Kristen Ellis

What do I value most about myself as a woman? Why?

I value my caring nature and kind heart. I always care about the person first
before any other issues in their life and make sure their happiness is the top
priority. I am also a good listener which is important for me to form bonds
with other people. Trust is a very big part of my life and it is important to me
that people can trust me. I value my very close friendships and deep bonds
and that was only possible through being trustworthy.
What do I value most about myself as a counselor? Why?
I value my ability to see different perspectives in a situation and understand
everyone comes from a different background that can affect how they act or
feel. I think empathy is an important part of being a good counselor because
it allows you to come up with reasonable goals together with the client and
understand what is attainable for them. I value my honesty as well. Even in
difficult situations it is important to stay honest with your client so they can
trust you and know what you say will always be the truth. Without that trust,
it will be very difficult to motivate your client to reach their goals.
What three things would I absolutely never do to a client? Why?
I would never tell them that what they are feeling is wrong. Everyone is
affected differently by events in their life and thus everyone reacts differently
and it is not for me to decide how someone should respond to a situation.
I would never judge anyone for anything about their life. Everyone has a past
and that should not reflect the respect they deserve. I have no right to judge
someones situation and tell them they are wrong for what they have or have
not done.
I would never tell them they are a failure or have failed at their task. Dwelling
on the past or on mistakes will not fix them and it is just not beneficial. Just
because you do not complete your goal right away or make some wrong
turns does not mean you have failed in the least. Life is difficult and full of
surprises and twists and sometimes priorities change.
What three things do I expect from clients? Why?
I expect that they are open to the idea of change with the proper support and
motivation. They do not have to make huge strides but they need to have
some desire to at least discuss what they are going through and why change
may be an option for them.
I expect they will share with me pertinent information about their life so I
can help them to the best of my ability. Without their trust and openness I
will not be able to do my job successfully and that will affect their success
with their goals.
I expect my client will trust me to help them to the best of my ability. They
need to trust that everything I do is to try to help them and not with
malicious intent.
What three values are most central to my beliefs about life? Why?

You should never pass judgment- everyones life experiences are different.
Everyone thinks and feels differently. No one persons opinion or feelings is
ever more important than someone elses. It is not fair to you or the person to
judge their choices or life.
Honesty is always number one- even if it is out of good spirit, not being
truthful to someone can harm trust and damages a relationship. It is
important to find a balance between being honest and keeping your clients
feelings in mind.
A lot can be accomplished through communication-sometimes just talking
out your clients thoughts and issues can be enough for them to have a change
of heart. Most of the time it is not that someone needs to be fixed, they just
need to talk out their thoughts to sort it out.

Name __Kristen Ellis__

Section __MW 2:30-3:45___ Date___3/5/14_____

Client: Alyssa Garrett

WELLNESS WORKSHEET 3

Stages of Change
The stages of change model of behavior change includes six well-defined stages that people move
through as they work to change a target behavior. It is important to determine what stage you are
in now so that you can choose appropriate techniques for progressing through the cycle of
change.
Target behavior/problem: ____eating too much junk food and not working out enough___
Goal of behavior change:____to feel more comfortable in her own skin and increase self
confidence. Also, to know that she is doing something good for her body that will keep her
healthy and happier throughout her life.
Examples of target behaviors include smoking, eating candy bars every afternoon, and never
wearing a safety belt; the goal of your behavior change program might be quitting smoking,
eating only one candy bar per week, or wearing a safety belt every time you are a driver or
passenger in a car.
Part I. Assess Your Stage
To determine your stage, check true or false for each of the following statements:
True

False

_____ F_____ 1. I changed my target behavior more than 6 months ago.

_____ _F____ 2. I changed my target behavior within the past 6 months.
_____ _T____ 3. I intend to take action in the next month and have already made a few small
changes in my behavior.
_____ T_____ 4. I intend to take action on my target behavior in the next 6 months.
Find the stage that corresponds to your responses and underline/bold the stage you are in:
False for all four statements = Pre-contemplation
True for statement 4, false for statements 13 = Contemplation
True for statements 3 and 4, false for statements 1 and 2 = Preparation

