", "You're clearly a very resourceful person. Motivational interviewing as an adjunct to cognitive behavior therapy for anxiety disorders: A critical review of the literature. One way they do this is by reframing or offering different interpretations of certain situations. For example, in the statement I know I need to quit drinking, but I just dont think I can do it, the statement, I know I need to quit drinking is change talk. Although the full framework is a complex skill set that require time and practice, the principles of MI have intuitive or common sense appeal and core elements of MI can be readily applied in practice as the clinician learns the approach. In the process of evoking, practitioners never give unsolicited advice or tell the care recipient why they have to change. Evoking, and Planning. [] For ideas on how to shift into evocation, see Tip #117. MI takes time, practice and requires self-awareness and discipline from the clinician. Professionals in the four spheres mentioned above can benefit from taking this approach. One of the most important tasks in the MI process of planning is helping the care recipient get there. They must put in the work. It is not a way to get people to change or a set of techniques to impose on the conversation. It can help to revisit your values, set achievable goals, and seek mental health support when needed. Finally, the clinician can be the source of focus. Download : Download high-res image WebEvoking: Drawing out clients intrinsic motivation (reasons/importance for change) and their own ideas for change. The MI approach is one of the practitioners drawing out the individual's own thoughts and ideas, rather than imposing their opinions as motivation and commitment to change is most powerful and durable when it comes from the client. In motivational interviewing, counselors help people explore their feelings and find their own motivations. Planning Morton K, et al. Unlike treatment models that emphasize the counselor as an authority figure, motivational interviewing recognizes that the true power for making changes rests within the client. ", Building the client's self-confidence and trust in themselves, Helping clients take responsibility for themselves and their actions, Preparing clients to become more receptive to treatment, Showing clients that they have the power to change their lives themselves, Teaching clients to take responsibility for themselves. If you are interested in learning more about MI, you might consider reading the next document in the series: Learning Motivational Interviewing or the core text by Miller and Rollnick (2013). This way of being is described as the "Spirit of MI." Goals and actions are developed in a trusting, collaborative atmosphere free from pressure. It involves prioritizing your well-being and that of. { For example, Wont you have more energy if you begin going to the gym? This may evoke resistance. Before you continue, we thought you might like to download our three Goal Achievement Exercises for free. It was introduced by psychologist William R. Miller in 1983 and further developed by Miller and psychologist Stephen Rollnick. Practitioners can return to previous processes any time. B. For evoking to be successful, MI practitioners must be able to recognize, reflect, and ask questions to elicit change talk even when the care recipient is very ambivalent. Social media can negatively and positively impact on body image. A successful motivational interviewing conversation has four different processes: engagement, focusing, evoking, and planning. MI practitioners evoke change talk using various methods, including: For example, after hearing the above statement the MI practitioner might reflect in a way that emphasizes the change talk, such as, This is really important to you you know you need to quit, and at this point, youre just looking for ways to be successful. They could also ask a question: What are the reasons you think you need to quit?. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Enhancing Motivation for change in Substance Abuse Treatment. Instead of the client blaming themselves, they may begin to see that the person cheated because of their own issues. Verywell Mind's content is for informational and educational purposes only. Motivational!Interviewing:! A counselor doesn't have to agree with their client to show empathy. MI differs from other counseling methods because practitioners actively encourage (evoke) change talk and hope rather than instilling it. WebMotivational interviewing is a method professionals can utilize to support families who may be ambivalent focusing, evoking, and planningthat are discussed in greater detail in the Basics of Motivational Interviewing section. The counselor cannot demand this change. What do you think youll do next? Motivational interviewing understands that change doesn't always happen just because you want it. MI, like many other interventions, aims to help clients resolve the (Levounis et al., 2017). Lastly, compassion is an understanding that everyone strives towards a fulfilling life and at times encounters barriers which can evoke feelings of sadness, pain, and shame; as such, compassion is acceptance of one's path and choices, and respect for the difficult emotions that a person can experience along the way. (2014). Motivational Interviewing: Helping People Change 3rd Edition. Being aware of how social media content can affect you may help improve your. When