CASAC Motivational Interviewing and Counseling Skills 5 — Questions and Answers
Question 1: A client resists every suggestion the counselor makes. According to MI, this is best understood as:
- A sign that the client is not ready for treatment and should be discharged
- A natural response to perceived pressure, signaling a need to back off and use more reflective listening (Correct answer)
- Evidence of an antisocial personality that requires a different therapeutic approach
- A manipulation tactic that should be confronted directly
Correct answer: A natural response to perceived pressure, signaling a need to back off and use more reflective listening
In MI, resistance signals that the counselor may be pushing too hard; the appropriate response is to roll with resistance and increase reflective listening.
Question 2: Which technique involves the counselor intentionally exaggerating the client's position to prompt the client to argue against it?
- Double-sided reflection
- Amplified reflection (Correct answer)
- Complex reflection
- Reframing
Correct answer: Amplified reflection
An amplified reflection overstates the client's statement, which often causes the client to pull back and express counter-arguments that contain change talk.
Question 3: A CASAC counselor is seeing a client mandated to treatment who says, 'I'm only here because the judge made me. I don't have a problem.' The MOST appropriate initial MI response is:
- Explain that denial is a common symptom of addiction
- Reflect that being here wasn't their choice and explore their perspective on the situation (Correct answer)
- Review the legal consequences of non-compliance
- Administer a formal assessment to establish diagnosis
Correct answer: Reflect that being here wasn't their choice and explore their perspective on the situation
Acknowledging the client's autonomy and exploring their experience without confrontation reduces reactance and builds rapport.
Question 4: Which of the following best describes the MI concept of 'rolling with resistance'?
- Agreeing with the client that they do not need to change
- Avoiding conflict by shifting to a different topic when resistance arises
- Using the client's momentum to explore their perspective without arguing (Correct answer)
- Waiting silently until the client resolves their own resistance
Correct answer: Using the client's momentum to explore their perspective without arguing
Rolling with resistance means moving with the client's energy rather than opposing it, often through reflection, to avoid power struggles.
Question 5: During a group counseling session using MI principles, one member says, 'Drinking is the only way I can have fun socially.' The counselor reflects: 'So far, alcohol has felt necessary for you to enjoy social situations.' This is an example of:
- An affirming statement
- A simple reflection (Correct answer)
- A double-sided reflection
- A summary
Correct answer: A simple reflection
This is a simple reflection that mirrors the client's statement back to them, demonstrating understanding and inviting further elaboration.
Question 6: A client reports she has been abstinent for two weeks but is afraid she will relapse at an upcoming family holiday event. In MI, the counselor should FIRST:
- Teach a specific relapse prevention strategy for the event
- Explore the client's own ideas and plans for managing the situation (Correct answer)
- Discuss past relapse triggers to identify patterns
- Contact the family to request they remove alcohol from the event
Correct answer: Explore the client's own ideas and plans for managing the situation
MI prioritizes evoking the client's own solutions and self-efficacy before offering advice or information.
Question 7: What is the role of 'affirmations' in Motivational Interviewing?
- To reward the client with praise when they agree to make a change
- To recognize the client's strengths, efforts, and past successes to build self-efficacy (Correct answer)
- To provide positive reinforcement on a fixed schedule to shape behavior
- To reframe negative self-talk into positive statements the client repeats
Correct answer: To recognize the client's strengths, efforts, and past successes to build self-efficacy
Affirmations in MI acknowledge genuine client strengths and efforts, supporting self-efficacy and reinforcing the client's capacity for change.
CASAC Motivational Interviewing and Counseling Skills 5
A client resists every suggestion the counselor makes.
According to MI, this is best understood as: