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.

    Monica Sonner

    Question 1:
    The physician listens to the concerns and goals of the client. The physician helped to better break down the goals the patients has. The physician also helped to discuss what the reasons were that the client is using cigarettes to try to find better alternatives such as helping to calm the client down and relaxing the client. After this the physician helped to look at the negatives to help the client see why the client wants to quit such as medical problems, expenses, and impacts on physical appearance. The physician helped to provide a small goal of keeping a journal of keeping track of when she is smoking to see patterns of habits and helped to see her triggers. This helped the client to see what areas of her life she may need to have more support. The physician helped to listen to the client’s ideas such as getting a hobby, not smoking in the house, and finding something to do in her free time. The physician also helped discuss how the client will follow up with their goals, such as how the client will cut down.
    Question 2:
    The physician used open ended questions and reflective listening to see from the client’s perspective to see the client’s goals. The physician uses scales to help better understand where the client is on their goals and their desire to quit and confidence to quit. The physician helped to walk through a plan with client to understand how to get the client to feel more confident in her progress in change. This helped the client feel more confident in the process by making it smaller steps and to feel more support. It also helped her feel more in control of the situation by having a firmer grasp on why she is wanting to quit and how that may impact her life so she can start thinking of alternatives.
    Question 3:
    The client seemed to gain more confidence over the course of the interview by breaking down the goal instead of seeing one big goal of completely cutting out cigarettes. She was able to break down some of the pros and cons to better understand her goals and different ways to help her through the process. One thing that she did mention, but the physician never asked further questions on is the idea of a peer support group. One thing I would have changed was looking more into that or saying that he will follow up at the next meeting with more information with that if it wasn’t the right time at the moment.
    Question 4:
    This course has helped me to better communicate with my clients and help them to gain more independence and confidence with their treatment. Although my intention is always to help them, this course has helped me to take a step back and instead of just providing them with information taking the time to step back and see their thoughts. For example, if I have a client who wants to feel less symptoms of anxiety instead of just saying what I recommend I can ask what has helped them in the past and what they have thought about trying. This could be trying a new hobby, joining a support group, seeking counseling, etc. This will help them feel more in charge of themselves and be more willing to follow through with their goals.

    Kelly Jeremie

    I like watching the videos i liked he was very interested in her telling her story as well as letting her know that there were benefits to smoking however still gave her conversation back and mimicking her language. i like how he acknowledged her accomplishments as well and used that she did a great job.
    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.
    Having goals in quitting is key i like the part that reducing the number of cigarettes per day and writing a journal to help keep track of thoughts, amounts, and situations, also checking in with accountability.
    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.
    the physician asked open ended questions , reflections and listened i like the past where the client felt they got stuck in the conversation and making another goal to quit.
    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?
    I like the idea that Clients are involved in the change and focus on the goal. Clients may be more a a part and active in change if they are asked the open ended questions and help with collaboration when the client gets involved and engages it is less of a struggle and they feel a part of accomplishment

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