Posted: September 22nd, 2023
Homework help, Motivational Interviewing techniques and therapeutic communication skills
You are required to make a video with a partner using Motivational Interviewing techniques and therapeutic communication skills. You will need to reflect on the video and gain feedback from your partner before attending an oral exam to show the video and discuss your reflection.
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The Oral Assessment will be in the examination weeks. Students will be allocated through Central Examinations or the Lecture in Charge an appointed day and time to attend the Oral Assessment. Your video must be submitted via LEO as an ECHO360 capture into the LEO dropbox (your state/campus) prior to October 26th by 1600 hours (4pm)
40%
1. 5-minute video made with a partner from this unit
The aim of this assessment is to reflect on and evaluate your use of therapeutic communication skills and motivational interviewing techniques learnt over the course of the semester.
Appendix D
Assessment 3 Reflection template
Simple reflections are short statements that reflect the content or emotion of what was said in an interaction. You can then use these to analyse and reflect more deeply on your practice.
Choose and record some elements and aspects of your interview that are noteworthy and then use them to reflect on your practice. The aim is to improve your Motivational Interviewing techniques, therapeutic communication skills and clinical interviewing practices.
Describe, examine, analyse, and then tell the examiner what you have learnt from this assessment task and reflective practices. The more thorough and comprehensive the details you can tell the examiner, including highlighting your critical thinking and reflective skills, the higher the possible grade you might receive.
My reflection:
I asked my patient/client:
1. What did I do well when conducting an interview with you?
2. What did I not do so well?
3. Did anything distract you, annoy you or make you feel bad or unsupported in the interview?
4. What could I improve on in my practice?
I asked myself and reflected on my own practice including:
1. What areas of motivational interviewing did I utilise in this interview effectively?
2. Did I use multiple motivational interviewing techniques or just a few? Which ones?
3. Did I use therapeutic communication skills? Can I identify what they are and how they impacted positively or negatively on the interaction?
4. What areas was I not so good at or forgot to use? Did anything have a negative impact on the patient/client?
5. How can I improve my skills in MI and therapeutic communication for enhanced outcomes the next time I interview a patient/client?
6. Did I understand the needs of my chosen case study and was I effective in helping them with their issues? Explain.
7. Did I understand what stage of the Transtheoretical Model of Change the patient/client was at?
8. What reflections did I make about my own performance as the healthcare professional?
9. What feedback did I receive from my patient/client about how I performed and how did I reflect on this feedback? What ideas and solutions did I come up with after hearing what they had to say? Appendix C
Assessment 3 role plays
Case study 1: Your name is David and you are a 36-year-old male journalist who has a very demanding job which involves working long hours. You have been smoking since you were at university and you estimate that you currently smoke between 30-40 cigarettes a day. You love to catch up with your friends at the pub for a smoke and a drink as you say it helps you relax. You have tried to stop smoking on a number of occasions, with limited success as you suffer badly from nicotine withdrawal. Your father recently died of lung cancer at age 68 after many years of smoking. In his final stages of cancer, Donald was in a great deal of pain and distress. You are worried that if you keep smoking like this, you will end up with lung cancer like your dad.
Case study 2: Your name is Sally, you are a 28-years old female and you work as a financial adviser for a large finance company. You have always struggled with your weight and you currently weigh 122 kilograms. You have a family history of type 2 diabetes and hypertension. Your GP has said you must lose weight and keep it off. You would prefer to have gastric band or gastric sleeve surgery. However, your GP is against this as you they believe you need to make lasting lifestyle changes through a combination of diet and exercise. You realise this is a more logical approach to take but do not believe you have the time or energy to do this.
Case study 3: Your name is Mark and you are a 19-year old male university student. You have moved away from home to attend university and you are studying exercise science. In an effort to meet people and form new social networks you have joined several societies. Your favourite group is the ‘pubs along the pier’ night. You are generally reserved but find that after a few drinks you are more outgoing and confident. People have commented how easy going and friendly you are which increases your desire to be part of this group. Over the last two months however you have woken up the next morning with no recollection of how you got home on several occasions and on the last occasion you woke up in another person’s house. A friend from your hometown is visiting you and when you tell them this story which you laugh about, they urge you to stop drinking with this group of people. You agree to go and see a health professional but really don’t see what the issue is.
Case study 4: Your name is Tessa and you are a 29-year-old female single parent of three children under the age of eight (8) years old. You work 4 days a week at a local supermarket. By the time you pick up your children from school and childcare you are too tired to cook, so your meals are invariably takeaway meals and you use the left overs the next day for lunches. Your eldest child has brought a note from their teacher asking to meet with you. At the meeting the teacher indicates that you need to be providing more nutritious meals for your child. You know the teacher has a valid point, but you feel like you are being made out to be a bad parent and you have no idea how to go about making this change to your children’s diets and making the teacher happier.
HLSC111 202260_Extended Unit Outline FINAL MODERATED_ Australian Catholic University 2022 Page 20 of 21
Motivational Interviewing techniques and therapeutic communication skills in a video assessment with a partner:
Introduction
Motivational interviewing (MI) is an evidence-based therapeutic approach used to help people change problematic behaviors by exploring and resolving ambivalence (Miller & Rollnick, 2013). MI utilizes specific techniques designed to elicit from clients their own motivations for change in a caring, guiding, and non-confrontational manner. When combined with strong therapeutic communication skills, MI has been shown to be an effective method for facilitating behavior change across a wide range of health behaviors and clinical populations (Lundahl et al., 2013).
This article will discuss the process of completing a video assessment requiring the use of MI techniques and therapeutic communication skills with a partner. Specific techniques utilized will be highlighted, along with reflections on strengths and areas for improvement. Research supporting MI will be integrated, and references will be provided in APA format. Subheadings have been included for organization. Examples from the video will be used anonymously to protect privacy. The learning outcomes and insights gained from engaging in this reflective process will also be discussed.
Preparing for the Assessment
My partner and I chose to role play using a case study involving a client struggling with problem drinking behaviors that were putting their safety at risk (Case Study 3 from Appendix C). We took time to carefully review the client’s background and discuss which stage of change they appeared to be in based on the Transtheoretical Model of Change (Prochaska & DiClemente, 1982). The client exhibited precontemplation and contemplation stage characteristics, as they did not fully recognize their drinking as problematic but were considering the concerns of others (Prochaska & DiClemente, 1982).
Understanding the client’s stage of change allowed us to select MI strategies appropriate for their level of motivation. We focused on developing discrepancy between current behaviors and important goals or values, as well as expressing empathy and developing self-efficacy for change through reflective listening (Miller & Rollnick, 2013). Research has shown addressing ambivalence and developing discrepancy are particularly effective MI strategies during early stages (Lundahl et al., 2013).
Conducting the Interview
The interview began with open-ended questions to explore the client’s perspective non-judgmentally, such as “Tell me about your experiences drinking with this group.” Active listening skills like affirmations (“It’s clear this means a lot to you”), reflections (“It sounds like drinking is an important social activity”), and summarizations (“So drinking helps you feel more confident but others are worried”) were used to convey empathy and understanding (Miller & Rollnick, 2013).
As ambivalence emerged, complex reflections highlighted discrepancies without confrontation: “While drinking helps you socially, it’s also led to some experiences you can’t remember that concern your friend.” When the client minimized risks, change talk was gently elicited by asking about values and long term goals, then linking current behaviors back non-defensively: “How does that fit with the future and relationships you want?” (Miller & Rollnick, 2013). This helped the client recognize incongruities and argue for their own change.
Throughout, a collaborative spirit and respect for autonomy were maintained. The client was never forced into change but instead supported in exploring it for themselves (Miller & Rollnick, 2013). Overall, the interview aimed to develop the client’s intrinsic motivation rather than impose compliance. Research shows this autonomous type of motivation predicts long term maintenance better than controlled motivation (Williams et al., 2006).
Reflections on Technique
In reviewing the video, several strengths in our MI approach were identified. Complex reflections effectively raised awareness of ambivalence. Open-ended questions allowed the client’s perspective to emerge without judgment. The emphasis on personal values over problem behaviors helped develop self-motivating reasons for change. However, there is always room for improvement.
At times, reflections could have been deeper or more focused on change talk. While empathy was conveyed, occasional direct guidance may have been more helpful for a client in earlier stages. Future interviews could be improved by more targeted use of the FRAMES components – Feedback, Responsibility, Advice, Menu of options, Empathy, and Self-efficacy (Miller & Rollnick, 2013). Overall though, the techniques selected appropriately matched the client’s stage of change and needs.
Learning Outcomes
Completing this assessment reinforced several important learning outcomes. It strengthened understanding of MI as a collaborative, evocative approach respecting client autonomy. The Transtheoretical Model provided a useful framework for case conceptualization and selecting stage-based strategies. Practicing MI techniques firsthand highlighted their power for developing discrepancy, empathy, and intrinsic motivation. Receiving feedback from the partner and critically reflecting enhanced awareness of clinical strengths and areas for development.
Overall, this assessment experience solidified knowledge of MI and therapeutic communication skills in a practical, applied manner. It demonstrated their utility across settings and populations for addressing ambivalence and facilitating behavior change. Most importantly, it emphasized the importance of ongoing self-evaluation to continue honing these evidence-based techniques.
Conclusion
In conclusion, completing a video assessment using MI and therapeutic communication skills with a partner provided invaluable opportunities for learning, practice, and reflection. While challenges remain, strengths in empathic listening and developing discrepancy were identified. Continued focus on stage-based strategies, FRAMES adherence, and targeted change talk should further improve skills. Overall, this assessment process reinforced understanding of MI as an effective, client-centered method for addressing ambivalence and facilitating behavior change.
References
Lundahl, B., Kunz, C., Brownell, C., Tollefson, D., & Burke, B. L. (2013). A meta-analysis of motivational interviewing: Twenty-five years of empirical studies. Research on Social Work Practice, 20(2), 137–160. https://doi.org/10.1177/1049731505280386
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.
Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research & Practice, 19(3), 276–288. https://doi.org/10.1037/h0088437
Williams, G. C., McGregor, H. A., Sharp, D., Levesque, C., Kouides, R. W., Ryan, R. M., & Deci, E. L. (2006). Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial. Health Psychology, 25(1), 91–101. https://doi.org/10.1037/0278-6133.25.1.91
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