Participant ID: ______
Motivational Interviewing Training Evaluation Packet
Enclosed you will find a brief set of questions that are designed to help us evaluate this training program. The information you provide may help us design future trainings that are beneficial to our VA providers.
Your answers to these questions will be kept strictly confidential.
Please provide a “Participant ID” above (and on each page) so that we may match your responses to the enclosed questions with those of future questions. We recommend that your participant ID consist of the last four of your Social Security Number, followed by the day of the month you were born (e.g., 165724).
Please tell us a little about you:
1. Do you have any prior experience with motivational interviewing? Yes No
2. Please tell us your job title (e.g., physician, nurse, psychologist): ______
3. How long have you been in this role (in years) at the VA? ______
4. Using the scale below, please indicate to what extent you agree with the following statements:
/ Totally Disagree / Partially Disagree / In Between / Partially Agree / Totally Agree /a. My task is to give information on lifestyle-related risks / 1 / 2 / 3 / 4 / 5
b. My task is to motivate and support the patient in his/her lifestyle change / 1 / 2 / 3 / 4 / 5
c. My task is to make the patient follow the given lifestyle instructions / 1 / 2 / 3 / 4 / 5
d. I have sufficient skills for lifestyle counseling / 1 / 2 / 3 / 4 / 5
e. I feel uneasy intervening in an obese patient’s weight / 1 / 2 / 3 / 4 / 5
f. I feel uneasy intervening in a smoker’s smoking / 1 / 2 / 3 / 4 / 5
g. I feel uneasy intervening in a patient’s substance abuse (e.g., alcohol or illicit drugs) / 1 / 2 / 3 / 4 / 5
h. I have been able to help many of my patients to change their lifestyle to a healthier one / 1 / 2 / 3 / 4 / 5
i. Our current working schedule is too hectic to allow us to tackle the patient’s life situation / 1 / 2 / 3 / 4 / 5
Please read and answer the following multiple choice questions. Please choose only ONE answer for each question.
1. Patient says: “I don’t see what the problem is in drinking a 6-pack of beer a day. My buddies drink just like I do. But I sure don’t like the way I feel the next day after a binger.” If you wanted to increase this patient’s motivation, choose the statement that would be most helpful.
_____ A. The problem with drinking as much as you are is that you are at a very high risk of a host of health and social problems.
_____ B. The bottom line is that you’re drinking way above safe limits, and you really need to make a change before it’s too late.
_____ C. So you don’t like the way drinking makes you feel sometimes. What other concerns – if any – do you have about your drinking?
_____ D. Comparing oneself to friends is usually not a good indicator of whether or not someone is drinking too much, because heavy drinkers tend to hang out with heavy drinkers. The typical recommendation for men is no more than two drinks per day or 14 per week, and the safest solution is to stop drinking altogether.
_____ E. Tell me more about your drinking patterns. How often and how much do you drink, and when do you typically go on a ‘binger’?
2. This 30-year old male patient has a history of stomach ulcers. Based on screening responses, he is averaging about 42 standard drinks of alcohol a week. If you wanted to increase this patient’s motivation, what advice statement would be most helpful?
_____ A. If you don’t make a change in your drinking – like cutting back or stopping entirely – you’re setting yourself up for a lot of health problems in the future.
_____ B. From a medical standpoint, I recommend that you cut down on the amount of alcohol you’re currently drinking or stop entirely from drinking for a while.
_____ C. I’m going to be honest with you. You really should make a change in your drinking if you seriously want your stomach to heal.
_____ D. I don’t know if this will make sense to you or not, but based primarily on your stomach ulcers, I highly recommend you consider cutting down on the amount of alcohol you’re currently drinking or stop entirely from drinking for a while. And – of course – what you do about your drinking is up to you. So, what do you think about my recommendation?
_____ E. Your drinking is a problem, and you need to do something about it. Have you thought about cutting back or maybe stopping drinking entirely?
3. Patient motivation for behavior change is primarily influenced by:
_____ A. Personality characteristics
_____ B. Advice delivered by the health care professional
_____ C. Socio-economic factors
_____ D. Knowledge and attitude
_____ E. Interpersonal style of the health care professional
4. On a scale of 0 (not confident at all) to 10 (complete confidence), please indicate your level of confidence in building and strengthening your patients’ inner motivation to engage in lifestyle change:
0------1------2------3------4------5------6------7------8------9------10
not confident complete
at all confidence
Please write a response to the following patient statements.
1. Patient says: “Who are you to be talking to me about my smoking?”
Write a response that shows you are listening.
2. Patient says: “I want to feel normal again and be a good father to my children.”
Write a response that shows you are listening.
3. Clinician says: “Have you thought about going to treatment?”
Change to an open-ended question guiding to change talk.
4. Situation: Patient has asthma and smokes a pack of cigarettes a day
How might you raise the issue of smoking?
5. Situation: Diabetic patient is not checking blood sugars
What two questions might you ask to explore mixed feelings (ambivalence) about checking blood sugars?
6. Situation: Patient is consuming 50 standard drinks of alcohol in an average week
What information might you share, and how would you do it?
7. Situation: Patient experiencing combat-related PTSD symptoms and is not receiving help
What advice might you offer, and how would you do it?
Core Motivational Interviewing Concepts / 0 ------10Low High
Competence
1. Demonstrates a counseling STYLE that is:
- Warm & friendly
- Empathic (seeks to understand things from the participant’s perspective)
- Collaborative (dances versus wrestles)
- Accepting/non-judgmental
- Respectful
- Positive & Hopeful
- Honoring of autonomy (respects the participant’s freedom of choice)………..
2. Suspends the expert-didactic-prescriptive-authority role …………………………..
3. Resists the “righting reflex” (the desire to fix things)………………………………..
4. Rolls with resistance versus fighting it………………………………………………..
5. Listens first! Patient does most of the talking! ......
6. Uses O.A.R.S. to support the patient in safely exploring experiences, concerns, values, and motivations………………………………………………………………..
- Open-ended questions
- Affirmation
- Reflective Listening
- Summaries
7. Asks mostly open-ended versus close-ended questions…………………………...
8. Encourages “change talk!” Invites the patient to give voice to their own wisdom, concerns, ambivalence, motivations, aspirations, ideas, and solutions…………..
9. Asks permission before raising a topic, addressing concerns, offering advice or exchanging information…………………………………………………………………
10. After exchanging information (advice, education, clinical feedback), asks for patient’s response……………………………………………………………………….
11. Holds the reins on goal setting until the patient is ready……………………………
12. Able to let go when patient is not ready to change………………………………….
Please read the following two statements, and using the numbered scale below, indicate the extent to which each statement applies to you.
a. I feel burned out from my work / 0 / 1 / 2 / 3 / 4 / 5 / 6
b. I have become more callous toward people since I took this job / 0 / 1 / 2 / 3 / 4 / 5 / 6
REV 09/30/2010 (A) Page 2