Reading: How your practice is scored
The MI-consistent and MI-inconsistent behaviors the AI coach looks for in every practice conversation.
Reading: How your practice is scored
What you’ll learn
- Name the MI-consistent behaviors your practice conversations are scored on.
- Recognize the MI-inconsistent responses that cost points.
- Understand what the scores can and can’t tell you.
The practice conversations in this course are scored on criteria built from MIA:STEP, a set of tools from the ATTC Network that supervisors use to give counselors feedback on motivational interviewing. Its rating guide describes ten behaviors that are consistent with MI, five that are inconsistent with it, and one optional item to track.
MI-consistent behaviors
- MI style or spirit: warm, nonjudgmental and collaborative, following the client’s lead rather than your own agenda.
- Asking open-ended questions.
- Affirming strengths and change efforts.
- Making reflective statements.
- Fostering a collaborative atmosphere: shared decisions, asking permission.
- Discussing motivation to change: drawing out the client’s own reasons.
- Developing discrepancies between the client’s values and their substance use.
- Exploring pros, cons and ambivalence.
- Discussing a change plan.
- Discussing problems and giving feedback in a client-centered way.
MI-inconsistent behaviors
- Unsolicited advice, direction or feedback.
- Emphasizing abstinence as the only acceptable goal.
- Directly confronting the client.
- Emphasizing powerlessness and loss of control, or using labels.
- Asserting authority.
- Closed-ended questions (an optional item supervisors can track).
- MI spirit and collaboration
- What raises your scorePartnering, asking permission, respecting the client’s choices
- MIA:STEP items1, 5, 10
- Open questions, affirmations and reflections
- What raises your scoreOARS, including double-sided reflections, and few closed questions
- MIA:STEP items2, 3, 4, 16
- Evoking motivation
- What raises your scoreDrawing out the client’s reasons, exploring pros and cons, developing discrepancy
- MIA:STEP items6, 7, 8
- Change planning
- What raises your scoreA next step the client chooses, with a when, checked back with them
- MIA:STEP items9
- Avoiding MI-inconsistent responses
- What raises your scoreStarts high. Each piece of advice before asking, push for abstinence, confrontation, label or appeal to authority costs points
- MIA:STEP items11–15
| Criterion | What raises your score | MIA:STEP items |
|---|---|---|
| MI spirit and collaboration | Partnering, asking permission, respecting the client’s choices | 1, 5, 10 |
| Open questions, affirmations and reflections | OARS, including double-sided reflections, and few closed questions | 2, 3, 4, 16 |
| Evoking motivation | Drawing out the client’s reasons, exploring pros and cons, developing discrepancy | 6, 7, 8 |
| Change planning | A next step the client chooses, with a when, checked back with them | 9 |
| Avoiding MI-inconsistent responses | Starts high. Each piece of advice before asking, push for abstinence, confrontation, label or appeal to authority costs points | 11–15 |
I’ll cut down to weekends. I don’t need to quit completely.
Cutting down to weekends is the goal that makes sense to you right now. How would you know if it was working?
Insisting on abstinence here would be MI-inconsistent. Exploring the client’s goal, and agreeing to check how it goes, keeps the conversation collaborative. You can still share a concern, after asking permission.
Respond without labeling, arguing or taking control of the agenda.
ClientLook, I’m an alcoholic, I get it. Can we just move on?
Show a model answer
“You’d rather not dwell on labels, and you want this time to be useful. What would make it useful for you?” It doesn’t reinforce powerlessness talk, and it gives the client a say in what happens next.
Key takeaways
- Scores reward MI spirit, OARS, evoking motivation and client-owned planning.
- Advice before asking, pushing abstinence, confrontation, labels and authority all cost points.
- Treat scores as practice feedback, and look for patterns across conversations.
Adapted from the ATTC Network’s MIA:STEP Motivational Interviewing Assessment rating guide (2006). Public domain. Open MIA:STEP, description of rating items