Reflective listening
What are two examples of how we demonstrate active listening?
~Know that we are hearing them, and that we are listening
~Know what it is that we are hearing
~Hear important things that they are saying
~Think about things that they are saying
~Steer the conversation
Reflective listening is only partly about what you say to the person. Mostly it’s about what they hear themselves saying to you!
What is the third process in Motivation Interviewing?
Evoking.
This is what we describe as the practitioner "drawing out" the person's own motivations and skills for change, not to tell them what to do or why they should do it.
4.Planning
3.Evoking
2.Focusing
1.Engaging
What is Change Talk?
Change talk is self expressed language that can become part of an argument for change.
Change talk statements are those that indicate by the participant making a possible change in their behaviour, thought, attitude, or situation.
What is definition of "Sustain Talk"?
Sustain Talk is lack of desire, lack of ability, lacking a reason and need. This should not be mistaken for a resistance. Sometimes arguing for status quo just a normal part of verbalizing the status quo side of ambivalence.
Sustain Talk is participant's language that indicates change is unlikely to occur.
What does EARS stand for ?
EARS:
1. Elaboration
2. Affirmation
3. Reflection
4.Summarizing
This question is what not to do during MI.
________is Non MI Adherent (MINA) behaviour when we encourage others for our own perception of change. _______ can be either direct and obvious, or indirect and subtle.
Persuasion is Non MI Adherent(MINA) behaviour when we encourage others for our own perception of change.
Persuasion can be either direct and obvious, or indirect and subtle.
What is acronym DARN-CATS?
Desire, Ability, Reason, Need. Commitment and Taking Steps.
Examples:
*What do you wish you would have done differently? (Evoke Desire)
*What is one step you could take to get the ball rolling? (Evoke Ability)
*What would happen if nothing happens? (Evoke Reason)
*How important is such a change for you? (Evoke Need)
*What’s your plan for how you’re going to get this happening? (Evoke Commitment)
What are the three elements present in a change talk?
1. Readiness
2. Willingness
3. Ability
What is this example of " I am not going to do it, Nope!"
Sustain talk commitment.
What are the four elements in the spirit of MI?
1.Partnership
2. Evocation
3. Compassion
4. Acceptance
What are the difference between: Information and Advice Giving
Definition of
Information Giving
•Neutral knowledge, such as resources or protocols
•Implies no preferred response, choice or action to be taken
•Information is shared when a participant asking for specific information and Practioner using reflective listening skills to listen with intention.
Definition of Advice Giving
•Implies that there is a correct course of action
•Suggests the practitioner is endorsing something
•Interviewer behaviour that is not consistent with the spirit, principles, or skills of MI
• The practitioner is not engaging in reflective listening, but instead jumps into expert trap. ( Fixer mind)
What is an example of the "Importance Ruler" ?
On the scale of 1- to 10 how important do you think it is to pursue this kind of change right now?
Amplify: Why not a higher or lower number?
To evoke participants statements about the importance or necessity of change.
What is an example of change talk using "Preparatory Language"?
Preparatory language are four components
Desire, Ability, Reason and Need
D: I want to... I hope I can...
A: I guess I could do it.. It might work...
R: If I don't do this then...
N: I've got to do something about this...I just have too...
What is, " I have done nothing about it, and I don't care. It is not important"
Sustain Talk taking steps.
What is "EPE" Information Sandwich
EPE
E-Elicit first
P- Provide information or advice or suggestion in a small increment.
E-Elicit again.
~Further information Allows the participant to process the implications of what was provided.
When is the right time to provide information?
•When a participant asked for it.
•Once a successful rapport is built between the participant and practitioner
• At any stage of the MI process.
What is an example of "Confident Ruler" statement question?
On a scale of 1 to 10 how confident you are you that could make this kind of change if you are trying to it?
Amplify: Why not ______? ( Use a lower number expressed by participant)
The confidence ruler helps the participant to strengthen their perception of their ability to change.
What are examples of "Mobilizing Languages"?
C- Commitment
" I am going to follow through here."
A- Activation
" I think I am willing to try. I am ready to give it a go.... "
T. Taking steps.
"This week I didn't eat deserts even once I walked every day too!"
What is " I can't do it, no way"
Sustain Talk ability.
What are the three Change talk skills?
1. Recognize it when you hear it.
2. Elicit it when you are not hearing it
3. Responding to it every time it emerges.
Respond to the following participant statement using the best Carkhuff response possible.
"I know I could do things differently, but if she would just back off, the situation would be a whole lot less tense. Then things wouldn't happen."
1. "If she would just back off..."
A. You are saying if you had a space you would be able to breath. ( Responding to content.)
B. You feel hopeful. (Responding to Feeling.)
2. "The situation would be a whole lot less tense..." You feel overwhelmed, because you don't have the space to think. (Responding to meaning.)
3."I know I could do things differently.."
You feel hopeful, because you believe in your ability to set boundaries. (Personalizing the meaning.)
4. You feel stuck, because you can not set boundaries when you need to. ( Personalizing Problems.)
5. You feel optimistic that you can set boundaries. (Personalizing goals.)
Spot light on a DARN-CATS on the following statements. Where is the R ?
"Except that I have to do it. I cant pay my part of the rent. Being off work has eaten up my savings, so I have to do it; that is why I am here- I want to figure out some way to cope."
D- " I want to figure out some way to cope."
A-
R- "I cant pay my part of the rent."
N-"Being off work has eaten up my savings"
-
C-I want to figure out some way to cope
A-
TS-"that is why I am here"
Except that I have to do it. ( Reason)
A reflection might go like this: "You are here to get some tools, because you know the situation requires you do something different."
There is more need language and also desire in the last statement. Coming in for a session might be considered taking steps, but it seems most clearly to be in the area of wanting some skills and coming for help to find them.
What is the "Self Perception Theory" by Darrel Bem
“I know what I think when I hear myself speak”
-Daryl Bem (Self-Perception Theory)
Sustain talk and Discord are the same thing.
True or False
Please explain.
False.
MI experts now differentiate these two types of behaviour. Trainers (MI) recommend that practitioners use the term "Sustain Talk" to identify client statements that favor maintaining the status quo, and use "Discord" to describe client behaviour that signals dissonance in the clinical relationship itself.
What is the quote by Victor Frankl when thinking about "Discord"?
"When we are no longer able to change a situation we need to change ourselves" ~Victor Frankl