In general the physician uses good reflections and elicits good information from the patient in these videos. He also takes opportunities to provide information on ways that she can reduce her smoking and eventually quit. I think that he had more opportunities to use scaling questions, particularly in the second video. I would have used these to more fully understand how she was progressing through the process. The patient did present already feeling somewhat motivated to make changes and had a plan in place to reduce her smoking, which allowed the physician to simply use more reflections rather than initially focusing on resistance.
I don’t think that the patient presented with much ambivalence to quitting as she seemed relatively motivated from the onset. She had clearly been contemplating her plan for moving forward. The physician did use good reflection early on to help the patient identify the risks for her if she continued to smoke. When the patient mentioned that she was 35-40% ready to commit to quitting, the physician used a good reflection and then followed up by asking what it would take for her to move to 45%. This allowed the patient to think about what would motivate her.
The physician did well with adapting to a series of brief interventions. He did well to ask questions to understand where the patient was in the change process. He then listened to what the patient had to say about what she wanted to do and what would get in her way. Ultimately he guided her to choose her own steps and commit to the change process. I think the patient responded well to his use of MI. In the second video he immediately asked the patient what was different since their last meeting. He then listened to her success. He did not necessarily engage in informing much after this or in this meeting. By the final meeting he was engaging well in using all three techniques and the patient responded well to these. Ultimately the patient was successful in reducing smoking and she considered using an smoking cessation aid to help with her success.
I have taken motivational interviewing trainings in the past, and this course was a great refresher of those skills. I don’t think I learned anything necessarily new, but it definitely helped me refocus on the core components and expand my skill levels. I have already been more actively using this with my current clients and am noticing changes in motivation and commitment to the change process.