Trait or state?
A trait is a relatively enduring personality characteristic.
A state is something that is variable and context dependent
Clinical application of motivation
Prochaska and Di Clemente’s transtheoretical model of change
1. Pre contemplation
4. Action maintenance
Client presentation is different depending on what stage he is in. The therapist must recognize
what stage the client is in and apply different motivational strategies suited for different stages
in the transtheoretical model.
As severity of substance use problem increases, motivation goes down. So what do we do?
Client centered to the very core
Non-confrontational and was developed in reaction to highly confrontational clinical
approaches like hotseating.
Subtly uses clinical skills and strategy to foster a context in which the client engages in
self confrontation. The therapist provides feedback, points out descrepancies, and rolls
These techniques can be used at any point in the stages of change. FRAMES approach
Feedback: Providing feedback to client about the risks and negative consequences of
R esponsibility: Emphasize that the client is responsible for his decisions about his drug use.
A dvice: Give straightforward advice on modifying drug use
M enu: Offer a menu of treatment options. This fosters the client’s involvement in decision
E mpathy: Be empathetic, respectful, and non-judgmental
Self-efficacy: Enhance the client’s belief in their own success in treatment. Enhance their
personal effectiveness, not necessarily their self-esteem. You don’t want criminals feeling good
about doing crimes.
Key motivational interview techniques DARES
D evelop discrepancies
This is one of the slickest things about motivational in