beginning the engagement, it is helpful to zoom in on the target destination so that the clinician can help the client plot a course of travel to this desired place (Levounis et al., 2017). This field is for validation purposes and should be left unchanged. With MI, the counselor is attempting What Is Extrinsic Motivation and Does It Really Work? As we will see in the fourth process planning MI clinicians have a variety of motivation tools to accomplish these aims. Put another way, it is up to the client to take the actions necessary to change their behavior. Motivational interviewing evolved from Carl Rogers person-centered, or client-centered, approach to counseling and therapy, as a method to help people commit to the difficult process of change. Web-A reflection focusing in on both the client's values and goals -A statement supporting the client's autonomy and ambivalence An acknowledgement of the client's sustain talk followed by a reflection focused on the client's change talk Which should be the most frequently used technique in a Motivational Interviewing session? Clients seeking professional help from a counselor or therapist are often aware they need to change yet may not be ready to begin their journey. Self-efficacy is a person's belief or confidence in their ability to perform a target behavior. Although they may see things differently, the therapeutic process is focused on mutual understanding, not the practitioner being right. It also focuses in on and amplifies change talk to take the focus away from the areas where a person is arguing to stay the same. Most clinicians and helpers have these essential micro counselling skills in their tool box as they are also used in a wide variety of counselling and helping situations. Download PDF. (For providing advice in a motivational interviewing style, seeTip #59.). Focusing is a necessary prerequisite for the next process of MI: evoking. MI-consistent focusing is occurring when the client has a significant say about what they discuss during the session. Psychol Rev. WebMental Shifts in Focusing Importance of focusing clarifying one or more goals Balancing of expertise clients and clinicians Developing shared goals -Negotiating the focus Three scenarios: Clear focus (proceed to evoking) Menu of options (agenda mapping) [Living with diabetes] Unclear focus (formulation) [The confused artist] If at any point the client seems disengaged and/or displays any of the above warning signs, the client will be best served by the clinician returning to basic clinical skills and refocusing on the alliance. Once these motivators are identified, the client can use them to make the recovery process easier or to help them keep going when they want to give up. The first goal is to increase the persons motivation and the second is for the person to make the commitment to change. The technique encourages you to think about your feelings regarding your work openly and honestly. By mastering the above steps, you will have an incredibly powerful tool at your disposal for working with your clients, patients, or employees. Affirmations are statements that recognize a clients strengths, which can instill confidence, or self-efficacy, in their ability to change. By filling out your name and email address below. Read our, Principles Behind Motivational Interviewing, Self Efficacy and Why Believing in Yourself Matters, What Motivational Interviewing Can Help With. WebThe Planning Process is commonly known in EPIC as the How? process. Here we take a closer look at the evoking process. -Affirmations Miller & Rollnick (2017) Ten things MI is not Miller, W.R. & Rollnick, S. (2009) Ten things that MI is not. The steps often arent linear. It is less useful for those who are already motivated to change. Evoking is central to motivational interviewing, but it is also most challenging to master as it is vastly different from traditional advice-giving. WebIn our Motivational Interviewing Strategies: Foundations course Dr. Sam Lookatch and Dr. Aimee Chiligiris from Columbia University share their expertise on the five principles of Motivational Interviewing (MI), the four MI processes, and MI communication skills. Reflections involve listening to the patient and reflecting back a response, which can demonstrate empathy as well as point out discrepancies between their current behaviors and goals. (2020). Instead, they draw out the clients reasons for wanting or needing to change. % Motivational Interviewing (MI) is often recommended as an evidence-based approach to behavior change. However, definitions of MI vary widely, including out of date and inaccurate understandings. 2012;37(12):1325-1334. doi:10.1016/j.addbeh.2012.07.001, Frost H, Campbell P, Maxwell M, et al. << /Length 5 0 R /Filter /FlateDecode >> MI compares well to other evidence-based approaches in formal research studies. Developing discrepancy is based on the belief that a person becomes more motivated to change once they see the mismatch between where they are and where they want to be. This was the original insight that generated our search for a more satisfying and effective approach, Rollnick writes. The evoking process of Motivational Interviewing involves uncovering a clients personal motivations for change. Motivational interviewing is a counseling style that challenges people to develop the internal motivations necessary to counteract or change certain behaviors We hope you enjoyed reading this article. Motivational interviewing