Motivational Interviewing - REFLECTIONS

Different types of Reflections you can use in Motivational Interviewing (MI) - for more see www.miinlondon.org

1. 1
www.miinlondon.org / [email protected] / Tweet @miinlondon

How to use reflections in
Motivational Interviewing

2. 2
Using
Reflections
in MI

3. 3
Welcome to MI Club
with John Russell (Member of the Motivational Interviewing Network of Trainers)
www.miinlondon.org / [email protected] / Tweet @miinlondon
Using Reflections in
Motivational Interviewing

4. 4
Reflections
Let’s go!

5. 5
Aims
1. Be curious, adopt a learning mind-set.
2. To learn about what a reflection is.
3. To learn about the different types of
reflections
4. To start using, or improve your current use of
reflections.

6. 6
Objectives
1. Presentation
2. Individual practise (on your own)
3. Partner practise (with one other person)
4. Questions

7. - John Russell
7
“A reflec'on is a statement that holds up a
mirror to your conversa'on…
It lets the person you’re talking to hear
what they’ve said…
It might be the first 'me that’s ever
happened to them”.

8. 8
Why reflect?

9. 9
Why reflect?
• Reflective Listening deepens our understanding
of the person
• Demonstrates active listening, empathy and MI
Spirit
• Keeps the person focused on change which
results in a higher likelihood of change occurring

10. 10
What is a
reflection in MI?

11. 11
What is a reflection?
Well, there are two types of reflection, these are
split into:
1. Simple Reflections
2. Complex reflections

12. 12
What is a
simple reflection?

13. 13
Simple reflections
Used when:
• You want to keep the conversation going as it
is, but not guide it.

14. 14
Simple reflections
A simple reflection would be when you:
• Repeat what a person has said
• Slightly Rephrase what the person has said

15. 15
Simple reflections
For example, if someone said: “I really want to
lose weight”
• Repeat
– “You want to lose weight”
• Slightly Rephrase
– “You want to some weight to come off”

16. 16
Simple reflections
Simple reflections repeat or rephrase the
conversation that is above water.

17. 17
That’s this bit

18. 18
What is a
complex reflection?

19. 19
Complex reflections
Are great for taking the conversation deeper.

20. 20
That’s this bit!

21. 21
Complex reflections
Used when:
• You want to prevent conversations going round in
circles
• You want to add meaning to the clients words, or
take a guess as to what they really meant to say or
are trying to say
• You want to guide the conversation towards change

22. 22
Complex reflections
A complex reflection would be when you:
• Paraphrase what a person has said
• Use metaphor, meaning or describe feeling
• Lay out change talk and sustain talk (double-
sided) or Continue the sentence where the
person left off

23. 23
Complex reflections
It’s worth noting that not every type of complex
reflection can and should be used, pick which
ever one you think will work best in the
situation.
Here’s some examples…

24. 24
Complex reflections
For example, if someone said: “I really want to
lose weight”
• Paraphrase
– “It’s time to drop some lbs”
• Continue the sentence
– “it’s going to help you achieve what you want to
achieve”

25. 25
Complex reflections
For example, if someone said: “I’m tired, Ive got so
many things I have to do before I exercise”
• Metaphor
– “You’ve got a lot of hurdles to jump over”
• Feeling
– “It seems draining to do, but it’s something you’re
interested in doing”

26. 26
Complex reflections
For example, if someone said: “I’m worried about
my health with drinking but it’s so much fun to do”
• Double-sided
– “You want to have a good time, and yet it’s going to
be better for you cut it out for good”
• Meaning
– “You want to live a long and healthy life”

27. Individual Practise
27
Think about the following statement:

“I want to lose weight, but I just love to eat,
especially sugary treats, I can’t stop myself
when they’re in the house, I know it’s not
good for me”

See if you can come up with some reflections
to this statement. We’ll come back in 5 mins.
Give it a go!

28. “I want to lose weight, but I just love to eat,
especially sugary treats, I can’t stop myself when
they’re in the house, I know it’s not good for me”
28
Simple reflec+ons:
Repeat
• 
Simple Rephrase
• 
Complex Reflec+ons:
Paraphrase

Double-sided
Amplified
Metaphor
Feeling
Meaning

Con+nue the sentence…


For a reminder of each
reflecBon go to:
miinlondon.org/exercise

29. “I want to lose weight, but I just love to eat,
especially sugary treats, I can’t stop myself when
they’re in the house, I know it’s not good for me”
29
Simple reflec+ons:
Repeat
•  You want to lose weight
Simple Rephrase
• It’s hard to not eat treats and
you find it hard to stop
yourself
Complex Reflec+ons:
Paraphrase
It’s tough to stay away from the sweet treats but deep
down you know you’re beOer of without them
Double-sided
You love to eat sugary foods and lose weight is a priority
for you
Metaphor
You want to show others you can tame this lion
Feeling
You’re upset you can’t control your eaBng
Meaning
Controlling your eaBng is important for you to feel good
about yourself
Con+nue the sentence…
And now might be the Bme to make your first steps
towards change

30. 30
How did you do?
• The key to these is to practise, here are some examples
that you could’ve used…
• Some people ask how many reflections should they be
using in a conversations.
• There’s no hard-and-fast rule, however you want to be using
at least one reflection for every one question used. Try and
increase the number of reflections to questions as you get
better with practice.

31. Practise in pairs
31
OK. Let’s give this a go. Please go to
the chat function, you’ll see your name
there along with a link that will take
you straight to your discussion room.

I’ll ask you to come back in 10 minutes
time.

32. Practise in pairs
32
Please introduce yourself (if you’ve
checked that you’re happy to appear
on webcam remember to enable it
when you get into the room)

Discuss what you like in the room, but
you might want to try and practice one
type of reflection with each other.

33. Practise in pairs
33
See you in 10 minutes! I’ll mute myself
so you can talk without hearing me.

I’ll still be in the join.me chat room if
you want to ask questions.

I’ll unmute after 10 minutes to bring
you back

34. 34 Send us a Tweet: @MIinlondon
Ques%ons

Q: Can you give any more examples of double-sided reflec%ons?
A: Let’s use an example someone might say if you were talking about cuDng down on alcohol.
“I want to drink less but all of my friend’s do it”
Double-sided reflec%ons use a person’s change talk ”(a statement that is pro-change) , such as “I
want to drink less and a person’s sustain talk (a statement that keeps the status quo) which might
follow, such as “but all of my friends do it”.
A Double-sided reflec%on switches the change talk and sustain talk, and replaces the central
word ‘but’ with the word ‘and’.
Therefore a reflec%on to “I want to drink less but all of my friend’s do it” might be:
1. “It’s a social thing and yet you’re not sure if it’s working for you”
2. FRt mi6mbwo7@ail55i7mboCilo7iew?iet i7to@?iBlo?i?tGiIfle8wili8b?if ;AKid
3. “You don’t want to lose your friends and you want to be healthier”

35. 35
See you for online
MI Club SOON!
Thanks for coming!
Sign up to our newsletter for updates on MI Club online!
Visit www.miinlondon.org