Motivational interviewing (MI) is a focused and goal-directed counselling method that helps clients to explore ways to resolve mixed or conflicting feelings about changing their behaviour. MI encourages clients to form the desire to change internally and on their own, rather as an option introduced or enforced from outside. One of the major aspects of the MI process is to participate in role-playing activities with the client to help enable him to identify and change specific aspects of his personal or professional life. These role-playing activities help MI clients acquire and develop the skills needed to make lasting, satisfying changes in their behaviour. Role-playing also helps counsellors-in-training hone their skills and develop better methods for interacting with clients.
Time to Think
This activity is also referred to as slow-motion role play. Divide your training group into groups of four and create slips of paper describing different types of resistance a patient might show. This resistance might include arguing with, interrupting, denying or ignoring the counsellor. In addition, create scenarios for the role-play session, such as a situation in which a husband has been increasing his alcohol use slowly but surely over time. Other scenario examples are available at the Knowledge Application Program.
In each group of four, have two participants act as the counsellors and have one person act as the patient. The last participant will serve as the observer. The player who is acting as a patient picks up a slip and role-plays the type of resistance listed there while the counsellors attempt to perform a motivational interview with the patient. In between each sentence there should be 10 seconds for the other person to think about what he will say. This will help an MI counsellor learn to deal with conflict during a session.
Create a role-playing session in which your students make every effort to implement the four segments of OARS (Open questions, Affirmation, Reflective listening, Summarising). Divide your group into pairs and have them engage in a role-playing scenario with each other. The two should tape each section so that they can analyse the situation afterward. Instruct the students to choose a role not too different from themselves so that they can easily think of a quick response to certain questions and comments of the counsellor. A few questions that can be used are "What is your dream job?" "What is the best advice you ever received?" and "Who in your family are you most like?" At the end of each exercise, have the students study the tape to see if there were times they could have performed OARS better. For example, have them identify if they asked any closed questions when they could have asked open ones.
Siding with the Negative
One activity that can be tested in a role-play setting is referred to as siding with the negative, rolling with resistance or agreement with a twist. Have one student choose to take on the role of the client with a scenario that is blocking him from doing something he wants. For example, the client may want to avoid exposing his children to smoking by smoking outside. The person playing the counsellor should not say that the person is doing anything wrong and should praise the positivity of the situation. The counsellor can say that the negativity may be worth it for aspects such as having a few moments to yourself and giving the kids some time alone as well. This teaches counsellors to learn to be on the side of the client instead of being opposed to them.
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