True for statement 2, false for statement 1 = Action

True for statement 1 = Maintenance
Preparation

_____ Make change a priority in your life; plan to commit the necessary time and effort to
change.
______ Create a specific plan for change, and complete the SMART Goal Worksheet
_____ Tell the people in your life about the change youll be making, and enlist their help. List
the people youve spoken with and how they will help in your program for change (also
included on the SMART Goal Worksheet)

My mom- she understands why I want to change and knows how to keep me
motivated to continue with my goal.
My roommate- she lives with me and knows my goal so when I do not want
to stay on track, she will be able to keep me in check.
My friends- They will support me and keep my spirits up so I can be
successful with my goals.

SMART Goal Worksheet

S.M.A.R.T.
Specific

Questions
Does your goal clearly and specifically state what you are trying to
achieve?
If your goal is particularly large or lofty, try breaking it down into
smaller, specific SMART goals.

Measurable How will you (and others) know if progress is being made on achieving
your goal?
Can you quantify or put numbers to your outcome?
Attainable

Is achieving your goal dependent on anyone else?

Is it possible to reframe your goal so it only depends on you and not
others?
What factors may prevent you from accomplishing your goal?

Relevant

Why is achieving this goal important to you?

What values in your life does this goal reflect?

Timebound

What effect will achieving your goal have on your life or on others?
When will you reach your goal?
Again, if your goal is particularly large, try breaking it down into smaller
goals with appropriate incremental deadlines.

Todays Date: 3/5/14

Date by which you plan to achieve your goal: 6/5/14
What is your goal in one sentence? (Whats the bottom line?)
My goal is to lose 15 lbs and work out at least 5 days a week until
my goal weight is achieved on 6/5/24, which I am able to do
because 3 months is a reasonable time to lose 15 lbs and I have
access to a gym and outdoor exercise activities and this is
important to me because I want to be more confident and
comfortable with myself and healthier for myself and my family.

The benefits of achieving this goal will be: being more self
confident and happier with my body image and my life. I also want
to be healthier so I can be my best for my family and friends.

Action Plan
What specific steps must you take to achieve your goal?
This action plan may just get you started. Feel free to create a more
detailed step-by-step plan.
Task/ to-do item
Expected
Date
Reward
completion actually
date
completed

OBSTACLES/CHALLENGES
What obstacles stand in the way of you achieving your goal?
Obstacle
How will you address the
challenges if/when they
arise?

Network of Support and Accountability

When working towards achieving a goal, it is helpful to have one or two
people whom you agree to check in with on a regular basis. Keeping
others informed on your progress can be a useful external motivator!
Who can you share your goal with?
1. Talk to one or two individuals who will genuinely want to see you
succeed in achieving your goal.
2. Explain to them why achieving this goal is important to you.
3. Ask if they will support you and hold you accountable in reaching
your goal.
4. Select and agree upon future dates/times you will report
updates on your progress.
Contact

My mom

roommate

Frequency of
updates on progress
(i.e. weekly, biweekly, monthly)
List future dates/times
you will report your
progress
Weekly

Agreed upon method

of communication (i.e.
face-to-face, phone,
email)

everyday

A quick chat in person

about how the day went
and goals for tomorrow.

Through phone calls

Date your goal is ACHIEVED: 6/5/14

Congratulations on creating a SMART goal and sticking with it! Be
sure to share your achievement with your network of supporters and
find a way to celebrate your success.

Therapist Evaluation of Motivational Interview (TEMI)

[TO BE COMPLETED BY THE THERAPIST/COUNSELOR]

Please rate each response on the scale below relating to your MI sessions with your
client.
1.
2.
3.
4.