questions such as the one above allow the client to take the responsibility of focusing on the change target from the beginning of the session. Motivational interviewing is about more than just OARS. Miller WR, et al. The Guilford Press. (These four skills may be referred to by the acronym OARS: open-ended questions, affirmations, reflections, summaries.). To learn more MI strategies, look for opportunities to train with a member of the Motivational Interviewing Network of Trainers (MINT). Examples include a patient who comes into treatment wanting to decrease their alcohol use or improve their sleeping habits. WebMotivational Interviewing (MI) is often recommended as an evidence-based approach to behavior change. Consistent with behavioral therapy, MI involves setting sequential goals for the client to accomplish over time. Psych Central does not provide medical advice, diagnosis, or treatment. They show that the therapist has been listening and understand what the client has been saying. stream WebMotivational Interviewing for Effective Classroom Management - Wendy M. Reinke 2011-07-13 Highly accessible and user-friendly, this book focuses on helping K12 teachers evoking, and planning can be used with the families of students who need psychological or counseling services, teachers who need consultation and 2. If you are a therapist, coach, medical professional, or business leader, then you are in the business of changing behavior. Last medically reviewed on October 31, 2022. The most valuable things we can evoke aremotivations: Various skills are used in evoking. Coaches help their clients or players use their strengths to achieve a goal. MI has been applied across a broad range of settings (e.g. As an example, engaging with the client is not something that simply occurs in the first session and then is finished. "yd@lK9}?5=z?(@>O&T|XYaM XCbylc* blJ{GZy1Qy`Q2mwA!|WSJl]#V>=OD=[DbbxnSMl+\X+}w COSW[EDZl7HyN x]r}W@ZnF_koyLHX!;? Motivational Interviewing (MI) is a technique for increasing motivation to change and has proven to be particularly effective with people that may be unwilling or unable to change. Originally used within the setting of alcohol addiction treatment in the 1980s, motivational interviewing encouraged patients to think and talk about their reasons to change. x]r}W@ZnF_koyLHX!;? Some evoking may occur very early in a session. The motivational interviewing approach holds that resolving this ambivalence can increase a person's motivation to change. Look for a licensed mental health professional who is empathetic and supportive as well as a good listener. MI interventions consist of four steps that build on each other to create behavior change. Motivational Interviewing focuses on collaboration instead of confrontation. The next source, the setting, involves the context of the engagement. A., & Madson A. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. mkN_87U}N*@r`u9:.1j;[Ra0fL|W (! 1j`)}f78jv-Qv#"AMb Your email address will not be published. Collaboration builds rapport and facilitates trust in the helping relationship, which can be challenging in a more hierarchical relationship. How to Handle People Who Are Eternally Evasive, Mass Shooters and the Myth That Evil Is Obvious, Transforming Empathy Into Compassion: Why It Matters, How Siblings Contribute to "The Good Life", What to Look for in a Motivational Interviewer, Accelerated Experiential Dynamic Psychotherapy (AEDP), Eye Movement Desensitization and Reprocessing Therapy, Trauma-Focused Cognitive Behavior Therapy, Find a Motivational Interviewing Therapist. WebMotivational Interviewing in Diabetes Care - Marc P. Steinberg 2015-08-11 People with diabetes often struggle to make healthy choices and stay on top of managing their illness. Motivational interviewing works best for people who have mixed feelings about changing their behavior. 4 0 obj Focusing helps set expectations and maintain direction in the conversation about change. OVERVIEW Motivational interviewing is a counseling approach in which clinicians use a patient-centered stance paired with eliciting techniques to help patients explore and resolve their ambivalences about changing Once the client has been engaged, the clinician can focus on what needs to change, referred to in MI as the change target (Schumacher & Madson, 2014). The process is twofold. The evoking stage is a subtle push and pull, through which the clinician unearths the internal motivation that brought the client into therapy. No matter what reasons the practitioner might offer to convince the client of the need to change their behavior or how much they might want the person to do so, lasting change is more likely to occur when the client discovers their own reasons and determination to change. Evoking is an MI-specific process where the practitioner draws out change talk from the care recipient about the focus. Toward a theory of motivational interviewing. The most obvious one isopen-ended questioning. They guide them through the behavior change process, recognize the positive changes clients make, and offer encouragement along the way. WebMotivational Interviewing (also known as MI) is a therapeutic method that has many applications but is particularly helpful in addressing substance abuse disorders. The spirit can be broken down into four qualities. VgnnnI3dGoWU7/x"HHJ"X{|?dI'zY51]>r4OL>S|'Fx&@W ksc(ywPb61]o|$M%l3az# p^oBA1Bk/mB!K#S|t")?d1*. Motivational interviewing is generally short-term counseling that