3 Motivational interviewing Core Skills in Action

SBIRT IPE

11 Dec 201413:44

Summary

TLDRThe video script showcases a health psychologist, Dr. Turner, engaging with a patient referred by her GP due to concerning drinking habits. Through attentive listening and motivational interviewing techniques, Dr. Turner encourages the patient to reflect on the pros and cons of her alcohol consumption. The discussion highlights the patient's awareness of the risks, especially in relation to her future family plans, and her readiness to consider cutting back. The session aims to motivate change by examining the patient's social drinking habits and their impact on her health and future goals.

Takeaways

😀 Building a collaborative relationship from the start is crucial, showing interest and attentive listening to the patient.
🗣️ Utilizing motivational interviewing strategies such as open-ended questions, reflecting, affirming, and summarizing is effective.
📊 The readiness ruler and pros and cons technique are helpful tools to assess and reflect on behaviors and current situations.
👩‍⚕️ The patient was referred by her GP due to concerning drinking habits revealed by a secondary screening tool.
🎓 The patient is a grad student in Environmental Policy with plans to possibly travel abroad and start a family.
🥂 Alcohol consumption is a social activity for the patient, often involving friends and weekend gatherings.
🚫 The patient acknowledges the risks associated with alcohol, especially with future family plans and personal health.
🤔 The patient is surprised to be referred for counseling, as they perceive their drinking habits as normal among peers.
🔢 The patient's drinking pattern includes three to four nights a week with occasional heavy drinking on weekends.
🤰 The patient is aware of the health risks of alcohol during pregnancy and plans to abstain when starting a family.
🔄 The patient is willing to consider cutting back on drinking, motivated by future family plans and health concerns.

Q & A

What is the main purpose of the interview between Marcia and Dr. Turner?
-The main purpose of the interview is to address concerns about Marcia's drinking habits, which were flagged by her GP during a secondary screening tool, and to discuss how these habits might affect her future plans, including starting a family.
What motivational interviewing strategies does Dr. Turner use during the session?
-Dr. Turner uses open-ended questions, reflecting, affirming, summarizing, and readiness rulers as motivational interviewing strategies to help Marcia examine her drinking behaviors.
Why was Marcia referred to Dr. Turner by her GP?
-Marcia was referred to Dr. Turner because her scores on a secondary screening tool for drinking indicated a level of risk that concerned her GP.
What degree is Marcia pursuing in grad school, and how does it relate to her future plans?
-Marcia is pursuing a degree in Environmental Policy, and she sees herself possibly going abroad with her fiancé Ben, who is interested in international politics, after they get married.
What are some of the social activities Marcia enjoys in her free time?
-In her free time, Marcia enjoys outdoor activities like whitewater rafting and rock climbing, hosting parties at her house, and cooking for friends.
What does Marcia consider the pros of her drinking habits?
-Marcia considers the social aspect and the ability to feel less inhibited as the pros of her drinking habits, especially when she is with her group of friends.
What are some of the cons or negative effects Marcia has experienced due to her drinking?
-Some negative effects Marcia has experienced include hangovers, blackouts, and embarrassing situations, such as being involved in an incident in college that required her mother's involvement.
How does Dr. Turner bring up the topic of alcohol and its relation to Marcia's future family plans?
-Dr. Turner brings up the topic by asking Marcia if she has considered the health risks of drinking during pregnancy and by connecting her current drinking habits with her future family plans.
What is the safe limit for women's alcohol consumption according to the script?
-The safe limit for women's alcohol consumption mentioned in the script is seven drinks per week.
What is Marcia's readiness level on a scale of one to ten to address her drinking habits seriously?
-Marcia's readiness level to address her drinking habits is 8.5 on a scale of one to ten.
What steps does Marcia plan to take in the following week to change her drinking habits?
-Marcia plans to talk to her fiancé and her mother about her intentions to cut back on drinking, and she considers limiting her alcohol consumption to only weekends as a manageable change.

Outlines

00:00

🤝 Building Rapport and Understanding Patient's Lifestyle

This paragraph introduces the video script's setting, where a health psychologist, Dr. Turner, is having a conversation with a patient referred by her GP due to concerns about her drinking habits. The psychologist uses motivational interviewing techniques, such as open-ended questions, reflection, affirmation, and summarization, to establish a collaborative relationship and understand the patient's life, including her academic pursuits, social activities, and future plans involving marriage and family. The patient acknowledges her drinking habits and expresses a desire to reduce alcohol consumption, especially considering her future family plans.

05:01

🍻 Discussing Alcohol Consumption and Its Impact

The second paragraph delves into the specifics of the patient's alcohol consumption, noting the frequency and quantity of her drinking. The psychologist explains the health risks associated with exceeding the recommended weekly limit for women and the potential complications it may cause, both medically and psychologically. The conversation explores the pros and cons of the patient's drinking, highlighting the social benefits and the negative aspects such as hangovers and blackouts. The patient expresses concern about the impact of alcohol on her future family and acknowledges the need to address her drinking habits.