[1]
[2]
[3]
[4]

Not At All
Only a Little
Some
A Great Deal

In your sessions, how much did you:

|_1_| TEMI01.

focus only on client weaknesses.

|_4_| TEMI02.

help the client to feel safe in talking honestly about your concerns.

|_4_| TEMI03.

help the client to actively participate in the therapy session.

|_3_| TEMI04.

respect the clients point of view.

|_3_| TEMI05.

comment that the client seemed ready to change.

|_2_| TEMI06.

help the client to talk about changing their behavior.

|_4_| TEMI07.

help the client to recognize their strengths.

|_4_| TEMI08.

act as a partner in the clients behavior change.

|_3_| TEMI09.

helped the client discuss their need to change their behavior.

|_1_| TEMI10.

make the client feel distrustful of you.

|_4_| TEMI11.

make the client feel accepted by you.

|_3_| TEMI12.

help the client examine the pros and cons of changing their
behavior.

|_3_| TEMI13.

help the client to feel hopeful about changing their behavior.

|_1_| TEMI14.

argue with the client to change their behavior.

|__2_| TEMI15.

change the topic when the client became upset about changing
their behavior.

CONT.
Please rate each response on the scale below relating to your MI sessions with your
client.
1.
2.
3.
4.

[1]
[2]
[3]
[4]

Not At All
Only a Little
Some
A Great Deal

In your sessions, how much did you:

|_3_| TEMI17.

praise the clients accomplishments.

|_1_| TEMI18.

push forward when the client became unwilling to talk about an

issue further.

|_1_| TEMI19.

act as an authority on the clients life.

|_2_| TEMI20.

help the client recognize the need to change their behavior.

|_1_| TEMI21.

tell the client what to do.

|_1_| TEMI22.

argue with the client about needing to be 100% ready to change

their behavior.

|_4_| TEMI23.

work with the client to address their concerns.

|_4_| TEMI24.

show the client that you believe in their ability to change their
behavior.

|_2_| TEMI25.

help the client discuss any reasons for continuing the problem
behavior.

|_4_| TEMI26.

show the client that you believe in their ability to change their
behavior.

|_4_| TEMI27.

help the client to feel confident in their ability to change their

behavior.

|_4_| TEMI28.

help the client to feel hopeful about changing their behavior.

CONT.
Please rate each response on the scale below relating to your MI sessions with your
client.
[1]
[2]
[3]
[4]

Not At All
Only a Little
Some
A Great Deal

In your sessions, how much did you:

|_1_| TEMI29.

make judgments about the client.

|_1_| TEMI30.

disrespect the clients point of view.

|_4_| TEMI31.

comment on the clients strengths.

|_4_| TEMI32.

help the client to feel safe in talking honestly about their concerns.

|_4_| TEMI33.

help the client talk in depth about concerns important to them.

|_3_| TEMI34.

comment that the client seemed ready to change their behavior.

|_3_| TEMI35.

comment that part of the client is ready to change and part of them
wants to stay the same.

|_1_| TEMI36.

base your respect for the client on their behavior.

Client Evaluation of Motivational Interview (CEMI)

[TO BE COMPLETED BY THE CLIENT]

Please rate each response on the scale below relating to your experiences with your
health coach.
1.
2.
3.
4.

[1]
[2]
[3]
[4]

Not At All
Only a Little
Some
A Great Deal

In your meetings, how much did your health coach:

|__2_| focus only on your weaknesses.
|_4_|

help you to feel safe in talking honestly about your concerns. help you to actively

|_3_|

participate in the therapy session.

|_4_|

respect your point of view.

|_3_|

comment that you seemed ready to change.

|_3_|

help you to talk about changing your behavior.

|_4_|

help you to recognize your strengths.

|_4_|

act as a partner in your behavior change.

|_3_|

helped you to discuss your need to change your behavior.

|_1_|

make you feel distrustful of him/her

|_4_|

make you feel he/she accepts you.

|_4_|

help you examine the pros and cons of changing your behavior.

|_4_|

help you to feel hopeful about changing your behavior.

|_1_|

argue with you to change your behavior.

|_2_|

change the topic when you became upset about changing your
behavior.

Please rate each response on the scale below relating to your meetings with your
health coach.
1.
2.
3.
4.

[1]
[2]
[3]
[4]

Not At All
Only a Little
Some
A Great Deal

In your meetings, how much did your health coach:

|_4_|

praise your accomplishments.

|_1_|

push you forward when you became unwilling to talk about an issue further.

|_2_|

act as an authority on your life.

|_3_|

help you recognize the need to change your behavior.

|_1_|

tell you what to do.

|_1_|

argue with you about needing to be 100% ready to change your behavior.

|_4_|

work with you to address your concerns.

|_4_|

show you that she/he believes in your ability to change your behavior.

|_2_|

help you discuss any reasons for continuing your problem behavior.

|_4_|

show you that she/he believes in your ability to change your behavior.

|_4_|

help you to feel confident in your ability to change your behavior.

|_2_|

help you to feel hopeful about changing your behavior. makes judgments about
you.

|_1_|

disrespect your point of view.

