This lecture explores how authenticity in motivational interviewing supports person-centered change, how to support the change process of self-discovery, how to change talk moves an individual closer to their authentic self, and how that authentic self supports building a life that matters for people.

1. Motivating Change
Class 4 – Change Talk moving to authentic
wholeness

2. CLASS OUTLINE
 10 Min – Review, Connect and Reflect, 1 Thing to Share
from Reading
 20 Min – Mini-topic Lecture: Change Talk moving to
authentic wholeness.
 20 Min – True North Exercise: Outlining My Mission,
Motivation and Gifts in Clinical Relationship ‘DARN CAT’
 20 Min – Learning Pod ‘Skill Discussion’ Exploring seeing
and engaging ‘DARN CAT’
 10 Min – Learning Video, Understanding Change Talk
 20 Min – Role Plays
 10 Min – Class Discussion
 10 Min – Recap, Reflect, Wrap up and Announcements

3. CONNECT
AND
REFLECT
This week in
learning MI?
Share 1 Thing
from That
Mattered to
You From the
Reading?

4. TRUE NORTH EXERCISE
Who are we in clinical
relationships what is our
true north

5. TRUE NORTH LEARNING PODS
EXPLORE WHO YOU REALLY WANT TO BE
IN RELATIONSHIP AS PART OF MI AND
OR AS A THERAPIST DO BRIEF WRITING
USING PROMPTS OFFERED BY
PROFESSOR. VALUES REFLECTION &
WRITING MY PERSONAL MISSION
01
IN SMALL GROUPS DISCUSS THE VALUES
AND TRUE NORTH MISSION YOU
DEVELOPED. EXPLORE HOW YOU NOW
WHEN YOU LIVE THESE VALUES AND
HOW YOU CAN COURSE CORRECT WHEN
YOU ARE OFF THE VALUES. EXPLORE
HOW TO CELEBRATE YOUR SUCCESSES
AS A DAILY HABIT AND REFLECT ON
YOUR GROWTH AS A DAILY HABIT.
02
SHARE SOME VALIDATIONS WITH PEERS
ABOUT VALUES AND TRUE NORTH
MISSION AND WHAT YOU LEARNED
FROM THEM.
03

6. Motivating Change
Centering in Relational Power

9. CHANGE TALK AND THERAPIST
BEHAVIORS
Client change talk was significantly more likely to immediately follow individual therapist behaviors: [affirm
(p = .013), open question (p < .001), simple reflection (p < .001), and complex reflection (p < .001)],
Change talk was significantly less likely immediately following others (giving information (p < .001) and closed
question (p < .001)].
Sustain talk was significantly more likely to follow therapist use of open questions (p < .001), simple
reflections (p < .001), and complex reflections (p < .001)
Sustain talk was significantly less likely to occur following therapist use of therapist affirm (p = .012), giving
information (p < .001), and closed questions (p < .001).
Apodaca, T. R., Jackson, K. M., Borsari, B., Magill, M., Longabaugh, R., Mastroleo, N. R., & Barnett,
N. P. (2016). Which individual therapist behaviors elicit client change talk and sustain talk in
motivational interviewing?. Journal of substance abuse treatment, 61, 60-65.

11. Spirit
Principa
ls
Microsk
ills Change
Talk
Commitm
ent
Behavior
Change
ACE - A: Autonomy, Collaboration, Evocation
Acceptance
Role with Resistance, 2. Express Empathy, 3.
Develop Discrepancy, 4. Support Self-Efficacy
Desire, Ability, Reason,
Need
Commitment,
Activation, Taking
Steps
OARS - O = Open Ended Questions, A =
Affirmation,
R = Reflective Statements, S = Summaries

13. Unfortunately, when relapse
occurs many deem treatment
a failure. This is not the case:
Successful treatment for
addiction typically requires
continual evaluation and
modification as appropriate,
similar to the approach taken
for other chronic diseases.
https://www.drugabuse.gov/publica
tions/principles-drug-addiction-
treatment-research-based-guide-
third-edition/frequently-asked-
questions/how-effective-drug-
addiction-treatment

15. Motivational
Interviewing
Hill Metaphor
Pre- Cont. Prep. Actio
Types of Change Talk
D = Desire talk is expressions of
desire to change
A = Ability or expressions that
someone feels able to change.
R = Reasons the patient explores
their responses that they want to
change
N = Needs the patient explores
needs for change.
________________________________
C = Commitment at this point
the patient has crossed into
action. They are exploring their
commitments for change,
A = Actions change talk is
exploring the actions needed to
be successful.
T = Taking Steps is the time

16. ROLLING WITH RESISTANCE…
Signs of Resistance
Arguing with your point.
Interrupting the clinician
Negating or denial
Sustain talk/Ignoring facts
----------------------------
--------------------
These are a cue to: Change
strategies, Normal expression of
ambivalence, related to
interpersonal dynamic
How to Roll with Resistance
Reflections – Once you have
engaged the patient using double
sided reflections can help support
change while allowing ambivalence
Shift Focus – Don’t push against the
resistance shift the focus to
exploring the ambivalence
Come along side – Join the person
and explore their thoughts, fears
and concerns.
Emphasize Choice and Control –
Reinforce that the individual is the
one with choice and power and that
they can work on their goals and
visions.

19. LEARNING PODS
DARN CAT SKILL
PRACTICE
Small group
learning and
development.

20. An adult patient who uses
methamphetamine receives
a brief intervention.
SBIRT Oregon Training
Video
Listening for change talk… While
watching this video count the
number of times that you hear each
kind of change talk. Considering MI
Skills after the video is over choose
one moment of change talk and
explore how you would valite or
increase exploration of change talk.
http://www.sbirtoregon.org/video-demonstrations/

23. SMALL GROUPS ROLE
PLAYS MI
Use Ask-Evoke-Ask model to
work through a role play using
the DARN CAT skills.
Take 10 minuets for a brief role
play and then switch. Discuss
learning.
Either practice a role play or a real
play on the health change you set
the goal to work on in the last
class.

24. Self Evaluation Form… Committments
for Change.
What are you able to commit to for
exploring and increasing MI Skills in
your patient interactions?

25. CLOSE AND REFLECTION
Working on Embodying these Skills in Life

26. REFERENCES
1. Link: https://youtu.be/XsmY1VVxUIE
2. Link: https://youtu.be/T_iBbEr5e4M
3. Apodaca, T. R., Jackson, K. M., Borsari, B., Magill, M., Longabaugh, R., Mastroleo, N. R., & Barnett,
N. P. (2016). Which individual therapist behaviors elicit client change talk and sustain talk in
motivational interviewing?. Journal of substance abuse treatment, 61, 60-65.
4. NIDA. 2020, June 3. How effective is drug addiction treatment?. Retrieved from
https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-
guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment on
2022, January 26
5. Saitz, Richard. “How to Increase Motivation - Boston University.” Boston University , BU,
https://www.bumc.bu.edu/care/files/2012/07/09-SAITZ-MI.pdf.
6. William Miller & Stephen Rollnick. Motivational interviewing: Helping people change (3rd edition).
(2013). New York, NY: Guilford Press.
7. Wyatt, J. G., Soukup, S. M., & Blomquist, M. E. (2021). Motivational Interviewing Skills.
8. Link Skills Overview:
https://iod.unh.edu/sites/default/files/motivational_interviewing_tips_for_working_with_youth-
oars.pdf