CASAC Motivational Interviewing and Counseling Skills 1 — Questions and Answers
Question 1: Which of the following best describes the 'spirit' of Motivational Interviewing (MI)?
- Confronting the client about their denial and resistance
- A collaborative, person-centered approach that evokes intrinsic motivation for change (Correct answer)
- Providing direct advice and education about the harms of substance use
- Using structured behavioral techniques to modify maladaptive patterns
Correct answer: A collaborative, person-centered approach that evokes intrinsic motivation for change
The spirit of MI is characterized by collaboration, evocation, and autonomy — it is person-centered and draws out the client's own motivation rather than imposing it.
Question 2: What does the acronym OARS stand for in Motivational Interviewing?
- Observe, Assess, Reflect, Summarize
- Open questions, Affirmations, Reflective listening, Summaries (Correct answer)
- Open questions, Analyze, Reinforce, Support
- Outline, Assess, Reinforce, Summarize
Correct answer: Open questions, Affirmations, Reflective listening, Summaries
OARS (Open questions, Affirmations, Reflective listening, Summaries) are the core communication skills used in MI to engage clients and elicit change talk.
Question 3: In Motivational Interviewing, 'change talk' refers to:
- The counselor explaining reasons why the client should change
- Client statements that favor movement toward change (Correct answer)
- Discussing how other clients have successfully changed
- Setting specific behavioral goals with the client
Correct answer: Client statements that favor movement toward change
Change talk consists of the client's own statements that reflect desire, ability, reasons, need, or commitment to change, which are key predictors of behavior change.
Question 4: A client says, 'I know I drink too much, but I'm not sure I want to quit.' This statement best reflects which stage of the Transtheoretical Model?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Maintenance
Correct answer: Contemplation
Contemplation is characterized by ambivalence — the client recognizes a problem and is weighing the pros and cons of change but has not committed to action.
Question 5: Which MI technique involves the counselor intentionally highlighting discrepancies between a client's stated values and their current behavior?
- Rolling with resistance
- Developing discrepancy (Correct answer)
- Affirmation
- Simple reflection
Correct answer: Developing discrepancy
Developing discrepancy is a core MI strategy where the counselor helps the client see the gap between their values or goals and their current behavior to increase motivation for change.
Question 6: When a counselor 'rolls with resistance' in MI, they are:
- Agreeing with the client that change is unnecessary
- Confronting the client's minimization directly
- Avoiding argument and reframing the client's statements to reduce discord (Correct answer)
- Using silence to allow the client to experience discomfort
Correct answer: Avoiding argument and reframing the client's statements to reduce discord
Rolling with resistance means the counselor does not argue or confront but instead shifts perspective or reframes to reduce discord and maintain the therapeutic relationship.
Question 7: The concept of 'ambivalence' in addiction counseling refers to:
- A client's complete denial of their substance use problem
- Simultaneous conflicting feelings about changing substance use behavior (Correct answer)
- The counselor's uncertainty about treatment goals
- A client's refusal to participate in group therapy
Correct answer: Simultaneous conflicting feelings about changing substance use behavior
Ambivalence describes the coexistence of both wanting and not wanting to change, which is a normal part of the change process that MI is specifically designed to resolve.
CASAC Motivational Interviewing and Counseling Skills 1
Which of the following best describes the 'spirit' of Motivational Interviewing (MI)?