Please rate each response on the scale below relating to your meetings with your health
coach.
1.
2.
3.
4.

[1]
[2]
[3]
[4]

Not At All
Only a Little
Some
A Great Deal

In your meetings, how much did your health coach:

|_4_|

comment on your strengths.

|_4_|

help you to feel safe in talking honestly about your concerns.

|_4_|

help you talk in depth about concerns important to you.

Did your health coach:

|_3_|

comment that you seemed ready to change your behavior.

|_3_|

comment that part of you is ready to change and part of you wants to stay the
same.

|_1_|

base his/her respect for you on your behavior.

Client Encounter & journal Reflection #1

My clients goal is to lose weight (15lbs) and be overall healthier. When we
first starting discussing her goals she seemed to have a low self-efficacy. She has
tried losing weight in the past and has been successful at first, but would then
relapse and gain it all back. This has lead to her low self-confidence. As we talked
about the ways she could lose the weight, such as incorporating salads into her
meals, going to the gym 5 days a week, being active with her friends (like plays
sports/hiking), she seemed to gain more confidence. We discussed what obstacles
may be in her way of achieving her goal that she does not have control over. She was
concerned about her school work taking up too much time in her day to have time to
work out since she has a lot of exams coming up. We came up with ways she could
incorporate physical activity into her day for times when she did not have time to go
to the gym. We decided she could walk to campus from her apartment (since it is
only about 1 miles away) instead of driving, and take the long way around campus
to her classes. We also discussed the option of joining an intermural softball team to
keep her workouts fun and possibly find some other people with a similar goal to
herself. Another issue is that she does not have time to cook her food so she is
dependent on campus food and sometimes the unhealthy choices in the dining halls
can be very tempting. One way we decided to combat this was to plan ahead what
food she was going to eat that day so when she got to the dining hall hungry she was
not deciding what to eat based off of her hunger.
My client is in the preparation stage because she is making the change within
the next 6 months and she has already begun to make behavior changes. She goes to
the gym at least 2x a week and has cut back on the amount of unhealthy food she
buys at the grocery store. She is ready to move into the action phase with the
support of her mother and her roommate. Having someone who lives with her know
her goals is important to her and believes it will really help her stay on track
because her roommate will hold her accountable every day. She continued to show
some ambivalence to her goal, but that seemed to decrease as we discussed her
reasons why she wanted to do this. She has struggled with her weight for her whole
life and it has taken a toll on her happiness. She wants to be proud of losing the
weight and being healthy. She also finds a lot of motivation through her dad who is
struggling with health complications due to his weight. The more we discussed her
motivators and the ways she could accomplish her goals, the higher her self-efficacy
went and I am confident in her ability to make strides towards her goal in the near
future.

