When he reflects what she is saying without judgment she is open to explore her options. The conversation expands out from what she already knows, he makes sure she understands her options. The guided style is a challenging balance of asking, listening, and informing. The doctor does this very well. I appreciate that in MI there is no judgment of the client’s choices. This really shows in the video when the doctor acknowledges that she gets some benefits from smoking in dealing with stress. When this benefit is compared to the damage to her health and the cost, she is able to consider her options for methods and supports in quitting.
He helped her focus on her goal to quit using complex reflection that built on her confidence with taking small steps toward success. He also explored possible obstacles and strengths from her perspective. She was able to identify how important reaching her goals was and with each visit her confidence in her ability to reach her goal increased.
He starts by asking and listening and reflecting back. He gives her information as part of the conversation that included making reasonable goals with her input as to what she believed she could do. The goal to cut back rather then just quit is more attainable and helps her build confidence that can then be used to motivate bigger goals. He checks in with her about her confidence in quitting and that leads to a conversation about medication and the benefits and side effects. I wondered about how I would feel as the client when offered the choice of medication in helping me quit.
I don’t often work with clients for long periods of time and health risks are not usually the primary focus. That being said, I can see the benefit of using MI when trying to set goals both long and short term. Clients I work with are often overwhelmed to the point that moving forward can seem impossible. They are often ambivalent about a lot of things. I can see how using MI would benefit them and help them to start to set goals and move forward toward their goals.