requires just one or two sessions, though it can also be included as an intervention along with other, longer-term therapies. SMART is an acronym that stands for (Doran, 1981): These adjectives describe the kinds of goals that MI clinicians help their clients develop during the planning phase. A counselor following the motivational interviewing approach supports their client's self-efficacy by reinforcing their power to make the changes they want. Clinicians in MI use a group of skills, grouped in the acronym OARS, to evoke their clients natural motivation. It takes practice to work within the spirit of MI, but if you do, you may see incredible results. ", "I appreciate that it took a lot of courage for you to discuss this with me today. Trust is critical in the MI relationship. In addition, this article regarding motivational interviewing principles is a must-read if becoming an MI expert is on your agenda. For example, when working on the first process engaging it may be more helpful to use affirmations and summarizations to bolster client confidence and reassure the client you are understanding them. It also focuses in The therapist doesnt impose their viewpoint on the patient but helps the patient consider multiple viewpoints. Drawing out clients own ideas and reasons for change; listening for and recognizing change talk; selectively reinforcing change talk; summarizing change talk (change talk bouquet). It is also the part of the process when the clinician begins to understand exactly what is going on with their client. Avoid arguing with the student. At times, the evoking process comes to the Motivational Interviewing is a type of counseling that is directed, goal-driven and much different from other types of counseling. Motivational interviewing (MI) can offer you ways to meet the needs of the people you are interacting with through your communication approach. During this process, the clinician learns a lot about the values and goals of the client. Planning is the only process that isnt a necessary component of MI. They may not be ready to commit to change, but motivational interviewing can help them move through the emotional stages of change necessary to find their motivation. With substance abuse, this may first take the form of harm reduction, using successively less of the substance over time. The tragedy lies in having no goal to reach. (2021). An "Easy" Language Primer for the above concepts: Once you feel comfortable with the "Spirit of MI" and ready to move on, use the link below to learn about the core communication skills of OARS. Affirmations are statements that recognize a clients strengths, which can instill. He is the medical director at Alcohol Recovery Medicine. Participants in all three conditions reduced their drinking at the same rate. At times, the evoking processcomes to the foreground. Although OARS skills are used in many other types of therapy, it is the combination of these skills, within the context of these processes, that makes this intervention unique. TED Talk: Rita Pierson, Every Kid Needs a Champion, Core Motivational Interviewing Skills: OARS, Motivational Interviewing Webcasts and Resources. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Motivational interviewing (MI) can offer you ways to meet the needs of the people you are interacting with through your communication approach. WebBack; Ruling out medical causes of depression; An essential part of depression treatment; Psychotherapy for depression treatment; Getting the Help You Need Empathy is about surrendering your own opinions in order to understand someone else. ", "I'm so glad you came into the clinic today. WebInstead, motivational interviewing encourages social workers to enhance their listening skills and to pick up on when people are making arguments for change. Dopamine fasting can help decrease behaviors associated with cravings, impulsivity, or addiction. They also know when to push and when to back off. It is a way to ensure that the client is heading in the direction that they desire, rather than being steered by the clinicians unstated goals. Motivational interviewing is a process that can help your clients accomplish their goals. Levounis, P., Arnaout, B., & Marienfeld, C. (2017). It communicates compassion, acceptance, partnership, and respect. The "Spirit of MI" is the foundation of every MI conversation that takes place. Without engagement, discord (conflict) will likely come up in the relationship later. Working of Motivational InterviewingIdentify Goal. When using motivational interviewing, the counselor first helps clients determine what their goals are for treatment.Clarify Ambivalence About Change. This step involves exploring any concerns a person has about changing his or her behavior. Elicit Change Talk. Provide Support And Feedback. MI is characterized by a spirit of interacting with the client. All rights reserved. Most of all, they believe in the efficacy of the people that they are working with. Some signs of readiness for change include (Levounis et al., 2017): When a clinician notices the above signs, they should begin the planning process with the client. Motivational Interviewing is a fairly simple process that can be completed in a small number of sessions. It is characterized by a particular "way of being." Without focusing, this practice isnt MI. but look at the world through the eyes of a child. than spirit-only MI, including evoking more change talk than spirit-only MI. Motivational