CASAC Motivational Interviewing and Counseling Skills 2 — Questions and Answers
Question 1: Which of the following is an example of an 'affirmation' in Motivational Interviewing?
- 'You need to stop drinking before you lose your family.'
- 'It sounds like you have made some difficult decisions to protect your health.' (Correct answer)
- 'Have you considered how your use affects your work?'
- 'Let me tell you about the stages of recovery.'
Correct answer: 'It sounds like you have made some difficult decisions to protect your health.'
Affirmations acknowledge and recognize the client's strengths, efforts, and positive qualities to build self-efficacy and reinforce the therapeutic alliance.
Question 2: According to the Transtheoretical Model, a client who has been abstinent for six months and is working to prevent relapse is in which stage?
- Action
- Preparation
- Maintenance (Correct answer)
- Termination
Correct answer: Maintenance
The Maintenance stage begins after six months of sustained change and focuses on preventing relapse and consolidating the gains made during the Action stage.
Question 3: A counselor uses 'double-sided reflection' when a client expresses ambivalence. This technique involves:
- Reflecting only the client's desire to change
- Reflecting both sides of the client's ambivalence in a single statement (Correct answer)
- Repeating the client's exact words back to them
- Asking the client to weigh the pros and cons in writing
Correct answer: Reflecting both sides of the client's ambivalence in a single statement
Double-sided reflection acknowledges both sides of a client's ambivalence in one statement, helping them hear their own conflicting motivations and often prompting movement toward change.
Question 4: Which of the following best represents a 'closed question' in counseling?
- 'What does a typical day of drinking look like for you?'
- 'How has your substance use affected your relationships?'
- 'Are you currently using any substances?' (Correct answer)
- 'What would be most helpful to discuss today?'
Correct answer: 'Are you currently using any substances?'
A closed question elicits a brief, often yes/no response and limits elaboration, whereas open questions invite the client to share more information.
Question 5: The 'ruler technique' used in MI asks clients to rate their readiness to change on a scale from 0 to 10. This is primarily used to:
- Diagnose the severity of substance use disorder
- Assess motivation and elicit change talk by exploring the client's rating (Correct answer)
- Determine the appropriate level of care needed
- Measure the effectiveness of a previous treatment episode
Correct answer: Assess motivation and elicit change talk by exploring the client's rating
The ruler technique (readiness ruler) is an MI strategy to assess motivation and elicit change talk by asking clients why they chose a particular number and not a lower one.
Question 6: In MI, 'sustain talk' refers to:
- The counselor encouraging the client to continue in treatment
- Client statements that favor maintaining the status quo or not changing (Correct answer)
- Summarizing the client's progress at the end of a session
- Discussing long-term recovery goals with the client
Correct answer: Client statements that favor maintaining the status quo or not changing
Sustain talk is the counterpart to change talk — it reflects the client's arguments for not changing and is associated with less likelihood of behavior change.
Question 7: Which of the following is a key principle underlying person-centered counseling as developed by Carl Rogers?
- The counselor is the expert who directs the course of therapy
- The client's behavior must be confronted to promote insight
- Unconditional positive regard, empathy, and genuineness are necessary for therapeutic change (Correct answer)
- Cognitive restructuring is the primary mechanism of change
Correct answer: Unconditional positive regard, empathy, and genuineness are necessary for therapeutic change
Rogers identified unconditional positive regard, accurate empathy, and genuineness (congruence) as the core conditions necessary and sufficient for therapeutic change.
CASAC Motivational Interviewing and Counseling Skills 2
Which of the following is an example of an 'affirmation' in Motivational Interviewing?