the challenges that a patient faces when dealing with a chronic condition?
Which affirmation best acknowledges the challenges that a patient faces when dealing with a chronic condition?
When using a confidence ruler (0-10 scale) and a client rates themselves at a 0 or 1, what is the most appropriate next step?
When using a confidence ruler (0-10 scale) and a client rates themselves at a 0 or 1, what is the most appropriate next step?
Following the confidence questioning, what is the purpose of asking 'What would it take to move your number a little higher?'
Following the confidence questioning, what is the purpose of asking 'What would it take to move your number a little higher?'
A client rates their confidence in starting a new exercise routine as a '3'. Which follow-up question is MOST likely to elicit information about what contributes to their current level of confidence, rather than focusing on barriers?
A client rates their confidence in starting a new exercise routine as a '3'. Which follow-up question is MOST likely to elicit information about what contributes to their current level of confidence, rather than focusing on barriers?
In the context of motivational interviewing, reflecting on the reasons a client gives for their confidence level primarily helps the practitioner to:
In the context of motivational interviewing, reflecting on the reasons a client gives for their confidence level primarily helps the practitioner to:
A patient is working to change a behavior. Using a scale of 0 to 10, they rate their confidence as an 8. According to the principles of eliciting confidence, what would be the BEST question to ask next?
A patient is working to change a behavior. Using a scale of 0 to 10, they rate their confidence as an 8. According to the principles of eliciting confidence, what would be the BEST question to ask next?
What is the MOST important reason for asking about a client's confidence level in achieving a specific health-related goal?
What is the MOST important reason for asking about a client's confidence level in achieving a specific health-related goal?
A new client tells you that they are not confident that they can cut back on sugars in their diet. Using the confidence ruler technique, once they state their number, what is the MOST appropriate interview technique to use next?
A new client tells you that they are not confident that they can cut back on sugars in their diet. Using the confidence ruler technique, once they state their number, what is the MOST appropriate interview technique to use next?
Why is it important to reflect on the reasons given by a patient for their confidence score (on a scale of 0-10), regarding a health behavior change?
Why is it important to reflect on the reasons given by a patient for their confidence score (on a scale of 0-10), regarding a health behavior change?
Flashcards
Diabetes Goal Attainment
Diabetes Goal Attainment
Many diabetic patients are not at their A1c, lipid, BP, or weight goals.
Diabetes Management Complexity
Diabetes Management Complexity
Significant lifestyle changes, including diet adjustments and increased activity, are needed.
Challenges in Diabetes Management
Challenges in Diabetes Management
Diet, activity, costs, depression, burnout, anger, denial and poor understanding.
Ineffectiveness of Fear Tactics
Ineffectiveness of Fear Tactics
Signup and view all the flashcards
Stages of Change
Stages of Change
Signup and view all the flashcards
Motivational Interviewing
Motivational Interviewing
Signup and view all the flashcards
Patient-Centered Approach
Patient-Centered Approach
Signup and view all the flashcards
Safe Setting Importance
Safe Setting Importance
Signup and view all the flashcards
MI's Goal in Diabetes Care
MI's Goal in Diabetes Care
Signup and view all the flashcards
Engaging (MI Process)
Engaging (MI Process)
Signup and view all the flashcards
Guiding (MI Process)
Guiding (MI Process)
Signup and view all the flashcards
Evoking (MI Process)
Evoking (MI Process)
Signup and view all the flashcards
Planning (MI Process)
Planning (MI Process)
Signup and view all the flashcards
Open Questions (MI)
Open Questions (MI)
Signup and view all the flashcards
Affirmations (MI)
Affirmations (MI)
Signup and view all the flashcards
Closed Questions
Closed Questions
Signup and view all the flashcards
Patient Disclosures
Patient Disclosures
Signup and view all the flashcards
Open Questions
Open Questions
Signup and view all the flashcards
Key Open-Ended Questions
Key Open-Ended Questions
Signup and view all the flashcards
Affirmations
Affirmations
Signup and view all the flashcards
Components of Affirmations
Components of Affirmations
Signup and view all the flashcards
Reflective Listening
Reflective Listening
Signup and view all the flashcards
What are Affirmations?
