Deliberate Practice in Motivational Interviewing

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Format: Paperback
Pub. Date: 2022-09-06
Publisher(s): American Psychological Association
List Price: $42.65

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Deliberate practice exercises help clinicians develop competence in fundamental motivational interviewing skills to better assist clients with change goals, like quitting addictive behaviors and developing healthier habits, and to improve treatment engagement and retention.

These exercises present role-playing scenarios in which two trainees act as a client and a clinician, switching back and forth under the guidance of a supervisor. The clinician improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common client questions and concerns.
The first 12 exercises focus on specific skills, such as offering simple and complex reflections and affirmations, eliciting change talk, supporting client autonomy, and collaboratively mapping session agendas. These are followed by two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate essential skills into one session.

Step-by-step instructions guide participants through the exercises, identify criteria for skill mastery, and explain how to monitor and adjust difficulty. Guidelines and forms to help trainers and trainees get the most out of training are also provided.

Author Biography

Jennifer K. Manuel, PhD, is Deputy Director of Psychology at the San Francisco Veterans Affairs Health Care System and an Associate Professor in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco. She has been a member of the Motivational Interviewing Network of Trainers (MINT) since 2005. She conducts MI training and coding workshops throughout the world. She has coauthored multiple MI behavioral coding systems including the widely used Motivational Interviewing Treatment Integrity (MITI) coding manual. Dr. Manuel’s research expertise is in the implementation and evaluation of MI in front-line clinical settings.
Denise Ernst, PhD, is an Adjunct Professor at the School of Social Work, Portland State University. She has been a motivational interviewing (MI) consultant for over 25 years, providing training, evaluation, research and implementation support, and private coaching internationally. Dr. Ernst has helped develop and refine MI coding instruments, including the Motivational Interviewing Skill Code (MISC) and the Motivational Interviewing Treatment Integrity (MITI) coding system. She participated in research efforts to enhance training effects, providing structured feedback and coaching for many professions. Dr. Ernst has been a member of the Motivational Interviewing Network of Trainers (MINT) since 1997.

Tony Rousmaniere, PsyD, is cofounder and Program Director of Sentio Institute. He provides workshops, webinars, and clinical training and supervision around the world. He is the author/coeditor of six books on deliberate practice and psychotherapy training and two book series: The Essentials of Deliberate Practice (APA Books) and Advanced Therapeutics, Clinical and Interpersonal Skills (Elsevier). In 2017, he published the widely cited article in The Atlantic Monthly, “What Your Therapist Doesn’t Know.” Dr. Rousmaniere supports the open-data movement and publishes clinical outcome data at He was awarded the Early Career Award by the Society for the Advancement of Psychotherapy.
Alexandre Vaz, PhD, is cofounder and Chief Academic Officer of Sentio Institute. He provides deliberate practice workshops and clinical training and supervision around the world. Dr. Vaz is the author/coeditor of four books on deliberate practice and psychotherapy training and two book series: The Essentials of Deliberate Practice (APA Books) and Advanced Therapeutics, Clinical and Interpersonal Skills (Elsevier). He has held multiple committee roles for the Society for the Exploration of Psychotherapy Integration (SEPI) and the Society for Psychotherapy Research (SPR). Dr. Vaz is founder and host of “Psychotherapy Expert Talks,” an acclaimed interview series with distinguished psychotherapists and researchers.

Table of Contents

Series Preface
Tony Rousmaniere and Alexandre Vaz
Part I: Overview and Instructions
Chapter 1: Introduction and Overview of Deliberate Practice and [Therapeutic Approach]
Chapter 2: Instructions for the Motivational Interviewing Deliberate Practice Exercises
Part II: Deliberate Practice Exercises for Motivational Interviewing Skills
Exercises for Beginner Motivational Interviewing Skills
Exercise 1: Simple Reflections
Exercise 2: Complex Reflections, Part 1: Guesses at What the Client Means
Exercise 3: Complex Reflections, Part 2: Guesses at Underlying Client Emotions or Values
Exercise 4: Reflections and Open-Ended Questions
Exercises for Intermediate Motivational Interviewing Skills
Exercise 5: Eliciting Change Talk
Exercise 6: Reflections of Client Change Talk
Exercise 7: Double-Sided Reflections
Exercise 8: Dancing With Discord
Exercises for Advanced Motivational Interviewing Skills
Exercise 9: Simple and Complex Affirmations
Exercise 10: Autonomy Support
Exercise 11: Agenda Mapping
Exercise 12: Elicit–Provide–Elicit
Comprehensive Exercises
Exercise 13: Annotated Motivational Interviewing Practice Session Transcript
Exercise 14: Mock Motivational Interviewing Sessions
Part III: Strategies for Enhancing the Deliberate Practice Exercises
Chapter 3: Additional Guidance for Trainers and Trainees: How to Get the Most Out of Deliberate Practice
Appendix A: Difficulty Assessments and Adjustments
Appendix B: Deliberate Practice Diary Form
Appendix C: Sample Motivational Interviewing Syllabus With Embedded Deliberate Practice Exercises
About the Authors

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