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Open-ended questions are ones that keep the conversation going; ones that cannot be answered by one word (like yes or no). You are trying to explore the ...
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All materials adapted from Motivational Interviewing , 2nd^ and 3rd^ editions, by William R. 1
Open-ended questions are ones that keep the conversation going; ones that cannot be answered by one word (like yes or no). You are trying to explore the ambivalence (both sides) and augment the discrepancy (difference) between them. We want to avoid having them feel judged. What follows are examples:
All materials adapted from Motivational Interviewing , 2nd^ and 3rd^ editions, by William R. 2
Commitment Self-Control Character Kindness Obstacles Hard work Will Generous Sensitivity
All materials adapted from Motivational Interviewing , 2nd^ and 3rd^ editions, by William R. 4
C: I don’t see how I ‘ve gained weight eating just a little bit of candy now and then. The nurse practitioner just two months ago said that I was doing fine. P: It doesn’t seem possible that you could have gained weight so quickly even though you recognize that you’ve slacked off in the last months.
C: I really don’t see how I could take night classes now with the baby, and all. P: So on the one hand you’d like to begin taking night classes and, on the other hand, you just don’t see where you’ll get the time to start right now.
Reframing: Provides a different meaning or perspective allowing the client to take a new way of looking at something that is more consistent with the behavior change or change talk.
C: I can party without getting really wasted better than my friends. P: You can drink more without feeling the effects including the warning signs that most people use to know when to stop drinking.
C: I ‘ve tried quitting three times before and after a week or so each time, I start back. I don’t understand; it’s hopeless. P: You’ve been serious enough about quitting smoking that you’ve tried several times and are here today. People who aren’t serious and believe they are truly hopeless don’t keep trying; they give up. I’m impressed with your perseverance (affirmation).
Emphasizing Autonomy: Reminds the person that it is their choice to decide what to do.
C: I don’t know if going back to school will really help me get a better job. I’m so busy taking care of my children and I never even liked school before. I’m worried if I did go, I might not do very well. P: You aren’t sure what you want to do about getting a better job. It is really up to you how you decide to handle this situation, as difficult as it is.
C: I really don’t know what I’d like to do about my relationship He provides me soe support, but I don’t trust him. But I don’t like anyone telling me what I should do. P: You know it’s really up to you. I’m not going to tell you what you should do.
Changing Focus (when you hit a wall, turn left): moving the focus from something that the patient/client seems unwilling to discuss at this time.
C: I’m sick of things. Sick of all of it. I want to eat the food I like. I can’t see making any changes at this point. I don’t really care what happens. P: You are not interested in talking about your diet and you’re frustrated that your health condition requires some changes in your eating. So I wonder what you might be willing to talk about to improve your health.
All materials adapted from Motivational Interviewing , 2nd^ and 3rd^ editions, by William R. 5
Agreeing with a twist: A reframe prefaced with a reflection that sides with the sustain talk. You agree with part of what the patient/client has said but you emphasize a different aspect of the conversation.
C: I just need to cut down on the amount of sugar I eat; I’m not going to give it up no matter what you say! P: What you want is to be able to eat what you want without the worry.
Coming Alongside or “Well, if you insist…”: this is rather like a paradox where you simply go along with the client, agreeing with whatever they say; be careful not to overuse this one - it can backfire!
C: I can’t do this anyway. I’m nothing but a loser! P: This might not be the right time to make this change; you might fail after all.