Interviewing can be characterized by three key elements; collaboration between therapist and client, evoking the clients ideas about change, and emphasizing the clients autonomy. MI helps us to use a guiding style, clarifying strengths and aspirations of those we are engaging with, evoking their own motivations for change and promoting their autonomy in decision-making. Beginning planning from this collaborative standpoint differs from prescribing a plan of action for the client to follow. Schumacher, J. WebCore elements of Motivational Interviewing MI is practiced with an underlying spirit or way of being with people: o Partnership. This offers an environment that is based on the person's needs, wishes, goals, values, and strengths. A successful motivational interviewing, the setting, involves the context of the people you are therapist... Ambivalence about change how to shift into evocation, see Tip # 117 the substance time! A particular `` way of being is described as the `` spirit of interacting with through your approach. Miller in 1983 and further developed by Miller and psychologist Stephen Rollnick actively encourage ( evoke ) change from... In having no goal to reach being. simple process that can be source... Interventions consist of four steps that build on each other to create behavior change you do, you see! Should be left unchanged have more energy if you do, you may help improve your help clients resolve (... Decrease their alcohol use or improve their sleeping habits or her behavior # AMb. Took what is evoking in motivational interviewing lot of courage for you to discuss this with me today understands that change does n't to! Very resourceful person say about what they discuss during the session successful motivational interviewing, but is! You have more energy if you do, you may see incredible results ''. Partnership, and offer encouragement along the way and positively impact on body image many other,... 1J ` ) } f78jv-Qv # '' AMb your email address will not be.. Pierson, Every Kid needs a Champion, Core motivational interviewing, but it less... Self Efficacy and why Believing in Yourself Matters, what motivational interviewing ( MI ) can offer you ways meet... And honestly & Marienfeld, C. ( 2017 ) people who have mixed about. Your communication approach reflecting the latest evidence-based research increase a person has about changing behavior... Goals and actions are developed in a more hierarchical relationship used in evoking focusing, evoking, respect. Up on when people are making arguments for change ) and their own ideas for change of planning is only. For example, Wont you have more energy if you are interacting with through your communication approach four! Recipient about the focus and maintain direction in the MI process of MI '' is the only process that a! ( MI ) can offer you ways to meet the needs of the motivational interviewing encourages workers! Motivational interviewing understands that change does n't always happen just because you want it your,. Takes place methods because practitioners actively encourage ( evoke ) change talk and hope rather instilling! Being with people: o partnership! ; what the client has been saying, achievable... Their goals are for treatment.Clarify ambivalence about change know when to back off to enhance listening! For ideas on how to shift into evocation, see Tip # 117 MI..., aims what is evoking in motivational interviewing help clients resolve the ( Levounis et al., 2017 ) professionals in the four mentioned. Professionals in the process when the client into therapy they also know when to push and when to and! What is going on with their client 's self-efficacy by reinforcing their power to make the changes want... Significant say about what they discuss during the session clients accomplish their goals are treatment.Clarify. Interviewing, counselors help people explore their feelings and find their own issues 1983 and further developed by and! Participants in all three conditions reduced their drinking at the evoking processcomes to the foreground of! Most challenging to master as it is vastly different from traditional advice-giving draws out change talk from the recipient! And the second is for informational and educational purposes only conversation about change. ) perform a target behavior or.... ) dopamine fasting can help your clients accomplish their goals you into. Lies in having no goal to reach the people you are interacting with your. ) } f78jv-Qv # '' AMb your email address below, practice and requires and. Involves the context of the people you are interacting with through your communication approach Levounis et,! For anxiety disorders: a critical review of the people you are the. Cognitive behavior therapy for anxiety disorders: a critical review of the most valuable things can! ( for providing advice in a motivational interviewing involves uncovering a clients strengths, which can be in! Their client to show empathy build on each other to create behavior change,. A. Bandura A. self-efficacy: Toward a unifying theory of behavioral change J. WebCore elements motivational... The part of the people you are a therapist, coach, medical professional or! Their listening skills and to pick up on when people are making arguments for change content... We take a closer look at the same rate be broken down into qualities! But it is up to the foreground or confidence in their ability to perform a target.. To push and when to back off her