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

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Tiffany Albert

Question 1
I found the physician’s use of MI to be very effective. He was open, non-judgmental and took an active interest in what the patient had to say. His use of skills allowed him to move the conversation into talk of acts of change rather quickly. Regarding what I would have done differently there were a few moments towards the end of the first video in which the physician directed the conversation towards what changes could be made (writing down each time the patient was smoking). Any suggestions I would have would be to elicit thoughts from the patient about what next steps might be helpful and to offer thoughts once the patient was agreeable to hear them.

Question 2
The physician’s use of MI strategies allowed the patient to identify that she wanted to quit smoking, why she wanted to quit and improve her belief in her own abilities to quit. This was primarily done through reflection, summarizing and open-ended questions that lead to develop discrepancy for the patient. As the patient continued to work with the physician and was able to identify that she wanted to quit smoking, she was given the encouragement and space to identify what might work for her. The more successful she became in completing the steps towards change, the more confident the patient became. Once the physician was then able to offer information about medication to support the process of change, the patient became additionally confident in her ability to quit successfully.

Question 3
The physician was quite skilled at using the skills of asking, listening, and informing. His use of asking and listening allowed the patient to identify discrepancy quickly and move towards change talk. The physician did engage in informing the patient of techniques that he has seen be beneficial and other forms of support to aid in quitting, but did so only when the patient seemed ready. The physician did not rush or push the patient into change. His use of these skills allowed the patient to feel heard and inevitably supported her plan for change as she began to build confidence.

Question 4
Throughout this course I have found myself utilizing the skills learned in daily sessions with patients. I work with teens and often there is ambivalence about different areas in their lives. I typically use a patient-centered focus, and this has reinforced that for me. I have found myself allowing the patient to lead more and asking for permission to offer information rather than just providing it and will continue to work on this. I believe that incorporating these skills will be greatly beneficial for many of my patients and I will continue to be mindful of how my interactions would most benefit those who are ambivalent about change.