Dear Sebastian,

Thank you for sharing your MI conversation with me for MITI coding and feedback. Strengths:

You set a tone of strong evocation with structured strategies (ex: importance and confidence rulers) and guiding with simple and complex reflections (mountain comparison)
You made consistent efforts to overtly support client autonomy and acknowledge strengths across the conversation that ultimately decreased client discord

Stretches:

You may want to consider some slight shifts in language and flow to elevate
- When asking permission to offer information, pausing to ensure client response (yes/no) will fully share the agenda and demonstrate their control over session flow
- At times you framed client change using language that could be offered in a neutral way to increase a focus on the expertise of the client [Consider reviewing timestamps for Per and PerW]

MITI Fidelity Summary

MITI Measure (Calculation)	Fidelity Standard		Current Practice Sample
MITI Measure (Calculation)	Basic	Advanced
1. Ave. Relational Foundation (Par + Emp ratings) / 2	≥ 3.5	≥ 4.0	3.5
2. Ave. Technical Component (CCT + SST ratings) / 2	≥ 3.0	≥ 4.0	4
3. % Complex Reflection CR / (SR + CR) x 100	≥ 40%	≥ 50%	70%
4. Ratio of Reflection to Question (SR + CR) / Q	≥ 1.0	≥ 2.0	2.8
5. Number of MI Adherent behaviors (EA + SEEK + AF)	≥ 1	≥ 2	6
6. Number of Non-Adherent behaviors (P + C)	= 0	= 0	1
Total number MITI measures at or above BASIC fidelity standard (0-6 scale)			5
Total number MITI measures at or above ADVANCED fidelity standard (0-6 scale)			4

MITI 4.2.1 Coding Summary

Clinician/Helper:	Recording #:	Coder:	Date:
Sebastian	Podcast sample	Katie	4-2-26

MITI Behavior Count Table

Behavior Count

Examples

Giving Information (GI)

We have recommendations. Options for frequency/interventions Yes, think about it

Persuade (P)

I would like for us to think about smoking in the same way (prep for climbing a mountain) I can help you plan route ~17:50

Persuade with Permission (PwP)

Health counselor, work on changes that are important, that they really need to make/consider. (2:40 – 3:40

Question (Q)

What’s your understanding of why doctor wants you to see me? What’s your understanding of my role?

What do you make of that?

1-10 how important to cut back? Why 6 and not 4?

1-10 how confident in ability to cut back? Why 3 not 1 or 2?

Simple Reflection (SR)

You think I’m here to tell you off Not thrilled

Cause cravings will step in and you’ll have to step out Quitting entirely feels too much

6 touch over half You’re thinking about it

Complex Reflection (CR)

Intro summary, partly here concern for cough and partly b/c people are trying to make you do something

I’m the stop smoking guy, you’re worried tell you what to do, not thrilled

		Hesitation, aware that smoking is bad for health Been thinking about quitting a long time, but social aspect is very important to you Smoking is part of the glue, like flipping switch from dad to guys Break, multiple breaks you really enjoy it Some things keep you going and also things that have you concerned or frustrated/thinking about quit/cut back Smoking might kill you 3, came for antibiotics now smoking, caught you off guard. Done challenging things before, you have experience Feels like another mountain to climb You would have been a 3 in the past that you eventually climbed You’ve conquered them all Sounds like your curious about what we offer
Affirm (Af)	2	Courageous, you’ve climbed mountains You seem careful in planning, strategy, thoughtful about it
Seeking Collaboration (Sk)	1	If ok to share about my role here
Emphasizing Autonomy (EA)	3	Can’t tell you want to do Some parts up to you ~18:20
Confront (Co)	0