Client-Centered Counseling Skills (Part 1) Lesson Five: Open-Ended Questions and Affirmations

Topics Covered

Review: Sustain Talk and Change Talk

Sustain Talk is any client statement that expresses a desire not to change. It is important to remember to avoid the Righting Reflex when we hear a client express reasons not to change. Change Talk is any client statement that indicates a desire or reason to consider moving towards change. We want to respond in ways that help the client continue talking in that direction. We provide examples of client statements that model either Sustain Talk or Change Talk, and we review the MI principles that can be used to effectively respond in these situations.

The Skills of MI

The core communication skills in Motivational Interviewing are presented through the acronym OARS - Open-Ended Questions, Affirmations, Reflections and Summaries. Much like the oars on a boat, the OARS skills give movement and direction when talking to a client. They help us to build a collaborative relationship, Evoke and focus on client reasons for change, and guide clients toward the next steps. We will explore each of the OARS skills in greater detail.

Reflective Listening

Skillful Reflections have a variety of roles in Motivational Interviewing. Reflections offer to the client that we are listening and understanding them while also giving them the opportunity to correct our understanding. Reflections can also be used as a skillful way to reinforce Change Talk from the client. Reflective listening is the key to engaging with clients and building a collaborative relationship.

Open-Ended Questions

Open-Ended Questions are questions that you ask the client and can’t be answered with a yes or no response. They are an effective tool to help clients talk more as they express their perspective and explore both sides of their ambivalence. As an interviewer, it is important to allow the client to talk more than you. We will provide some examples of Open-Ended Questions that you could ask your client in order to direct them towards further exploring their perspective. 

Closed Questions

Closed Questions are questions you ask the client that can be answered with a yes or no. These questions can be used to gather more information from your client but typically do not result in more talk from the client. Closed Questions can enhance collaboration through asking permission and can encourage commitment through summarizing change talk. We provide some examples of Closed Questions and explore why they are helpful.

Affirmations

Affirmations are responses we give to a client expressing ambivalence in order to direct them back towards exploring abilities and solutions, while also building trust and collaboration. Two types of Affirmations are Expressing Approval and Expressing Empathy & Understanding. Remember the difference between affirming and approving (Approving has“I” and Affirming has “you”). In the early stages of MI with a client Affirmation opportunities may not be obvious, in these situations you can affirm by reframing the client’s perception of the situation. We provide examples of staff responses that affirm the client’s statement and explore the use of Open Questions in Affirming.

Who Should Take This Course

• Therapists
• Counselors
• Addiction Counselors
• Professionals seeking continuing education hours to meet requirements for renewal of the following certifications:
  • Certified Advanced Alcohol and Drug Counselor (CAADC)
  • Certified Alcohol and Drug Counselor (CADC)
  • Certified Clinical Supervisor (CCS)
  • Certified Prevention Specialist (CPS)
  • Certified Prevention Consultant – Reciprocal (CPC-R)
  • Certified Peer Recovery Mentor (CPRM)