This lecture explores a basic overview of Motivational Interviewing, the spirit of MI and person-centered support for motivational change.

1. Motivating Change
Class 1 – OARS for Change - Getting unstuck
from habit through a flow-based conversation

2. CLASS OUTLINE
 10 Min – Review, Connect and Reflect, 1 Thing to
Share from Reading
 10 Min – Mini-topic Lecture
 10 Min – Learning Pod ‘Skill Discussion’
 10 Min – Learning Video
 30 Min – Experiential Learning
 30 Min – Class Discussion and Cases
 10 Min – Recap, Reflect, Wrap up and
Announcements

3. REVIEW COURSE
SYLLABUS AND
ASSIGNMENTS
Review of Course
Syllabus,
Connect and
Reflect,
Share 1 Thing
from Reading
Set Intention for
self-growth, role
in group, and
hope for clients
from class.

4. Motivating Change
Lecture on OARS Unfolding to Yourself

5. True
Self
I Am
Human
I Make
Mistake
s
Need
Suppor
t
Have
Unique
Skills
People
Respect
My
Boundari
es
I am
strong
and
whole
My
emotiona
l needs
are
important

9. MI Spirit comes from the foundation in humanistic psychology.
This foundation holds that people when supported to continue
to be authentically engaged with their experience will move
towards their own best health.
ACE is the Center of MI Spirit
Autonomy
Collaboration
Evocation
Authorit
y
Coercion
Educatio
n
VS

10. Who can wait quietly while the mud settles?
Who can remain still until the moment of action?
Observers of the Tao do not seek fulfilment.
Not seeking fulfillment, they are not swayed by
desire for change.
Tao Te Ching - Lao Tzu - Chapter 15

11. Motivational Interviewing – Your main goal in MI is to offer
presence and support a person opening to change they
want and explore change talk and avoid triggering the old
habit of sustain talk. Your presence keeps moving forward
patterns that are stuck. Change talk is talk that is
motivated towards a new more authentic direction and
sustain talk is focused on reasons why things are the way
they are.
More Change Talk = More Change
More Sustain Talk = More of the Same

12. Chang
e Talk
Sustain
Talk
1. MI is a person centered approach not a
disorder centered approach to health
and change.
2. Motivation has stages that can be
moved through and is not a character
trait.
3. Defensiveness/resistance is
therapeutic.
4. Therapist style impacts motivation and
behavior.
5. Resistance and change talk are both
part of the core challenge of
ambivalence.
Do More
that
supports…
Do less that
increases…

16. 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

17. LEARNING PODS
REFLECTIVE
STATEMENTS
Small group
learning and
development.

18. Presence and
Being With is
More Powerful
than
Technique.
Real therapy
works with all
four areas.

19. The Shift from Struggle to Connection

20. REFLECTIVE
STATEMENTS
1. Simple Reflection: Simply Repeats or
Paraphrases the patient response.
2. Complex Reflection: Hears what the
person says and reflects back with
new information and input.
3. Amplified Reflection: Amplifies a
particular point expressed by the
patient.
4. Double-Sided Reflection: Includes
both sides of the ambivalence.
5. Metaphor Reflection: Uses a
metaphor to capture the feeling and
experience of the patient.
6. Meaning Reflection: Captures depth
of meaning and reflects it back to a
patient.
7. Reflection of Feeling: Reflects back
the feeling state the patient
expressed.
• Reflective statements are statements
where you reflect back to a patient what
they have said.
• The ratio of reflective statements (RS) to
questions should be about RS to every
questions.
• Start interactions with simple reflective
statements and move to more deep and
integrated reflective statements at the
middle of the session.
• Metaphors, stories and emotional
reflections are types of reflective
statements used when there has been a
clear establishment of connection.
Types of Reflective
Statements

21. SMALL GROUPS DISCUSSIONS MI
In your small group come up with a name for their learning
Pod.
Exchange numbers, the goal to be people you can call with
consult questions on how to apply MI or other clinical
questions.
Set personal health goal for change.
In small groups discuss type of MI reflective statements, when
they will be used and which ones might have different impacts.
What would trauma do to the way you use clinical statements,
what would attachment difficulties do the way you use
reflective statements, what would change if you were working
with some one who had a different social location than you.

22. LEARNING VIDEO Growing the capacity to
change through presence.

26. GROUP SKILLS PRACTICE Use the Skills
https://www.youtube.com/watch?v=80XyNE89
https://www.youtube.com/watch?v=80XyNE89eCs

27. REFLECTIVE
STATEMENTS
1. Simple Reflection: Simply Repeats or
Paraphrases the patient response.
2. Complex Reflection: Hears what the
person says and reflects back with
new information and input.
3. Amplified Reflection: Amplifies a
particular point expressed by the
patient.
4. Double-Sided Reflection: Includes
both sides of the ambivalence.
5. Metaphor Reflection: Uses a
metaphor to capture the feeling and
experience of the patient.
6. Meaning Reflection: Captures depth
of meaning and reflects it back to a
patient.
7. Reflection of Feeling: Reflects back
the feeling state the patient
expressed.
• Reflective statements are statements
where you reflect back to a patient what
they have said.
• The ratio of reflective statements (RS) to
questions should be about RS to every
questions.
• Start interactions with simple reflective
statements and move to more deep and
integrated reflective statements at the
middle of the session.
• Metaphors, stories and emotional
reflections are types of reflective
statements used when there has been a
clear establishment of connection.
Types of Reflective
Statements

28. EXERCISE – REFLECTIVE STATEMENT
SPEED THERAPY
1. Before you start choose who will go first and each person choose one
type of reflection for when you are the clinician.
2. Choose one person to be the clinician, one person to be the ‘patient.’
3. In your small groups of four use the ask, reflect, ask model to ask about
diabetes and practice one of the reflective question styles.
4. Using affirmation based empathy share what you saw go well in the
interaction.
5. Once you have completed a question switch people in the therapist seat
and who’s in the client seat.
6. You can use your handout incase you forget the question and the
statement.
7. Come back to the big group and two or four groups will share their
expreinces.

29. THERAPY SKILLS
PRACTICE
Reflective Statements
‘I want my diabetes to be less out of
control. But I love sugar! Treats make me
feel better. I live in a really stressful
home. I know they are not good for me
but if they are around I can’t stop
myself.”

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

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

32. REFERENCES
1. Coping.us. 2022. Coping.us. [online] Available at:
<https://coping.us/motivationalinterviewing/learningmispeak.html> [Accessed 5
January 2022].
2. Link: https://youtu.be/ZxKZaKFzgF8
3. Link MI One Session: https://youtu.be/oSZljATX25s
4. Link MI Video with Founder: https://youtu.be/DSHh6V9yNzg
5. Marker, I., & Norton, P. J. (2018). The efficacy of incorporating motivational
interviewing to cognitive behavior therapy for anxiety disorders: A review and meta-
analysis. Clinical Psychology Review, 62, 1-10.What is Motivational Interviewing:
https://youtu.be/reTb-x6UOmY
6. Pauwels, E., 2022. Motivational Interviewing 24seven. [online] SlideServe. Available at:
<https://www.slideserve.com/early/motivational-interviewing-24seven> [Accessed 5
January 2022].
7. William Miller & Stephen Rollnick. Motivational interviewing: Helping people change
(3rd edition). (2013). New York, NY: Guilford Press.
8. Wyatt, J. G., Soukup, S. M., & Blomquist, M. E. (2021). Motivational Interviewing Skills.