NBHWC - National Board for Health & Wellness Coaching Motivational Interviewing Techniques Questions and Answers — Questions and Answers
Question 1: A health coach is working with a client who is ambivalent about increasing their physical activity. The client says, "I know I should exercise, and I feel better when I do, but I'm just so tired after work and can't find the motivation." Which of the following coach responses best demonstrates the spirit of Motivational Interviewing?
- "You could try exercising in the morning before work when you have more energy. Many people find that works better for their schedule."
- "It sounds like you're facing a real conflict. On one hand, you know exercise is good for you and makes you feel better, but on the other hand, your fatigue at the end of the day is a major barrier." (Correct answer)
- "Let's set a small goal of just 10 minutes of walking after work three times this week. That's a manageable start, isn't it?"
- "If you don't start exercising, you're putting yourself at a higher risk for several chronic diseases. It's really important to prioritize this."
Correct answer: "It sounds like you're facing a real conflict. On one hand, you know exercise is good for you and makes you feel better, but on the other hand, your fatigue at the end of the day is a major barrier."
The correct answer is a complex reflection that acknowledges both sides of the client's ambivalence without judgment. This response validates the client's struggle, which is a core tenet of the Motivational Interviewing spirit, particularly partnership and acceptance. The other options represent common coaching missteps: offering unsolicited advice (the 'righting reflex'), imposing a goal, and using a scare tactic, all of which can undermine a client's autonomy and intrinsic motivation.
Question 2: Which of the following is the primary goal of using the OARS (Open-ended questions, Affirmations, Reflective listening, Summarizing) technique in Motivational Interviewing?
- To gather detailed data for the client's wellness plan.
- To direct the client toward the most effective health solution.
- To build rapport and elicit the client's own motivations for change. (Correct answer)
- To ensure the client follows through on the goals set by the coach.
Correct answer: To build rapport and elicit the client's own motivations for change.
OARS are foundational skills in MI used to create a collaborative and empathetic environment. Their primary purpose is to engage the client in a conversation about change, helping them to explore their own reasons and motivations. While data gathering may occur, it's not the primary goal. MI avoids directing or imposing solutions, instead focusing on evoking the client's intrinsic motivation.
Question 3: In a coaching session, a client states, "I want to eat healthier, but my family brings junk food into the house all the time." This statement is an example of:
- Change Talk
- Sustain Talk
- The Righting Reflex
- Ambivalence (Correct answer)
Correct answer: Ambivalence
This statement perfectly illustrates ambivalence, as the client is expressing both a desire for change ("I want to eat healthier") and a reason for maintaining the status quo (the barrier of family habits). It contains elements of both change talk and sustain talk. Change talk would focus solely on the desire to change, while sustain talk would focus only on the reasons not to change. The 'righting reflex' is an action taken by the coach, not a statement made by the client.
Question 4: A coach notices they have a strong urge to tell their client, who struggles with time management, exactly how to organize their calendar to fit in meal prep. This urge is best described as:
- Evocation
- Affirmation
- The Righting Reflex (Correct answer)
- Reflective Listening
Correct answer: The Righting Reflex
The 'righting reflex' is the natural and well-intentioned tendency of helpers to want to fix a client's problems by offering advice and solutions. Motivational Interviewing encourages coaches to resist this reflex, as it can disempower the client and create resistance. Instead, the coach should evoke the client's own ideas for solving the problem.
Question 5: According to the four processes of Motivational Interviewing, which process is foundational and must be established before moving on to exploring a specific change goal?
- Planning
- Evoking
- Focusing
- Engaging (Correct answer)
Correct answer: Engaging
The four processes of MI are Engaging, Focusing, Evoking, and Planning. Engaging is the foundational process of establishing a collaborative and trusting relationship (therapeutic rapport). Without solid engagement, it is difficult to effectively focus on a specific topic, evoke the client's motivation, or create a viable plan. If engagement is lost at any point, the coach should return to this process.
Question 6: Which of the following client statements is the strongest example of 'change talk'?
- "I suppose I could try to go for a walk once or twice."
- "I'm going to pack my gym clothes tonight so I can go to the gym before work tomorrow." (Correct answer)
- "My doctor said I need to lower my blood pressure."
- "I wish I had more energy to play with my kids."
Correct answer: "I'm going to pack my gym clothes tonight so I can go to the gym before work tomorrow."
This statement demonstrates 'Taking Steps,' which is a high-level form of change talk indicating a concrete action toward the change goal. The other options represent weaker forms of change talk: "I suppose I could try..." is more contemplative; "My doctor said..." is an external reason, not an internal motivation; and "I wish I had more energy..." expresses desire (DARN) but lacks commitment or action.
NBHWC - National Board for Health & Wellness Coaching Motivational Interviewing Techniques Questions and Answers
A health coach is working with a client who is ambivalent about increasing their physical activity.
The client says, "I know I should exercise, and I feel better when I do, but I'm just so tired after work and can't find the motivation." Which of the following coach responses best demonstrates the spirit of Motivational Interviewing?