What are Affirmations?
Signup and view all the flashcards
What is Reflection?
What is Reflection?
Signup and view all the flashcards
Sustain Talk
Sustain Talk
Signup and view all the flashcards
Change Talk
Change Talk
Signup and view all the flashcards
DARN-CAT
DARN-CAT
Signup and view all the flashcards
Summary
Summary
Signup and view all the flashcards
Strategic Summarization
Strategic Summarization
Signup and view all the flashcards
Desire (Change Talk)
Desire (Change Talk)
Signup and view all the flashcards
Ability (Change Talk)
Ability (Change Talk)
Signup and view all the flashcards
Motivation for Change
Motivation for Change
Signup and view all the flashcards
Importance (in motivation)
Importance (in motivation)
Signup and view all the flashcards
Confidence (in motivation)
Confidence (in motivation)
Signup and view all the flashcards
Readiness Equation
Readiness Equation
Signup and view all the flashcards
Importance & Confidence Discussion
Importance & Confidence Discussion
Signup and view all the flashcards
Importance Ruler
Importance Ruler
Signup and view all the flashcards
Initial Question (Importance Ruler)
Initial Question (Importance Ruler)
Signup and view all the flashcards
Follow-up Question (Importance)
Follow-up Question (Importance)
Signup and view all the flashcards
Confidence Ruler
Confidence Ruler
Signup and view all the flashcards
Eliciting Confidence
Eliciting Confidence
Signup and view all the flashcards
Enhancing Confidence
Enhancing Confidence
Signup and view all the flashcards
Reassessing Values
Reassessing Values
Signup and view all the flashcards
Reflecting Priorities
Reflecting Priorities
Signup and view all the flashcards
Study Notes
- Motivational interviewing aims to help patients with diabetes self-management using open questions, reflections, affirmations and summaries.
Prevalence of Uncontrolled Diabetes
- Many diabetic patients are not at the goal for A1c , Lipids, BP, and weight showing that over 90% are still struggling
Barriers to Diabetes Management
- Diabetes management is not a matter of simply taking a pill
- Managing diabetes often needs a significant lifestyle change
- Significant life style changes include changing diet, activity, costs, depression, burnout, anger, denial, and poor understanding
Drawbacks of Physician Approach
- Describing potential complications of their condition doesn't result in behavior change
- Fear tactics emphasizing future suffering are not effective, especially when people are burdened with pain or other challenges
- Lectures on statistics and facts can cause patients to disengage
Patient Readiness for Change
- Change is a process, not an event including pre-contemplation, contemplation, preparation, action, maintenance and relapse
Motivational Interviewing
- It is a collaborative counselling technique designed to strengthen motivations for behavior change
- It can be incorporated into routine patient care as a patient centered approach where they do most of the talking
- It involves creating a safe setting for people to consider change
- It has been successfully applied to substance abuse management and diabetes
- Goal is to encourage discussion about behaviors associated with diabetes self-management, and improve motivation and confidence for change
Motivational Interviewing Principles
- Resist the righting reflex
- Understand the patient's motivation
- Listen to your patient
- Empower your patient
Motivational Interviewing Spirit
- Collaboration with the patient and avoid taking the expert role
- Evocation of the patient's desires and reasons for change, giving advice only with permission
- Autonomy, respecting the patient's autonomy and allowing control over their decisions
- Compassion: promote the patient's welfare
Four Processes of Motivational Interviewing
- Engaging including taking time to build a relationship
- Guiding in order to identify areas of beneficial change and evoke internal motivation
- Planning a behavior strategy
The Four Basic Motivational Interviewing Skills (OARS)
Open questions
- Questions that cannot be answered with one word
Affirmations
- Statements to form a respectful, collaborative relationship by acknowledging talent, quality, or commitment
Reflections
- Conversational statements for discussion
Summarization
-
A summary of the questions to promote shared decisions made during a discussion
-
Motivational interviewing assesses a patient’s confidence, ability, and commitment for them to achieve the goals and provide successful behavior change
Closed Questions:
- Answered with a yes or no, where the person asking does most of the talking
- They can be judgmental, and force the patient into a certain answer
Open Questions:
- Cannot be answered with yes or no and allow a fuller discussion
- They are non-judgmental, and allow the patient to think out loud and use their own words
Examples of starter questions for closed ended and open ended
- Closed Ended: "Do you...?" and "Are you...?"
