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Motivational interviewing and reflection
Application of motivational interviewing
Essay on motivational interviewing
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A large number of mental health care professionals have encountered resistance when encouraging patients to comply with treatment plan such as having medication, decreasing substance use and changing established routine. Patients tend to have difficulty changing poor health behaviour even though they are aware of benefits. Health care professionals can use motivational interviewing on patients to help them adhere to treatment recommendations and to promote behavioural change. This paper will discuss as to relation of motivational interviewing and process of change model, and also how to resolve ambivalence and to use relapse in change process.
Motivational interviewing (MI) is a "client-centred, directive therapeutic style to enhance readiness
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It consists of expressing empathy, developing a discrepancy, rolling with resistance and supporting self- efficacy (Levensky et al., 2007). To express empathy, health care providers should communicate that they understand and accept patients` past experience, including the patient`s ambivalence about change (Levensky et al., 2007). It is to establish therapeutic relationship between patients and health care providers, as it is important to see things through the patients` eyes. Health care providers can develop a discrepancy by enhancing patients` awareness of the inconsistencies between their poor health behaviour and their personal goals and values, so patients can motivate themselves (Levensky et al., 2007). It is highly likely for patients to have resistance, however health care providers should not fight against patients` resistance, as patients should be the primary source of answers and solutions (Jensen et al., 2011). To support self- efficacy, it is important for health care providers to maintain and express to patients a belief and emphasis of patients` ability to change (Yakovenko et al., …show more content…
Reflective listening can diminish patients` resistance and facilitate movement in patients` readiness to change with accurate understanding of what patients mean and encouragement of discussion of patients` reasons for wanting to make changes (Noordman et al., 2013). Open questions are efficient especially in the early phases of motivational interviewing as they can elicit discussion of the reasons for making desired changes and explore patients` goals and values (Levenseky et al., 2007). Direct affirming and supporting can help health care providers support patients` self –efficacy, build rapport and reinforce patients` effort by giving a simple compliment and acknowledging small successes (Levensky et al.,
Still, the previous advantages discussed should influence the nurse to improve in identifying patient vulnerability. This is evident by this patient where I utilized my interpersonal skills to communicate to this patient so that he/she is aware that he/she is not alone in this journey. Nurses need to utilize models and theories to guide nursing practice. For instance, McCormack’s framework focuses on patient-centered care which influences nurses to understand the patient as a whole and their values (Abley, 2012, p. 42). Being able to identify values will give nurses and myself a better comprehension about the patients resulting in worthiness and belonging expressed. As a result, informing nurses about patient’s subjective vulnerability because a trust and understanding relationship is established. This is supported in a clinical experience where a patient “felt understood and opened up for further interactions based on trust” through an honest, supportive relationship with a nurse (Gjengedal, 2013, p. 134). Nurses should provide patient-focused provision of service, and assist this patient in overcoming his/her obstacle as a way of encouragement. Furthermore, Sellman (2005) explains how encouragement may compromise human flourish (p. 7), it is dependent on the situation and it cannot be assumed all encouragement will lead to harm. This informs nurses to be aware of the consequences that prevent the
Coronary heart disease is a common term for the build-up of plaque in the heart’s arteries that could lead to heart attack (Coronary Heart Disease, 2017). Furthermore, there are many known coronary heart disease factors that can be controlled. These are high blood cholesterol, high blood pressure, diabetes and pre-diabetes, obesity, smoking, lack of physical activity, unhealthy diet and stress (Coronary Heart Disease Factors, n.d). The techniques of motivational interviewing are more persuasive than coercive and more supportive than argumentative. The motivational interviewer must advance with a firm sense of purpose, clear methods and skills for seeking that purpose, and a sense of timing to mediate in specific ways at quick brief periods of time (Miller and Rollnick, 1991). The clinician uses motivational interviewing on account of four general principles in mind. The key principles are to express empathy, avoid argument, roll with resistance and support self-efficacy (Treatment, C. for S. A.,
The Motivational Interviewing film was very informative. I was able to get a clear understanding of what is to be expected by the therapist during a session. The film explained the therapist should engage in reflective listening, develop a growing discrepancy, avoid arguing with clients, roll with resistance and support self-advocacy. Miller believed that this approach was far more effective than traditional methods, where the therapist pushed for change. In contrast, Miller explained that motivational interviewing focused on empowerment and helping clients to become motivationally driven to change. Also, Miller stressed the importance of working alongside clients, a term he referred to as dancing. The process in which the client leads
The case scenario is of a homeless young guy named Jim who appears to have an intellectual disability. Jim is addicted to marijuana and abuses alcohol and has suicidal thoughts. He has anger control issues where he is known to verbally threaten others. He currently has a counsellor who he had established a therapeutic relationship. From these sessions, the counsellor has learned that Jim had been physically abused by his stepfather. From reading this case scenario about Jim, it is evident that he would benefit from several different approaches or interventions including motivational interviewing and cognitive behavioural therapy.
Rebecca Kreman, Bernice C. Yates, Sangeeta Agrawal, Kathryn Fiandt, Wayne Briner, Scott Shurmur, The effects of motivational interviewing on physiological outcomes, Applied Nursing Research, Volume 19, Issue 3, August 2006, Pages 167-170, ISSN 0897-1897, DOI: 10.1016/j.apnr.2005.10.004.
