Appendix.

Explanation of Motivational Interviewing Proficiency Data

Measure	Description	Example
Behavior Counts
Open Questions (OQ)	Questions intended to elicit more than a yes/no or specific answer	Tell me about … What are your thoughts?
Closed Questions (CQ)	Questions that elicit yes/no or specific information.	When did you start? Did you try . . ..?
Simple Reflections (SR)	Statements made to demonstrate that the counselor hears what the subject has said.	“So one reason to quit is your health”
Complex Reflections (CR)	Statements that attempt to convey the underlying meaning of what the subject said	“So you’re health is something that’s really important to you”
MI Consistent Behaviors (MICO)	Counselor statements that affirm clients’ strengths or efforts, show support, ask permission before proceeding, or emphasize personal choice or control	“It’s great that you are trying so hard.”
MI Inconsistent Behaviors (MIIN)	Counselor statements that are inconsistent with the philosophy of MI such as advising, confronting, warning without permission.	“You know you should really stop smoking.”
Behavior Count Summary Scores
Percent Complex Reflection	CR/SR + CR
Percent Open Question	OQ/OQ + CQ
Percent MICO	MICO/MICO + MIIN
Question to Reflection Ratio	SR+CR/OQ + CQ
Global Measures
Autonomy	Counselor support of client autonomy
Collaboration	Counselor ability to treat client as a partner
Evocation	Counselor ability to draw out client’s reasons and ideas about change
Empathy	Counselor ability to demonstrate understanding of the client’s perspective
Direction	Counselor ability to remain focused on a behavioral change target