Client Encounter & Journal #2

I felt that in this client encounter, my client was more prepared and willing to
continue her action plan. She continues to show ambivalence about her goal and is afraid
of her success. With that said, she is still willing to work on her goal and look forward.
To help her overcome this ambivalence, we discussed her hesitations and why she would
like to continue with her goal. By having her say outloud that she wanted to change and
wanted to continue her goal, we enacted the self-perception theory; I did this because I
know it does not matter how many times myself, or anyone else tells her she should or
could change, but that she needs to be the one to say that she wants to change. I think she
was feeling much more confident about her abilities at our previous meeting and now she
has a lot of different problems floating through her head. We needed to do some agenda
mapping to figure out what she wanted to talk about first. Her classes have been
assigning a lot of tests and homework so that has preoccupying her. The stress from
school has cut into her time to workout and her motivation. We decided to discuss how
she could delegate her time effectively for her school work first, and then talk about what
she could do to continue her smart goal. Because of what we talked about, I decided to
try to ask her about stress and emotional eating. I used the Elicit-Provide-Elicit method to
begin the conversation. I asked her if she felt comfortable talking about how stress
changed her eating habits or if she had noticed any changes. Once she told me she would
like to discuss it, I explained that many people feel they eat differently when they are
stressed and that it is a normal response. After that, I asked if she could elaborate on her
experiences in the passed when she was stressed at school and how that changed her
eating habits. She freely discussed it with me and asked me if there were any helpful tips
I knew of to help her stay on track with her goal while dealing with stress. I told her I
would find current research on the topic and get back to her. I felt that we were spending
a lot of time talking about what she had to get done for her classes and wanted to get back
on topic so I used the tool of summarizing what we had discussed about her goal and
back on topic. Since she was still concerned about success under these conditions, we
discussed concepts of MI such as absolute worth, self-efficacy, and affirmation. We
talked about her absolute worth and potential to make choices for herself. Then we
discussed her self-efficacy and how she believed in her ability to reach her goal. Finally, I
affirmed for her all of the positive strengths she had that we had discussed. I think this
meeting was very important for her to regain her motivation. Even though she was
always in the action phase of the plan at our first meeting, we agreed it would be helpful
if we discussed mobilizing change talk and talk about Commitment, Activation, and
Taking steps (CATS). She reaffirmed her commitment to her goal and we reviewed the
reasons why she wanted to complete it in the first place. Then we talked about
reactivating her action plan since she admitted she had been slipping on it recently.
Finally, we talked about taking steps. She told me something she could do to start
immediately to get back on her plan was to walk home. She had taken the bus to meet
me, but now she was feeling new motivation to continue her physical activity. Since she
is busy with classes right now and is struggling to keep her workout schedule, we
discussed trying to walk more during her day instead of driving or riding the bus so she
did not need to set aside as much time for exercise. At the end of the meeting, I asked her
if I could suggest a way to keep her motivated to walk, using Elicit-Provide-Elicit again.
She told me that it was ok with her, so I suggested she wear a pedometer. I explained this

is because you can look at your steps and if she sets a goal for herself to meet, she can
monitor it throughout the day. That way, if she falls behind she will be motivated to walk
instead of taking the bus. On the other side, it will keep her motivated when she continues
to reach her goal number of steps every day. She agreed that it would be a good idea to
try. I asked her if she would like any more information on it, but she said she felt it was
pretty simple and would give it a try.

Client Encounter & Journal Reflection #3

It has been a few weeks since our last meeting and her confidence levels are much
higher than last time. She told me that she has lost 4 pounds since our last meeting and
that she is feeling more energetic than before. She also told me that a lot of stress from
her classes had subsided so she was better able to focus on her goal. We started by doing
some agenda mapping and finding out what she wanted to discusses today. She said the
first thing she wanted to talk about was the pedometer. She told me it was very helpful to
keep her on track and that it was motivating to her because she was constantly reaffirmed
of her success when she would meet her goal of 10,000 steps a day. It seems like her
ambivalence has really subsided at this point and her self-efficacy is very high. She told
me that one of her friends told her grapefruits would help her burn more calories
throughout the day. I resisted using my righting reflex and asked her if she had done any
additional research on it to find out if it was true. She told me she had not, but thinks it is
a good idea. It seems like she is in a state of self-actualization now; she is finally seeing
her potential and feeling like she can succeed in her goals. I practiced equipoise when she
discussed where she wanted to go from here. She was feeling very happy with the
progress she had made and considered not continuing all the way to finish her goal .
Although I believed this was not a good idea, I remained neutral on the topic and allowed
her to explore her ambivalence. This was another place where I had to restrict my
righting reflex. After we discussed her options, she said she thinks if she did not finish
her goal she would end up being unhappy again shortly. After this, I thought it would be
good to evoke some motivation for continuing her goal. I tried to guide her to find her
motivation instead of directing her because that could cause discord. Although
ambivalence is a natural part of human emotions and motivational interviewing, discord
because of my poor reaction to ambivalence could damage our trust and relationship,
which I did not want to do. I honored her autonomy to make her own decisions no matter
what I or anyone else said. She found that the reasons that motivated her to start her goal
were the same ones that are motivating her to continue her goal. We enacted the selfperception theory again to recap her motivations and deepen her commitment to her goal.
Since she was close to finishing her goal and that we would not have any more chances to
meet this semester, we decided to discuss where she wanted to go when she reached her
goal. She agreed that maintenance can be the most challenging part and she wanted to
discuss some ways to make her more successful. Using Elicit-Provide-Elicit I asked her if
she would like to talk about the difficulties of maintenance. She said she would like to so
we talked about what parts of maintenance people. I asked her if she would like to
discuss what she anticipated being difficult for her. She told me she is concerned about
keeping up her exercise and diet plan for an extended period of time and that if she
regains the weight she will feel like a failure. I did not want her to lose her self-efficacy,
so we discussed the reasons she would be able to succeed at maintenance. After this I
asked her to rate herself on a scale of 1-10, 1 being not confident at all and 10 being
absolutely confident, how successful she felt she would be at maintenance. She rated
herself at a 6. I asked her why she was not a 1. She explained that she knew that she had
some ability to maintain, so I asked her why she was not a 4 and she told me her reasons,
but she also explained ambivalence that made her not choose a higher number. To end
our meeting on a positive note, we addressed the ambivalence and reaffirmed the skills

