I would set up a table to hold the 18 card choices and another table that relates them to the client interview table (tblClientInterviewCards) we set up previously. Then you will need another table linked to tblClientInterviewCards to capture the specific action plan items related to each of the 6 cards. Regarding the action plan items, are these typically unique to the client? In other words, do you use the same action plan items across multiple clients?
I also had second thoughts on this:
Motivation tab
All questions have 2 drop downs that need completing
If an item has multiple items related to it then you have a one (motivation) to many items. You will have to explain more about this and what the 2 drop downs consist of in order to determine the best table design.