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Learning Advanced Skills

Some patients or clients do not or will not make brief action plans for behavior change. Others may be able to make plans but will not be able to follow through on the plans that they do make. These patients gnerally suffer with complex or persistent unhealthy behavior.

Learners who have completed Course One may be interested in developing more advanced skills to help such patients or clients change these more persistent unhealthy behaviors.

Drs. Steven Cole, Damara Gutnick, and Joseph Weiner have described 13 stepped care advanced skills for action planning (SAAP) in Chapter 18 of The Medical Interview: The Three Function Approach [1]. The 18 skills fall into three broad categories and are listed below.

    Six skills to respond to emotions:

  • Non-verbal behavior
  • reflection
  • legitimation
  • support
  • partnership
  • respect/affirmation
    Five skills to understand benefits or obstacles to change:

  • open-ended questioning
  • facilitation
  • open-to-closed cone of questioning
  • direction
  • checking and summarization
    Two advanced Motivational Interviewing skills:

  • elicit and resolve ambivalence
  • develop the discrepancy

Dr. Cole can provide individual coaching or workshop learning for groups in the advanced skills by contacting him at stevecolemd@gmail.com or through the “contact us” tab above. Learners can also receive advanced skills training through the Centre for Collaboration, Motivation, and Innovation (CCMI). (CCMI).


1. Cole S, Gutnick D, Weiner J: Stepped-Care Advanced Skills for Action Planning (SAAP) (Chapter 18), in Cole S, Bird J: The Medical Interview: The Three Function Approach. Elsevier. 2014.