Reply To: Week 4 Homework Assignment (Applications of MI)

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Carol Acedo

Question 1
What are your general reactions to the way the physician used MI to shape these brief conversations with his “patient?” What, if anything, would you have done differently? Why?
Within these videos, He did a great job on reflecting back on what the PT had done in the past that did not work. Listened and used open ended questions to be able to really listen to what PT had to say regarding her current diagnosis of COPD, how she wanted to quit smoking but had a very low confidence level at first. Although she did not say it was 10-20% confidence level but 40% as she was very focused on quitting smoking and was able to take the Doctors advice. Doctor utilized the information from the patent to give ideas on what might work for her and how she could be in control of the situation. I am not sure I would have done anything different.
Question 2
What are your thoughts on how the physician used MI to help this woman resolve her ambivalence about quitting, develop discrepancy, and increase her confidence about quitting? Which MI strategies were used to help her resolve ambivalence, develop discrepancy and increase confidence? Be specific
He asked questions and used reflection to as a way to better understand what she wanted to accomplish. She was not very confident in the first two videos that she could quit smoking as she had a group at work where she enjoyed a smoke with at break time. At home she was smoking at home and in her car, too much idle time on her hands on the weekend made this more difficult for her to not smoke as much. He had asked her the good and bad things around her smoking in the fact that she stated it is very expensive, bad for her health. These questions helped her put into perspective on why it was important for her to work through to help her quit.
Question 3
Evaluate the physician’s efforts to adapt MI to a series of brief interventions in a primary care setting, focusing specifically on his use of Asking, Listening and Informing? Be specific. What are your thoughts on the “patient’s” reactions to his use of MI? Be specific.
In the first video, he asked questions to be able to better understand what she was thinking about, her reasons to quit smoking and the fact that she was spending a lot of money on smoking, beauty products and the fact that she was just diagnosis with COPD. Suggestion of a smoking journal to help her be mindful on when she would smoke, think about it don’t just do.

In the second video, he let her tell him on how the first week went, acknowledged the fact that she had cut down by two cigarettes’ a day and was able to listen to her plan that she wanted to put into place to continue to move forward with not smoking as much. He used reflection on what she was doing to help her self and what other options that were there to help her continue to cut down on her smoking,

The third video, had more refection as to how she was continuing to make progress on cutting down. What steps she had done to make it easier for her to not smoke. She made a plan and she was putting a time frame on quitting all together. He discussed the marked improvements that she made and was able to go over the other visits and showed that he was proud of what she had accomplished so far. He offered medication to help with the end result and listened to why some of the medications did not work for her in the past. He also reminded her of the side effects to some of the medications to inform her on what she was taking and what to look for.
Question 4
Take a moment to reflect on the course material over the past four weeks and the new insights you have gained about Motivational Interviewing and the specific MI skills you have developed. How do you envision bringing this new insight and these skills into your work with people who are considering changing health or health-risk behaviors?
I have enjoyed this material, although a few of my clients would benefit from this kind of interviewing and most will not. I have thought back on the previous material and have found my self using the information that I have learned to show that I am showing empathy and active listening to better understand my clients needs. I need to let my clients try to understand the goal that they wish to accomplish and do my very best to keep them focused on the importance of what they are interesting in changing.
I look forward to implement these strategies within my meeting with my clients.