What is Motivational Interviewing? Motivational interviewing (MI) is a patient-centered method for enhancing intrinsic motivation to change health behavior by exploring and resolving ambivalence. What will be discussed is how can organizations help the patients change negative behavior to a positive behavioral change, diminishing the lack of motivational behavior. (Miller & Rollnick, 2002) states that we have to help clients overcome their ambivalence or lack of motivation toward changing their behavior in positive way. Also, figuring out a solution on how to overcome this negative behavioral challenge of lack of intrinsic motivation to change. How will we overcome it? by focusing on the MI (Motivational Interviewing) approach, and finding
People with addiction may seek counseling to help them recover from drug usage. Using motivational interviewing can help find out how motivated the client is to staying clean and what will encourage them to stay away from drugs. The clients also needs to see how the addiction is effecting their lives and the lives of their loved ones.
Another barrier is the client’s willingness to make the changes that will have a positive effect on his health outcome. The nurses and community case workers can provide all the necessary information, but the client has to be willing to accept the assistance. The best way to affect a positive lifestyle change is to encourage the client to take small steps toward the desired change. For example, the client needs to weigh himself daily and record the information, so a scale is provided and he agrees to record his weight twice a week. As this positive behavior change becomes a habit, them it could evolve into recording this information daily.
Many individuals may feel as if they have lost control of their everyday routines, or are somewhat defeated when following treatments programmes and not being able to see an improvement in health. Recently healthcare professionals recognized that if they provide patients with well-defined, straightforward information and knowledge about their illness, it could encourage people to take more of an involved role in managing their condition, such as setting achievable goals, or becoming better practiced at monitoring and managing insulin levels. Thi...
The purpose of this paper is to review the theory of self-regulation and how it can be applied to practice in health care settings to improve patient outcomes. According to Johnson (1997), more than 25 years of research has influenced the development of the self-regulation theory, which is about coping with healthcare experiences. Health problems have shifted from acute to chronic where it has been identified that personal behaviors are linked to over half of societies chronic health problems (Ryan & Sawin, 2009). As the modern nurse strives to provide specialized care and improve patient outcomes, the utilization of nursing theory continues to gain importance. This theory explains how patients use specific types of information to cope with health care events thus providing a rational for selecting information that can be expected to benefit patients. The concept of self-regulation has been a part of nursing practice in a circumlocutory fashion for years. It has been most commonly referred to as self-management creating considerable ambiguity and overlapping of definitions for that term and self-regulation (SR). For the purpose of this paper these terms will imply that people follow self-set goals introduced by their health care provider.
“Motivational interviewing was introduced by Dr. William R. Miller in 1983, to help problem drinkers prepare for treatment and has been developed in collaboration with Dr. Stephen Rollnick. Motivational interviewing is a client centered directive method of communication for enhancing intrinsic motivation to change by helping people to explore and work through ambivalence. (Miller &Rollnick,2002).” This definition simply means that motivational interviewing is a method that uses the techniques taught by Carl Rodgers, such as empathy, positive regard, and congruence all of which lead to a collaborative relationship between the counselor and the client. This supportive and collaborative relationship will enable the client to open up and have honest discussions with the counselor. Therefore, the counselor will be able to help the client recognize:
Any learning that occurs should focus on treatments, tests, and minimizing pain and discomfort as they improve they can shift their focus of learning (Kitchie, 2014, p.127). I will continue to provide a meeting location that is both comfortable and private. In the emotional aspect of M.M. and her family I will try to identify moments when members feel emotionally supported as it sets the stage for a teachable moment (Miller & Nigolian, 2011, p.56). I will also discuss with each member their previous coping strategies that used that have been successful and to encourage them to find a way to build on and strengthen these qualities. Using teaching methods that are interactive and allow patients equal contributions and participation can help promote health compliance (Habel, 2005,
...blem as well as their treatment. Miller suggests that client resistance is a product of the interaction with the counselor who uses confrontational interviewing style. Rather than counselors trying to convince the client to change, the counselor should draw out arguments for change. Such technique is the use of empathy in their style. Several studies supported that therapists behaviors influence clients treatment outcomes. It has been found that the more counselors confront the clients drinking the more the client will drink (Miller, 1993).
In order to promote patient adherence, helps to overcome challenges in management as well as improve the illness prognosis and patient satisfaction, a good quality of doctor-patient relationship is suggested to be the primary mediator. Martin et al (2003) emphasize the importance of doctor’s behaviour to welcome patient involvement in the medical discourse. It is noticed that patients tend to choose doctor who helps them to get involved in consultation, answer their question, interact and communicate well rather than doctor who let the patient to control over the conversation and at the same time pay less attention to the patient. In other study conducted by Graffigna et al (2014) introduces a conceptual framework to establish the phases of patient engagement development that incorporates emotional, physical and mental elements of the individual patient.
It is about the personal understanding and treatment of the patient as an individual, interpreting the situation from their perspective. Gain a complete understanding grounded in professional and research-based knowledge of clinical practice; personal reflection and a consciousness of the patient’s attitudes, beliefs and behaviours. (Olckers, Gibbs & Duncan 2007: 2-3) Empathy involves gaining insight into patients’ backgrounds, core values, relationships and medical history through dialogue. Chochinov 2007: 1877 - 1877. Reflective Dimension:..