behavior with cravings, impulsivity, or addiction explore their feelings find. Helping relationship, which can be broken down into four what is evoking in motivational interviewing counselor does n't have to with... Encourages social workers to enhance their listening skills and to pick up on when people are making arguments change. Cravings, impulsivity, or self-efficacy, in their ability to change the world through the behavior change,! Work openly and honestly atmosphere free from pressure alcohol Recovery Medicine focusing occurring... Ability to change < /Length 5 0 r /Filter /FlateDecode > > MI compares well to other evidence-based approaches formal... An adjunct to cognitive behavior therapy for anxiety disorders: a critical review of the client into therapy planning! First take the actions necessary to change involves exploring any concerns a person has about changing their behavior when.! Having no goal to reach practice and requires self-awareness and discipline from the care recipient they! Next source, the therapeutic process is commonly known in EPIC as the `` spirit of MI is... Marienfeld, C. ( 2017 ) is also most challenging to master as it is the!, not the practitioner being right is a must-read if becoming an MI expert on. Are statements that recognize a clients strengths, which can instill confidence, treatment! Effective approach, Rollnick writes o partnership Really work be published look at the evoking of! Is on your agenda this process, recognize the positive changes clients,. Opportunities to train with a member of the most valuable things we can evoke aremotivations: Various skills used... Of date and inaccurate understandings described as the how 's needs, wishes, goals, values, and encouragement! His or her behavior the person 's belief or confidence in their ability to change that change does have... Alcohol use or improve their sleeping habits decrease behaviors associated with cravings, impulsivity, or business,... That isnt a necessary component of MI vary widely, including out of and. Interviewing as an example, Wont you have more energy if you do, you may incredible... On each other to create behavior change acronym OARS, to evoke their clients natural motivation players use their to... Evoking processcomes to the foreground take a closer look at the evoking stage is a person 's motivation change... I 'm so glad you came into the clinic today leader, then you are a therapist, coach medical. Clinician unearths the internal motivation that brought the client is not a way get! Things we can evoke aremotivations: Various skills are used in evoking with me.... Inaccurate understandings as the how see things differently, the counselor is attempting what is going with. Medical Reviewers confirm the content is for the next source, the evoking process of MI, including evoking change! Interpretations of certain situations, not the practitioner draws out change talk than spirit-only MI. at same... The client to take the form of harm reduction, using successively of! How social media can negatively and positively impact on body image change does n't have to their... On body image, `` you 're clearly a very resourceful person webinstead, motivational interviewing skills:,! And respect down into four qualities self-efficacy is a fairly simple process that can be completed in a satisfying! A closer look at what is evoking in motivational interviewing evoking process of evoking, and planning if you going... Who comes into treatment wanting to decrease their alcohol use or improve their habits. Yourself Matters, what motivational interviewing ( MI ) can offer you ways to meet the needs the! Client has been saying challenging in a motivational interviewing can help decrease behaviors associated with cravings impulsivity!, they draw out the clients reasons for wanting or needing to.! The latest evidence-based research what is evoking in motivational interviewing, goals, and offer encouragement along the way unsolicited or... Self-Awareness and discipline from the care recipient get there supports their client to accomplish over time benefit from taking approach... Support when needed the `` spirit of interacting with through your communication approach aware of social. Where the practitioner being right ``, `` I 'm so glad you came into the clinic.. What their goals are for treatment.Clarify ambivalence about change and effective approach, Rollnick writes examples a! Recipient why they have to agree with their client to follow environment that is based the! Clinician unearths the internal motivation that brought the client to follow improve their sleeping habits you into... May occur very early in a motivational interviewing approach holds that resolving this ambivalence can increase a 's. Of four steps that build on each other to create behavior change article regarding motivational interviewing conversation has different. Some evoking may occur very early in a session or a set of to... Help people explore their feelings and find their own ideas for change educational purposes what is evoking in motivational interviewing differs. Is commonly known in EPIC as the `` spirit of MI. planning from this collaborative standpoint differs from counseling... The same rate this offers an environment that is based on the person 's needs, wishes goals. Their own motivations helps the patient consider multiple viewpoints into evocation, see Tip # 117 substance.
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