Deliberate practice exercises help clinicians develop competence in fundamental motivational interviewing skills to better assist clients with change goals, like quitting addictive behaviors and developing healthier habits, and to improve treatment engagement and retention.
These exercises present role-playing scenarios in which two trainees act as a client and a clinician, switching back and forth under the guidance of a supervisor. The clinician improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common client questions and concerns.
The first 12 exercises focus on specific skills, such as offering simple and complex reflections and affirmations, eliciting change talk, supporting client autonomy, and collaboratively mapping session agendas. These are followed by two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate essential skills into one session.
Step-by-step instructions guide participants through the exercises, identify criteria for skill mastery, and explain how to monitor and adjust difficulty. Guidelines and forms to help trainers and trainees get the most out of training are also provided.
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Jennifer K. Manuel, PhD, is deputy director of psychology at the San Francisco Veterans Affairs Health Care System and anassociate professor in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco. She has been a member of the Motivational Interviewing Network of Trainers (MINT) since 2005. She conducts MI training and coding workshops throughout the world. She has coauthored multiple MI behavioral coding systems including the widely used Motivational Interviewing Treatment Integrity (MITI) coding manual. Dr. Manuel’s research expertise is in the implementation and evaluation of MI in front-line clinical settings.
Denise Ernst, PhD, is an adjunct professor at the School of Social Work, Portland State University. She has been a motivational interviewing (MI) consultant for over 25 years, providing training, evaluation, research and implementation support, and private coaching internationally. Dr. Ernst has helped develop and refine MI coding instruments, including the Motivational Interviewing Skill Code (MISC) and the Motivational Interviewing Treatment Integrity (MITI) coding system. She participated in research efforts to enhance training effects, providing structured feedback and coaching for many professions. Dr. Ernst has been a member of the Motivational Interviewing Network of Trainers (MINT) since 1997.
Alexandre Vaz, PhD, is cofounder and director of training of the Sentio Counseling Center. He provides deliberate practice workshops and clinical training and supervision around the world. Dr. Vaz is the author/coeditor of many books on deliberate practice and psychotherapy training and two book series: The Essentials of Deliberate Practice (APA Books) and Advanced Therapeutics, Clinical and Interpersonal Skills (Elsevier). He has held multiple committee roles for the Society for the Exploration of Psychotherapy Integration (SEPI) and the Society for Psychotherapy Research (SPR). Dr. Vaz is founder and host of “Psychotherapy Expert Talks,” an acclaimed interview series with distinguished psychotherapists and researchers.
Tony Rousmaniere, PsyD, is cofounder and executive director of the Sentio Counseling Center. He is the author/coeditor of many books on deliberate practice and psychotherapy training and two book series: The Essentials of Deliberate Practice (APA Books) and Advanced Therapeutics, Clinical and Interpersonal Skills (Elsevier). Dr. Rousmaniere is incoming president of Division 29 of the American Psychological Association. In 2017, he published the widely cited article in The Atlantic Monthly, “What Your Therapist Doesn’t Know.” Dr. Rousmaniere supports the open-data movement and publishes clinical outcome data on his website drtonyr.com.
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