Responding to sustain talk and discord
Sustain talk or discord?..... "You don't seem to understand that I can't stop drinking this close to Christmas"
Discord
True or False? Accurate reflections can include elements that a client doesn't say.
True.
True or False? Evocation means you are drawing out motivation and resources from within the client.
True
What is the acronym (initial letters) for types of change talk?
DARN-CAT
True or false? Focusing is the means whereby you get the client to agree to the worker's agenda.
False. Focusing is a process of mutually establishing a direction for the conversation.
Tell us what is an 'amplified reflection'?
An amplified reflection involves making the reflection more exaggerated or extreme. Tone is empathic. It might elicit the other side of the person's ambivalence.
What does OARS stand for? Correctly identify the 4 key skills.
O-Open Ended Questions A-Affirmations R-Reflections S-Summaries
What is the righting reflex?
This is the urge to tell a person the solution to their problem, how to fix it. A more helpful approach is to elicit the person's own ideas about change.
Is there change talk here? "My partner has been trying to get me to take up competitive running. I think I could do it."
"I think I could do it" is change talk - ability type.
Transform this closed question into an open question:
"Have you considered getting help for your difficulties?"
Some possibilities:
"What do you think about getting help?"
"How would you feel about getting help with this?"
What is a double-sided reflection? How is it most helpfully arranged?
A double-sided reflection incorporates both sides of the person’s ambivalence. The most helpful arrangement is: (sustain perspective)..AND.. (change perspective)
Convert this closed question to an open question: "Do you want to get a job?"
Some examples: "What do you think about getting a job?" "How do you feel about getting a job?" "What are your thoughts on getting back into work?"
Which of these worker utterances do you prefer, and why? "I can give you some helpful tips if you're interested" OR "What might help you most going forward?"
"What might help you most going forward?" is preferred because it is evocative - elicits the person's own ideas about what might help.
Give an example of an evocative question - a question likely to elicit change talk.
Some examples:
What would you like to be different?
What might be some reasons for making a change?
How might you take things forward?
What is important to you?
What sort of thing could you say to a person to emphasise their autonomy?
There are many ways of expressing autonomy. Some examples are: "It's really up to you"
"It's your choice on how to take things forward"
"You're the only person who will decide what, if anything, to do"
Respond to the following using a reflection: "You're not helping me"
Some possibilities:
Straight reflection: "You're not getting the help you want"
Amplified reflection: "This is no help at all."
Double-sided reflection: "You're not finding this helpful, and you'd like something that it is going to be of more use."
Improve this affirmation: "I think you've done very well dear, you worked very hard and I'm pleased with what you've achieved"
Take out 'dear'.
Switch from 'I' perspective to 'You' perspective.
Name 4 components of MI spirit (Hint: PACE).
P-Partnership A-Acceptance C-Compassion E-Evocation
What is the helpful follow-on question when using the importance ruler? (How important on a scale 1 to 10?)
Why did you put yourself at that number rather than a number a bit lower. (e.g. Why did you put yourself at a 5 rather than a 3 or 4?)
Name and describe the two types of COMPLEX reflections.
Paraphrasing - adding in some underlying unspoken meaning
Feeling reflection - incorporating some emotional aspects
Respond to this sustain talk: "I don't think I can do this task. I've tried many times and I just can't get it".
Some possibilities:
Straight reflection: "You've tried many times"
Amplified reflection: "It feels too difficult"
Double-sided reflection:"This task is really hard, and yet it is important to you to keep trying."
Find a COMPLEX REFLECTION to respond to this statement: "Because of the pandemic lockdown, I haven't seen my son for a long time."
Some possibilities:
"You really miss him"
"He's really important to you"
"You feel quite isolated at the moment."
Is this worker statement consistent with MI Spirit? "What you should do is book an appointment with an employment advisor."
Inconsistent with MI spirit. 'Shoulding' doesn't acknowledge the person's autonomy.
Find a helpful response: " It's important for me to take care of my family, but I'm finding it hard to get work at the moment."
"It's important for me to take care of my family" is need-type change talk. Reflecting the change talk could be helpful. A double-sided reflection or amplified reflection or affirmation are also helpful options.
Tell us two techniques that can be particularly helpful in evoking change talk.
Choose from: Asking an evocative question; Asking for elaboration/examples; looking forward; looking back; querying extremes; importance ruler; exploring goals and values.