10:03

🚀 Planning for Change and Accountability

In this paragraph, the patient and the psychologist discuss the patient's readiness to address her drinking habits and the steps she can take to reduce alcohol consumption. The psychologist uses a readiness ruler to gauge the patient's motivation, which the patient rates as 8.5 out of 10. They talk about the patient's social circle and the influence it has on her drinking. The patient considers discussing her intentions with her fiancé and her mother to ensure accountability. The psychologist suggests setting a weekly alcohol limit and encourages the patient to make an appointment for a follow-up session to track her progress.

Mindmap

Keywords

💡Collaboration

Collaboration refers to the process of working together to achieve a common goal. In the video's context, it is about establishing a cooperative relationship between the health psychologist and the patient from the beginning of the session. The script illustrates this with the psychologist showing interest and attentive listening, which is essential for building trust and rapport in a therapeutic setting.

💡Motivational Interviewing

Motivational Interviewing (MI) is a counseling method that helps individuals resolve their ambivalence about change by exploring and resolving their mixed feelings. The video highlights the use of MI strategies such as open-ended questions, reflecting, and summarizing to engage the patient in a conversation about their drinking habits. This approach is crucial in understanding the patient's perspective and motivating them towards behavior change.

💡Open-Ended Questions

Open-ended questions are inquiries that cannot be answered with a simple 'yes' or 'no' and require more elaborate responses. They are a key part of motivational interviewing, as seen in the script where the psychologist uses such questions to encourage the patient to express their thoughts and feelings about their drinking habits, facilitating a deeper exploration of the issue.

💡Reflecting

Reflecting is a technique used in counseling where the counselor rephrases or echoes what the client has said to ensure understanding and to encourage further elaboration. In the script, the psychologist uses reflecting to show that they are actively listening and to validate the patient's experiences, which helps in building a therapeutic alliance.

💡Affirming

Affirming involves acknowledging and validating a client's feelings, thoughts, or behaviors in a positive way. The script demonstrates affirming when the psychologist acknowledges the patient's achievements and positive aspects of their life, which can enhance self-esteem and create a supportive environment for change.

💡Summarizing

Summarizing is the act of recapping or condensing the main points of a conversation. In the video, the psychologist uses summarizing to review the key points discussed with the patient about their drinking habits, ensuring that both parties have a clear understanding of the situation and the next steps.

💡Readiness Ruler

The Readiness Ruler is a tool used in motivational interviewing to measure a person's readiness to change a behavior on a scale, typically from 1 to 10. In the script, the psychologist uses this technique to gauge the patient's motivation to address their drinking habits, providing a quantifiable measure of their readiness to make a change.

💡Pros and Cons

Pros and cons refer to the advantages and disadvantages of a particular decision or action. The script shows the psychologist guiding the patient to list the pros and cons of their drinking, which helps the patient to weigh the positive aspects against the negative consequences, potentially leading to a clearer understanding of the need for change.

💡Alcohol Risk

Alcohol risk pertains to the potential harm or danger associated with consuming alcohol, particularly when it exceeds recommended limits. The video discusses the patient's drinking levels being at risk, indicating that their consumption patterns could lead to health complications, which is a central concern in the conversation.

💡Blackouts

A blackout is a period of amnesia where a person cannot remember events that occurred while they were intoxicated. In the script, the patient admits to having experienced blackouts, which is a significant concern as it indicates a level of alcohol consumption that can lead to memory loss and potential safety risks.

💡Family Planning

Family planning refers to the decision-making process about when to have children and how many to have. The script mentions the patient's thoughts about starting a family, which introduces the consideration of alcohol consumption in relation to health and the well-being of potential children, adding another layer of motivation for behavior change.

Highlights

Importance of building collaboration and showing interest in the patient from the beginning of the interview.

Use of motivational interviewing strategies such as open-ended questions, reflecting, affirming, and summarizing.

Introduction of readiness ruler and pros and cons techniques to assess patient's behaviors and readiness for change.

Patient's initial reaction to being referred by GP due to concerns about drinking habits.

Patient's personal background, including education in Environmental Policy and future plans.

Discussion of patient's social life and activities, including outdoor adventures and hosting parties.

Relevance of alcohol in the patient's social circle and its perceived normalization.

Patient's awareness of the risks associated with drinking and the desire to reduce consumption in the future.

Clarification of the patient's typical drinking pattern and the associated risks.

Patient's acknowledgment of the negative impacts of drinking, such as hangovers and blackouts.

The patient's consideration of the health risks of drinking during pregnancy.

Patient's readiness to address drinking habits and the use of a scale to measure motivation.

Identification of social drinking as the main reason for the patient's alcohol consumption.

Patient's commitment to discussing drinking habits with close ones and seeking support.

Setting a weekly alcohol limit as a goal for the patient to manage drinking.

Patient's plan to limit drinking to weekends as a first step towards change.

The role of follow-up appointments in reinforcing the patient's commitment to change.

Demonstration videos aim to replicate real-life scenarios for educational purposes in primary care settings.