Self-Evaluation for Motivational Interviewing
“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
Whenever you are learning something new, you need to know if you are doing the procedure the way it should be done. Usually, this is the job of a supervisor because people are not always good judges about themselves. But what if you don’t have a supervisor? The National Drug Abuse (NIDA) Treatment Clinical Trials Network (protocol 0005, 2006) developed rating tools for this purpose, including a self-assessment evaluation. Counselors who participated in studies using motivational interviewing needed to be certified to be competent in using the procedure. After taking courses, they made tapes of counseling sessions which were reviewed and rated by supervisors on how they performed on their interviews. Supervisor ratings could be compared to self-ratings by the clinicians to see how accurate the clinician was at self-observing. Without a supervisor, one must gauge the accuracy of your self assessment by how the other person responded to you. If you rated yourself well but the person was resistant and never opened up, you need to recheck your self-assessment. If the person became increasingly positive and open and you rated yourself well, then your viewpoint and your actions are probably right-on.
First, remember that MI is meant for “difficult discussions,” not casual interactions. Second, learning MI, like learning most things, requires practice, and it might feel a little awkward the first few times you try it. At the beginning, you must concentrate on doing the technique itself, which will distract you from really listening to the other person. However, once you feel more comfortable, you will find you are a better listener too.
Self-Assessment Forms
Beginner’s Self-Assessment Form is adapted from the longer Motivational. Interviewing Self-Assessment Form. It only rates the rates basic techniques of MI, like how frequently did you use open-ended questions, make reflective statements, affirm strengths, affirm change efforts, or develop discrepancies. (See Form 1) It is meant as a guage for how well you are applying the techniques.
The second form is the original NIDA Self-Assessment Form (See Form 2). This full self-assessment form rates more things than the basic technique. It includes questions about subjective aspects, like how well you do you think you are doing on applying the “spirit of motivational interviewing” such as change planning, coping with pitfalls, and dealing with alcohol counseling issues. It is also rated on a 7-point rating scale from Not at all = 0, to Extensively = 7. I doubt if many people will need this degree of detail when this is not for a study or counseling. It is just not relevant. Nevertheless, you may want to look at the scale to see how well you are doing at some of the “spirit” of the procedure aspects and may find the descriptions and prompts useful.
Conclusions
Motivational Interviewing is a procedure to use in difficult conversations about important things where there is disagreement. To see if you remembered to use all of the ideas, self-rating is the next best thing to being observed. Score yourself on either the modified (short form) or original NIDA (National Institute on Drug Abuse) Motivational Interviewing forms right after you tried to use the techniques. Use it until you think you are applying the tips appropriately and people seem to be comfortable talking with you.
There is a saying “You can lead a horse to water, but you can’t make him drink.” It needs a personal motivation of being thirsty. Similarly, people won’t change until they have a personal motivation to do so. Remember that if motivational interviewing is applied to the horse, the goal is not “to make the horse drink”, but “to realize when it is thirsty”.