she had to be successful. I look forward to talking with her while she continues to reach
her goal and into the maintenance phase.

Overall Evaluation
I think MI is a very important method to help people succeed in changing health
behaviors. I think I was successful at making my client feel safe and trusting of our
relationship. I do not judge people for their past, for their choices, or for their behaviors
and I communicated that to my client so that she could feel secure in sharing her
ambivalence. I think it is important to build that trust and safety, otherwise it motivates
clients to lie about how they are feeling or not want to discuss their ambivalence for fear
of sounding like a failure. I also encouraged my client to have higher self-confidence and
higher self-efficacy. I think this may have caused her some distress though because it
would point out to her that her self-confidence was lower than she wanted. I think I need
to work on remaining more neutral on my meetings because I would get very passionate
that I wanted my client to succeed and did not like to hear she put herself down and it
was very difficult for me to discuss what she was saying without wanting to correct her
with the righting reflex. I also think I still need to find the perfect balance between being
friendly and having a strong client-therapist relationship and being friends with my
clients. I naturally wanted to build that relationship with them and probably spend too
much time talking to them about other topics. This is not really a useful way to spend my
clients time and changes the nature of our relationship which could harm their ability to
succeed in changing their health behavior.
I consciously reminded myself not to tell my client what to do or to tell them why
it was good for them to change. It was hard not to do that because I naturally want to
teach people about health and tell them the information I know, but it is better for their
success if they discover what works for them on their own with me simply guiding them
in the right direction. I definitely have the personality that likes to help people and maybe
am too strong with my recommendations, so that is something I can work on.
One of my strengths is that I do not focus on weaknesses or failures from my
client. I do not think this helps anyone and is very demotivating for my client. This is
something I focus on so that any time we talk about an issue she is having or changes in
her change plan or possible setbacks, we also discuss her strengths and why she will be
able to succeed. I also remind her that her self worth is not based on completing this goal
and that I would never lose respect for her because of what she chooses to do with her
goal. Autonomy can be difficult, especially when my client wants to do or not do
something that could be harmful to them, but I have to remember it is not up to me to
decide for them and that whatever they choose is what is best for them at the time; the
client always has the right to choose and to change their mind at any time.
This project was absolutely, extremely useful to this class and understanding the
material. When you sit and class and get lectured it is easy to feel like you know
everything and would be able to apply it easily. But I found when I was actually doing
the counseling and trying to follow the guidelines of MI, it was sometimes harder than I
anticipated. The client encounter reflections have also been immensely helpful because it
forced me to use a lot of terms in different ways and really recognize when I was using
them. I also had to evaluate how good I was at using them and that makes them stick
better and remember them for when I really counsel people. Even with the exams, I think
this taught me more about MI. Sometimes exams can just cause people to memorize
terms and use them in one context, but this project forced me to understand the terms and

use them in a real situation. It was also a fun project because counseling is what I want to
do for my career.