Motivational Interviewing
Microskills Bootcamp
Getting to “Change Talk”
(but not there yet)
OARS
Plus Delta Feedback
Plus (+): What do you like about behavior?
Delta (∆): What would you change to improve?
Writing Assignment
1) Think of an adult patient with ‘manageable’ behavior change issues, with whom you can identify
enough to remember or make up details. Write a one sentence patient summary of the sort that
you might receive about a new patient on the outside of the envelope. Feel free to make up a
name for your patient.
2) Answer questions 3 to 7 on piece of paper.
3) What is the explicit reason for their physician visit today?
4) What is the implicit reason for the visit?
5) AMBIVALENCE: Why is there tension about change?
6) What are the patient’s strengths?
7) What is a useful visit agenda for this patient?
8) Fold the paper and put it in the envelope.
Groups of 3: Coaching
Physician (Be curious, collect data about what is difficult.)
Patient (Don’t make it TOO easy.)
Observer (Keep track of interview. Prepare to give feedback.)
Open Ended
What’s happened since we last met?
What would you like to see different about your current situation?
Why do you think others are concerned about your …?
Affirmation
By the way you handled that situation, you showed a lot of
courage, insight, willpower…
Sounds like you’ve given this a lot of thought…
Reflective Listening
Checks understanding.
I get the sense that….
It sounds like….
Summary
Ideally emphasizes ambivalence.
It sounds like you are concerned about your cocaine use because
it is costing you a lot of money and there is a chance you could
end up in jail.You also said quitting will probably mean not
associating with your friends any more.That doesn’t sound like
an easy choice.
Are we there yet?
Write about the patient you interviewed based on the
responses to open ended questions.
• What was the implicit reason for the visit?
• What ambivalence did you identify with your open
ended questions?
• What patient strengths did you identify?
• What is you agenda for this patient visit?
• What does OARS stand for?
Please open the envelope.
How did you do?
There is a summary of Motivational Interviewing Rationale and
Techniques derived from Sobell & Sobell, 2008 (on P:Conferences
Handouts\ 2014-2015)
Stay tuned for MI Change Talk Challenge coming in Spring of 2015