- Open Ended: ‘Tell me about...?" and "Help me understand...?"
Examples of questions:
- Closed Ended: "Are you here for your annual check-up?" vs. Open Ended: "What would you like to talk about today?"
- Closed Ended: "Are you having any problems with your child's behavior?" vs. Open Ended: "Tell me about successes you've had with managing your child's behavior..."
Open-Ended Key Questions to encourage patients to have conversation
- What does it mean to you about your health?
- What do you think has to change?
- What are the most important reasons to you for a change?
Affirmations
- Statements of empathy and support of past accomplishments and strengths
- They anchor patients to their strengths to address behaviours
- Use ‘you’ to emphasize the patient showing you are a real survivor for example
Acknowledgement of
- Struggles or difficulties and Successes,
- Identifying skills, strengths, goals and values
- Notice and appreciate good actions, encouraging positive reinforcements
Be specific about the affirmations
Reflective Listening Considerations
- Reflections are statement, and not a question and it captures what has been said and/or what the patient is feeling
Reflective Listening
- Allows people to hear things they may have only been thinking while understanding what they said
- Active listening to words and emotions, requires attention
- Reflections are not giving advice and are not a question
Tips when interacting with the patients
- Listen and acknowledge; remain supportive and non-judgemental.
- Reflect change talk vs sustain talk.
- Help clients discover solutions and don't offer advice.
Change talk includes:
- Desire- "I want to..."
- Ability- ‘'I can..."
- Reason- "Important..."
- Need- ‘I should..."
- Commitment- "I will..."
- Activation- "I am ready..."
- Taking steps- "I am doing it now.."
Example stems when reflecting
- "It sounds like...", ""It has been hard for you..."" or "You're feeling..."
Reflection Types
- Restating content is saying what was said in the conversation directly; making a guess about their feelings or the exact meaning behind their statement
- Siding with the patient to what they are stating and identify the ambivalence
Reflective Listening Considerations
- Reflect about the statements or emotions; helps to understand key issues; shows that thoughts matter
- Encourages conversation flow/rapport; never has to be perfected; allow the person to talk, feel understood
Summarizing is restating the key points which makes it useful in the conversation
- It can include thoughts and concerns while thinking of new ideas
- It creates a plan for their steps and feel confident about moving forward
Consider the following phrase:
-“Let me what you’ve said so far.." or "Here's what I've heard you tell me…"
-Summaries can connect discussions strategically to make connections -This can elicit change talk or statements the patient can signal they are willing to change
- You can also include; " I am wondering what you thinking in the plans."
Motivation to take care of themselves and their family can factor in
-Confidence to their ability to change, however small steps leads to larger goals increases confidence
- Importance+ Confidence = Readiness
Health care provides discuss issues because
-People may feel important but lack confidence
- Health care are a major part of making a realistic change of action
- These include; "How to make a realistic with you?"
- To help increase the amount and values to create benefits to behavior changes, boosting actions and connecting personal values to behavior
Help patients identify values, understand why are they important, and decide what link for their health
- It is best to stay judgement free and let the patients make a tie to connect for themselves
- Help them think about how they make changes and can use open-ended questions
To best move towards action
- Ask if there is a realistic action plan for behavior change- " You can see yourself from drinking 4 to 1or 2."
- First share the patients thought about what they are going for and agree with it with " Elicit-Provide-Elicit" .
It is important to note if some will be ready for an action plan such as
- "You are achieveing a heathly weight but are ready to start yet".
- If there are any values, confidence to depend to make a change they can respond with small changes or simply about making about the change
- Do not push, the way for building motivation.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore motivational interviewing techniques. Questions cover guiding principles, affirmations, open vs. closed questions, and evoking change talk. Learn how to effectively apply these skills in health coaching and patient interactions.