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

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Kristin Giguere

Question 1: I feel as though the physician was very effective with his use of reflective listening. The dialogue was the most natural out of all of the scenarios we watched, with it seeming less as though he was just repeating what was said, but more that he was reflecting back the underlying meaning to what the patient said. It was clear that he explored her motivation as well as what aspects will be challenging for her. He used a scaling question with regard to the importance of quitting as well as her confidence in her ability to be successful in quitting and had her identify what contributed to her rating it where she did. The doctor didn’t push the patient, and allowed her to be in charge of determining the time-frame for making changes as well as what her first step will be. He also covered previous attempts and what worked and what made it harder previously. I didn’t notice anything I would have done differently.

Question 2: The physician was very skilled at going back and forth between what the patient likes and doesn’t like about smoking, as well as the costs and benefits of quitting. This process of exploring pros and cons and engaging in a decisional balance of benefits and costs helped her resolve ambivalence and develop discrepancy. The physician was effective in increasing the patient’s confidence through his use of confidence scaling questions and asking open ended questions to explore confidence.

Question 3: The physician’s efforts to use MI in a primary care setting were effective and successful. The patient was responsive and engaged in the process. He asked what’s going well, what’s not going as well, listened to her answers, and helped her problem solve solutions to those problems as she developed next steps. The only informing he did was in response to specific requests for information (such as regarding new treatment methods/medications), not pushing information on her.

Question 4: This training has gone a lot more in depth than any of my previous MI trainings. I hope to be able to use these techniques more in my work to help move students into the next stages of change, as most of the kids I work with do not desire to change their health risk behaviors. I would view helping them go from pre-contemplative to a contemplative stage of change.