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

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thomas barrett

Question #1

In my opinion the physician did an excellent job with the patient by asking frequent open ended questions, listening to her concerns and reflecting them to patient , and by using a very empathic genuine attitude with patient.
He was non judgmental with her responses and maintained a constant pulse of her readiness and confidence to change throughout.
He made great and frequent use of the change ruler which almost always provided insight into the patients stage of change.
He listened carefully and did not interrupt the patient and allowed the patient the autonomy of making decisions.
He had good eye contact and was great using affirmations and summarizing.
I do not think there is anything I would do different with these presentations.

Question #2.

The physician always summarized what the patient was saying and made it clear and concise as to what she was saying. He was a very good listener. The physicians use of reflection and summarization allowed the client to understand what she was saying and opened up further information.
He asked what have I missed which also opened the door to more information and insight.
He used double sided reflection when addressing the ambivalence. He stressed the importance of the ambivalence but from a non judgmental way allowing the patient the autonomy of decided herself.
When addressing information he always asked permission which gave it the feel of collaboration and not lecture which the patient eagerly responded to in a very positive way.
He was always seeking her thoughts and opinions which gave the patient the feeling of control and autonomy and led to further insight and information, which he always summarized.


The physician always asked for permission when introducing information ,such as the medications or asked permission to talk about subjects which always opened up more information and insight. He listened to her ambivalence about medication and thru
permission and reflection was able to work nicely in a collaborative approach with the patient. Again giving the feeling of collaboration and not lecturing . He allowed the patient to be the expert and not him, which worked well
the patients reaction was always positive when he used this approach. This was a great example of collaboration.
When using the readiness or confidence scales he always asked why 4 instead of 7 . He always questioned the lower number which helped the client to focus on the positive without asking her to .
We heard the patient say ” I never thought of that way” and “sessions are helpful ” again feeling like this was a collaboration not a lecture and she was the expert.

Question #4.

These weeks have really helped me understand MI and have really helped me to be much more mindful of how effective these skills are.
I have begun applying these and have found the client doing considerably more talking when using reflecting, summarization and asking permission.
It has allowed me to allow the patient to be autonomous in setting goals and timing of goals. They seem much more enthusiastic about using the plans the more information they have in the plan.
I have been surpris3ed how the responses of the patient to simple reflection or summarization and have found the less I am the expert the more they respond. I love the autonomy approach in letting the client formulate through these skills there own solutions .
This has been very helpful in my practice and I thank you for the sessions and work we have been required to do.