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

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April Archibald

Question 1:
Generally, I think Dr. Selby’s use of MI skills was effective. He used affirmations where necessary and helped guide Jean to develop her own strategies. Dr. Selby’s use of open ended questions helped Jean identify how she might delay gratification thereby decreasing her nicotine use. I also appreciated the time he took to help her identify the good things about smoking. It seemed as though this was effective in acknowledging the benefit she received from smoking which quickly led her to list the negative consequences of smoking. The only thing I might have done differently in these interventions would be to ask permission to give information more frequently. I would have liked to know how she was feeling about her commitment and the information she heard.

Question 2:
Dr. Selby skillfully used reflections, open-ended questions, and affirmations to help Jean resolve her ambivalence about quitting smoking. He elicited her confidence level in quitting by using the scales. Dr. Selby made mentioned of previous conversations which allowed her connect the changes she had implemented. There are many examples of Jean’s desire, ability, reasons, and need for her to quit smoking. During the follow up, Jean was committed, activated her plan, and took steps by significantly decreasing her nicotine intake.

Question 3:
Dr. Selby effectively asked open-ended questions to elicit Jean’s ideas on how she might change her behavior. The doctor could have easily prescribed medications during the initial visit but this would not have aligned with Jean’s goals. It proved to be more effective to explore Jean’s ambivalence and develop discrepancy so that she could formulate her own plan of change. Jean gave positive feedback stating the sessions were helpful and requesting follow up appointments. Jean’s confidence improved as she followed through with her plan. She seemed excited and motivated to continue her pursuit.

Question 4:
I have enjoyed the material in this course. The videos provided helpful examples of how to implement the Spirit of MI and the various techniques. Elicit-Provide-Elicit is a strategy that I have been using more frequently over the past several weeks. It has been effective in helping clients clarify goals and seek out more information. I plan to continue to hone my MI skills and incorporate them into my work with those that want to change risky behaviors. Overall, this course has given me more information and confidence in helping individuals resolve their ambivalence. Thank you!