In this essay, I reflect on my interpersonal communication and motivational interviewing skills (Rollnick, Miller, & Butler, 2012). I do this by evaluating my case scenario role play, and the feedback forms from other students. In the role play, I interviewed Sally after she visited her doctor who had advised against surgery for weight loss. I played the clinic nurse taking her blood pressure after her appointment. I will evaluate, interpret and reference my observations of where I thought I did well and how I think I could have improved the interaction. In relation to Rollnick et al.’s (2012) Spirit of Motivational Interviewing, I feel I did well to express their ideas of compassion and acceptance by using body language, nodding, responses of ‘ah-hah’ and explicit paraphrasing and reflecting of what Sally said. For example when I reflected back to Sally the positive changes she wanted to make towards her weight loss. I worked well in partnership with Sally, assisting her to refine her goals, finding out what she had tried, and working out together how to achieve these goals. I did this by listening and acknowledging her realisation of the benefit of exercise in accomplishing her objective. I think I could have worked more on evoking Sally’s own ideas for change by eliciting ‘that which is already there’ (Miller & Rollnick, 2009). In suggesting a nutritionist, I attempted to fix the situation rather than motivate Sally to find that path (Barkway, 2013, pp. 172-173). I also expressed my own values around the taste of pre-packaged meals, but I feel this helped build rapport and understanding and guided us to find a more palatable solution. I made good use of open-ended questions to elicit unbiased responses and to encourage free and open change speech (Ostlund, Wadensten, Haggstrom, Lindqvist, & Kristofferzon, 2016). I asked Sally if she had thought about other exercises to incorporate into her routine. On a few occasions I recognised, reflected and affirmed change talk by letting her know Ithought her ideas were great initial steps to take. I acknowledge that my repetitive ‘hearing you’ when doing this may be interpreted as rote and I need to work on better phrasing. In our conversation I found there was a strong presence and elicitation of change talk with statements like ‘yeah it’s easy’ from Sally and ‘Is there any other benefits you can see...?’ from me. I think I did well to maintain and sharpen this focus to stay on topic with directional questions helping her think about specific exercise options that could support her knee situation. I was fortunate that Sally already expressed a readiness to change. I would place her at the ‘Contemplation’ stage of Prochaska, DiClemente, and Norcross’s (1997) Transtheoretical Model of Change model and I identify I could have done better supporting her to set an agenda and develop a plan for further preparation. Overall, I enjoyed completing this exercise and felt I did well listening, paraphrasing and reflecting. This involved constantly assessing readiness to change and affirming, recognising and reinforcing change talk. I did this by expressing empathy through kindness and reassurance whilst also maintaining focus. I however could have improved my interaction by evoking more, offering solutions less and reducing repetitive paraphrasing. References
Barkway, P. (2013). Psychology for health professionals (2nd ed.). Sydney, N.S.W.: Churchill Livingstone/Elsevier. Miller, W. R., & Rollnick, S. (2009). Ten Things that Motivational Interviewing Is Not. Behavioural and Cognitive Psychotherapy, 37, 129-140. doi:10.1017/S1352465809005128 Ostlund, A.-S., Wadensten, B., Haggstrom, E., Lindqvist, H., & Kristofferzon, M.-L. (2016). Primary care nurses’ communication and its influence on patient talk during motivational interviewing. Journal of Advanced Nursing 72(11), 2844-2856. doi:10.1111/jan.13052 Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1997). In search of how people change: applications to addictive behaviors. In G. A. Marlatt & G. R. VandenBos (Eds.), Addictive Behaviors: Readings on Etiology, Prevention, and Treatment (pp. 671-696). Washington: American Psychological Association. Rollnick, S., Miller, W. R., & Butler, C. C. (2012). Motivational interviewing: Helping people change ( 3rd ed.). New York, NY: Guildford Press.
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