Motivational Interviewing And OARS Skills: Video Analysis

Psychologists William Miller, PhD. and Stephen Rollnick, PhD. developed the counseling approach known as Motivational Interviewing (MI). Motivational Interviewing evolved out of experience in the treatment of persons who were problem drinkers, and was first described by Miller in 1983. In 1991 Miller and Rollnick provided these techniques as a method that promotes and engages intrinsic motivation within the client in order to change behavior. MI is a client-centered counseling style that is goal -directed and brings about behavior change by helping clients to explore and resolve ambivalence. Traditional Rogerian client-centered therapy does not guide or direct or focus in the way that MI therapists do to influence individuals to consider making changes, instead of non-directively explore themselves.

The discussion of the video below is in accordance with the Motivational Interviewing Reflection Tool (MIRT).

One more weakness encountered is that the nurse might have frightened the client by saying “that’s serious!” and the final outcome of the breast cancer when the client said she had discovered a hard substance on her left breast. The nurse may not be able to handle this situation as the client burst in to tears the moment that she heard the frightening statements. This would distract and confuse the client and therefore the pace of the interview would be disrupted (Hodgson, Martin, 2006).

Motivational interviewing is a practice wherein conveying acceptance of your client, you become an aid in the process of change. Motivational interviewing fosters Carl Rogers ' optimistic and humanistic theories; around ones competences for employing free choice and shifting through a course of self-actualization. The therapeutic relationship for both Motivational Interviewers and Rogerians’ is a democratic partnership. The concept of Motivational Interviewing (MI) progressed from the experience of treating problem drinkers. Motivational Interviewing was first described by William R. Miller, Ph.D., in 1983.

In the late 1980’s a study was performed by Lois Haggerty. Haggerty is a masters prepared nurse who wanted to study the differences of response to patient situations in different types of nursing education programs. Her study prompted a push for more research on this issue and for the increase in baccalaureate prepared nurses. The study began with 44 ADN and 31 BSN students preparing to graduate. They were presented with four case studies. They watched two videos of patients expressing somatic distress and two videos of patients expressing non-somatic distress. They were prompted to fill out a questionnaire for each scenario stating what they would say first to each patient. Haggerty discovered that both the ADN

One of the many roles of the nurse, in caring for their patient, is to advocate for the patient. The nurses in the clip did not exhibit this professional role, the nurses were hesitant in following the physician’s orders, but none of the nurses spoke up on the patient’s behalf. Nurses are often in the best position to communicate with team members and the patient’s family on behalf of the patient, because in most cases, the nurse provides the most interpersonal contact with the patient.

An interview utilizing motivational interviewing techniques was conducted by a nurse practitioner student and a consenting patient. The patient is a 55-year-old, male, with occupation as a heating, ventilation, and air conditioner technician that the nurse practitioner student identified on physical examination to have mild hearing loss. Hearing protection is admittedly not worn consistently at the jobsite during the history taking portion of the exam. This paper will discuss the behavioral health problem of noncompliance with hearing protection, the evidence supporting motivational interviewing strategies to support behavior change, and a discussion of the techniques used during the interview.

The process of motivational interviewing is essentially about creating "intrinsic motivation to change" within the client (Moyers, 1998). The choice to change must originate with the client and the process for helping this occur begins with motivational interviewing. There are two phases within motivational interviewing, the first focuses on increasing the client’s motivation to change and the second phase is negotiating a plan and consolidating commitment. It is important to understand the traps that can be encountered within this process, such as the question/answer trap. In this trap the client is led by the counselor with little chance to have free speech to explain themselves because the counselor is just focused on the next question instead of focusing on where the client is leading them. This trap is very similar to the expert trap in the fact that the client is left to believe they cannot find answers for themselves; they instead must listen to the expert who is giving them the answers. This is most definitely not the way to motivate a client to make changes for themselves. Other traps include premature focus, denial, labeling, and blaming; all of which can prevent the client from opening up in the treatment process.

The following essay is a reflective account on an event that I, a student nurse encountered whilst on my second clinical placement in my first year of study. The event took place in a Fountain Nursing Home in Granite City. I have chosen to give thought to the event described in this essay as I feel that it highlights the need for nurses to have effective communication skills especially when treating patients that are suffering with a mental illness. Upon arriving to the Nursing home for the second time on Thursday November 14,2013; assigned the same patient as before. On meeting my patient the first thing I noticed myself doing without even thinking about it was giving her a visual inspection. Before nursing school I never really looked at

Equally important the nurse indicated that she was in a hurry and unable to sit down, choosing rather to stand while she talks to the patient. What the nurse did not realise was that she had assumed a power stance and had failed to create an environment that was holistic, conducive and

Motivational interviewing is a counseling approach that was studied and understood as an applicable theory of practice that would be beneficial in the environment where I currently work which is an alcohol treatment facility. Whereas, it is understood that clinical and applied aspects of Motivational Interviewing (MI) have shown effective as a relatively brief intervention (Levensky, Cavasos, & Brooks, 2008), especially those dealing with an alcohol dependency. According to Miller and Roderick, MI, has been defined mostly as a directive, client centered counseling approach for eliciting behavior change by helping clients to explore and resolve ambivalence. In addition, with its goal-orientated approach it can help break down resistance to change (Corey, 2013, pp. 191-194). This theoretical approach is the most favored for the environment in my profession of choice, in addition, integrating it with the practice of Cognitive Behavioral Therapy (CBT) which is already in use.

The Nurse in Scenario one made it clear to the patient that she was busy and had other patients to tend to. Effective communication is not demonstrated here because the Nurse has not respected or placed herself at the service of the client (NMBA, 2008). As observed in the video the Nurse speaks quickly and interrupts the patient.

After this, I realized that I should not have judged anything about elderly people before talking to them. I should have researched about how to interview elderly people and prepared myself for the interview. I now feel that interview would have gone more smoothly and I would have more fun if I had not hesitated to ask the words that I did not understand. With the help of my mentor, I also realize that I need to be more confident to become a good interviewer and eventually a good nurse.

On a daily basis there is a lot of thought and focus directed at these patients to assure they are getting quality medical care; you may have caught a medication error, made multiple phone calls, waited on hold for what seems like forever, waited on doctors, ran to another floor all to get a patient something they needed or wanted, or may the nurse noticed an important change in the patients status that could dramatically affect their outcome. Most times the patient does not see or not even know about these behind the scenes battles to ensure quality care. Conversely, most often, especially when considering a patient in the hospital setting, our perception is our reality. Patients often do not know the ins and outs of procedure and protocol and rely solely on their perception of the care they are receiving. