5 Motivational Interviewing & MEDSTAT

Encounter Form: What is the purpose of the encounter form?

To organize session information and help complete documentation later.

Encounter Form Confidentiality: Why are only patient initials used on the encounter form?

To protect confidentiality.

Encounter Form Demographics: What student information is included on the form?

Initials, age, grade, and phone number.

Encounter Form Screeners: Name one screener listed on the encounter form.

PHQ, GAD, CDI, or SCARED.

Encounter Form Behavioral Health: What behavioral health topics are included on the form?

Smoking, alcohol use, family support, and self-regulation.

Encounter Form Customization: Can therapists customize the encounter form?

Yes.

MRN Abbreviation: What does MRN stand for?

Medical Record Number.

MRN School Code: What do the first letters of an MRN represent?

School identifier.

MRN Grade Code: What can the grade digits in an MRN represent?

Current grade level.

MRN Student Number: Does the final cumulative number stay the same over time?

Yes.

MRN Confidentiality: Do schools have access to MRN codes?

No.

Screening Order: In school settings, which screener should usually come first: PHQ or GAD?

PHQ.

PHQ Priority: Why is PHQ prioritized before GAD in schools?

Because of suicide-risk Question 9.

Child Anxiety Screener: What anxiety screener is preferred for younger children?

SCARED.

Child Depression Screener: What depression screener can be used for younger children?

CDI (Child Depression Inventory).

Pre-Contemplation Stage: What happens in pre-contemplation?

The client is not yet considering change.

Pre-Contemplation Error: What is a common therapist mistake in pre-contemplation?

Assuming the client already sees a problem.

Contemplation Stage: What happens in contemplation?

The client is thinking about change but not committed.

Preparation Stage: What happens in preparation?

The client brainstorms possible steps toward change.

Preparation Planning: Why shouldn’t therapists rush into solutions during preparation?

Ideas need realistic planning and support.

Action Stage: What happens in action?

The client actively makes changes.

Action Risk: Why is action vulnerable without support?

Clients may try to change alone.

Maintenance Stage: What happens in maintenance?

The client works to sustain changes long-term.

Maintenance Timeline: How long can complex change take to stabilize?

2–3 years.

Relapse Stage: What is relapse in this model?

Returning to old patterns or changing course.

Relapse Meaning: Does relapse mean failure?

No, it often means re-entering the change cycle.

Homeostasis: What is homeostasis in family systems?

A pull back toward familiar patterns.

Family Reinforcement: Why can families unintentionally maintain unhealthy behavior?

Old roles and habits reinforce it.

Family Therapy Role: Why is family therapy useful during behavior change?

The whole system must adapt.

Change Support Question: What should therapists ask about change efforts?

Who else needs to know or be involved?

Trans-Theoretical Focus: What does the trans-theoretical model focus on?

How clients move between stages of change.

Family Therapy Sweet Spot: What is the “sweet spot” for family therapists in this model?

Understanding what helped movement between stages.

MI Meaning: What does MI stand for?

Motivational Interviewing.

MI Goal: What is the goal of MI?

Elicit motivation and support change collaboratively.

OARS Meaning: What does OARS stand for?

Open questions, Affirmations, Reflective listening, Summarizing.

OARS Open Questions: Why avoid yes/no questions in MI?

They limit conversation.

OARS Affirmations: What is an affirmation?

Recognizing strengths and effort.

OARS Reflective Listening: What is reflective listening?

Checking that what you heard matches what the client meant.

OARS Reflective Benefit: Why is reflective listening powerful?

It builds trust and deepens discussion.

OARS Summarizing: What is summarizing?

Highlighting the main takeaways.

OARS Closing Question: What end-of-session question supports summarizing?

“What stood out to you today?”

DEARS Meaning: What does DEARS stand for?

Developing discrepancies, Expressing empathy, Amplifying ambivalence, Rolling with resistance, Supporting self-efficacy.

DEARS Discrepancy: What is developing discrepancy?

Exploring the gap between current behavior and desired goals.

DEARS Goal Setting: Why should goals be realistic in MI?

Early success builds momentum.

DEARS Empathy: What is expressing empathy?

Showing compassion without assuming identical experience.

DEARS Caution: Why avoid saying “I know exactly how you feel”?

You do not fully know their experience.

DEARS Ambivalence: What is ambivalence?

Feeling torn about whether to change.

DEARS Resistance: What is rolling with resistance?

Reducing struggle instead of arguing.

DEARS Resistance Meaning: According to the training, resistance often means what?

The therapist has an agenda the client does not share.

DEARS Self-Efficacy: What is self-efficacy?

Belief in one’s ability to change.

DEARS Self-Efficacy Benefit: Why support self-efficacy?

Change lasts longer when clients own it.

Customer Client Type: What is a customer client?

Knows there is a problem and wants to help solve it.

Complainant Client Type: What is a complainant client?

Sees a problem but thinks others must fix it.

Visitor Client Type: What is a visitor client?

Doesn’t see a problem or need for therapy.

Client Type Adaptation: Why must therapists adapt to client type?

Different readiness levels need different approaches.

Visitor Engagement: Why thank visitors for attending?

They chose to show up despite reluctance.

Visitor Need: What do visitors often need restored first?

Agency and voice.

Complainant Focus: What should therapy focus on with complainants?

What they can control.

Complainant Communication: What communication style helps complainants?

“I statements.”

Speaker-Listener Process: How does the speaker-listener tool work?

One person speaks briefly; the other reflects back before responding.

Speaker-Listener Purpose: Why use speaker-listener tools?

To slow conflict and improve listening.

MEDSTAT Meaning: What does MEDSTAT stand for?

Miracle, Exceptions, Differences, Scaling, Timeout, Accolade, Task.

MEDSTAT Exceptions: What is an exception question?

When did the problem happen less or not at all?

MEDSTAT Differences: What are “differences that make a difference”?

Contextual details linked to success.

MEDSTAT Scaling: What is scaling?

Rating progress on a 1–10 scale.

MEDSTAT Scale Design: Why should 10 not equal the miracle outcome?

Goals should feel reachable.

MEDSTAT Timeout: What is timeout?

A brief pause for reflection.

MEDSTAT Accolade: What is an accolade?

Affirming progress and effort.

MEDSTAT Task: What is a task?

A realistic between-session action step.

Goal Breakdown: If a client proposes step 10, what should you ask?

What step 1 would look like.

Previous Attempts: Why ask about past attempts?

Previous efforts guide better planning.

Pace of Change: Why not rush behavior change?

Meaningful change often takes multiple sessions.

Success Definition: What deserves more credit in therapy?

Maintenance and plateaus as real success.

Integrated Care Value: Why is integrated care valuable in medical settings?

It makes behavioral health accessible and natural.

Medical Barrier: What barrier historically exists in medicine?

Mental health stigma.

Integrated Care Settings: Where has integrated care been implemented successfully?

Pediatrics, family medicine, NICU, rehab, cardiac care, and more.

Integrated Care Cost Benefit: Why is integrated behavioral health cost-effective?

It improves outcomes and can reduce larger healthcare costs.