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

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Sherie Daigle

Question 1
What are your general reactions to the way the physician used MI to shape these brief conversations with his “patient?” What, if anything, would you have done differently? Why?
In watching this video, the conversation between the provider and client felt natural, respectful, and guiding. Overall, the conversation felt collaborative and open. At no point during the video did the feeling of judgement or resistance feel present.
Question 2
What are your thoughts on how the physician used MI to help this woman resolve her ambivalence about quitting, develop discrepancy, and increase her confidence about quitting? Which MI strategies were used to help her resolve ambivalence, develop discrepancy and increase confidence? Be specific.
The provider does a fantastic job asking open ended questions and then confronting both sides of ambivalence. Through this process, the client is able to work through the conversation without feeling “judged” which lessens the opportunity for resistance. The provider also utilizes reflection, especially double sided reflection to amplify the dilemma that the client is faced with. I really enjoyed watching this exchange, especially how the provider then helped the client explore small steps towards change and what the client may feel comfortable with. The client knows that they need to quit smoking, the provider does not need to state this or the reasons why, but rather assist the client in processing and working through these feelings towards small changes.
Question 3
Evaluate the physician’s efforts to adapt MI to a series of brief interventions in a primary care setting, focusing specifically on his use of Asking, Listening and Informing? Be specific. What are your thoughts on the “patient’s” reactions to his use of MI? Be specific.
Despite the short time frame, the provider is clearly able to engage the patient in a conversation that focuses on asking questions to help the patient understand what difficulties arose over the past week. The provider again, utilizes reflection to clarify and summarize what is being shared. This allows for the conversation to evolve into this exploration of what the patient might be willing to try for the upcoming week. There is no “why don’t you try this, or “you should”, but rather focusing on what the patient may feel comfortable working towards. Again, this process really minimizes resistance, encourages transparency and reflection.
Question 4
Take a moment to reflect on the course material over the past four weeks and the new insights you have gained about Motivational Interviewing and the specific MI skills you have developed. How do you envision bringing this new insight and these skills into your work with people who are considering changing health or health-risk behaviors?
Throughout this course, there are many times when I found myself making a “mental note” to try this skill with a certain client or family. In the program that I work within, we often are working with at risk youth that are frequently engaging in some pretty challenging behaviors. These skills can certainly assist in conversations with this population to help place them in the driver’s seat of the decision making process regarding change (something that is often lacking with teens) and to help them feel empowered to make change on their own terms.