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intermediateMETmotivational interviewingchange talkalcohol use disorderambivalence
A 45-year-old man with alcohol use disorder is seen for his second session of motivational enhancement therapy (MET). During the first session, the PMHNP provided personalized feedback from a comprehensive assessment showing his drinking exceeded the 95th percentile for his age group, his liver enzymes were elevated, and his spouse had reported significant relationship distress. In the current session, the patient states, 'I guess I was surprised by those numbers. I always thought I drank about the same as everyone else. Maybe I need to think about cutting back, but I'm not sure I could actually do it.' The PMHNP responds, 'You were genuinely surprised to see how your drinking compared to others, and now you're weighing whether making a change is something you could realistically do.' Which MET-specific strategy is the PMHNP primarily using in this response?
Explanation
Selectively reflecting change talk is a core MET strategy in which the therapist differentially attends to and reinforces the patient's statements favoring change. When patients express ambivalence, MET therapists strategically reflect the change-oriented elements to strengthen the patient's own arguments for change, consistent with the self-perception theory that underlies motivational interviewing.
Key Takeaway
In MET, selective reflection of change talk involves the therapist strategically attending to and reinforcing change-oriented statements within ambivalent speech, strengthening the patient's own motivation for behavior change.