RatingSamplesforMI.pdf

22

From Building Motivational Interviewing Skills: A Practitioner Workbook by David B. Rosengren. Copyright 2009 by The Guilford Press. Permission to
photocopy this exercise is granted to purchasers of this book for personal use only (see copyright page for details).

(cont.)

ExErcisE 2.2 Rating Samples for MI Spirit

Here are examples of short client statements and prac ti tion er responses. Review these exchanges and then decide if
the prac ti tion er’s response is consistent with the spirit of MI (thumbs up) or not (thumbs down). You might want to jot
down a few notes as to why you rated each sample as you did. Then look at the discussion for each example at the
end of this exercise.

1. Sarah’s husband (Richard) : I’m just furious that she lied to me and had this affair behind my back. I can’t
believe I didn’t see it. I feel like such an idiot.

Prac ti tion er: In retrospect, what signs did you overlook?

Thumbs up Thumbs down

Why?

2. Arthur: I know my dad told you I’m depressed, but I’m not. Just because I don’t want to play football doesn’t
mean I’m depressed.

Prac ti tion er: Your father is worrying needlessly. What do you think he’s seeing that makes him worry this
way?

Thumbs up Thumbs down

Why?

3. Tanya : I need to come up with some sort of plan to help me get back on track now. This health crisis has
thrown me for a loop. I can’t think about anything else. What do you think I should do?

Prac ti tion er: Well, I have some ideas about what might help, but first let me hear what you’ve already consid-
ered.

Thumbs up Thumbs down

Why?

4. Arthur: I’m not going to keep that stupid thought journal. How does it help me to monitor my “loser” thinking?
I’m coming here to feel better, and paying attention to all that makes me feel worse.

Prac ti tion er: OK, Arthur, you might be right. This works for many folks, but not everyone. Maybe we need to try
a different way to approach this. We’ve talked about other ways to approach this issue. What makes sense to
you to practice instead?

Thumbs up Thumbs down

Why?

5. Tanya : They told me I have to have this surgery right away. But I don’t trust them, so I haven’t scheduled it
yet.

23

Rating Samples for MI Spirit (p. 2 of 2)

Prac ti tion er: Why take the chance? They’re the experts, after all. Let’s call from this phone right now—maybe
you can get in this week.

Thumbs up Thumbs down

Why?

6. Sarah: I’ve had it with Richard’s guilt mongering. Okay, so I had an affair. I’m ready to end it and start working
on our marriage, but I don’t think he’s ever going to let me forget it. Maybe we should just get a divorce.

Prac ti tion er: Sarah, you are the only one who can decide if you should stay in this marriage or leave it. I wonder
what signs you would need to feel more optimistic about working on things with Richard.

Thumbs up Thumbs down

Why?

7. Arthur’s mother (Peggy) : They had a little “surprise party” for me. Everyone showed up when I wasn’t looking
and then spent the next 2 hours telling me how my drinking hurt them. They think I’m an alcoholic! I might have
a drinking problem, but I’m damn sure not an alcoholic.

Prac ti tion er: (gently) Peggy, if it walks like a duck and quacks like a duck, it’s probably a duck. I think if all those
people are telling you you’re an alcoholic, they’re probably right. You might be in denial, don’t you think?

Thumbs up Thumbs down

Why?

8. Arthur’s father (Lloyd) : I think Arthur is taking over too many of the household responsibilities. A boy his age
ought to be playing sports and chasing girls. Instead, he’s worrying about his younger brother and how the
house looks. He even does laundry. I can tell you I never did that at his age. But when I try to push him toward
more normal things, like football, he just gets mad at me and says I don’t understand him. What am I supposed
to do?

Prac ti tion er: In families where alcohol has been a problem, it often works like this. What if you tried the chess
club or the school newspaper instead of pushing him toward football? I think he’d be more receptive to that. I
don’t think you recognize how smart Arthur is. It could be that he will never be all that interested in football.

Thumbs up Thumbs down

Why?

9. Tanya : My doctor gave me a long list of all the things I have to do to manage my care. It’s overwhelming. I have
to take medication three times a day. I can’t even remember to feed my dog every single day. I just can’t do it.
But I’m afraid I’ll die if I don’t.

Prac ti tion er: (encouraging) You can do this. You have to.

Thumbs up Thumbs down

Why?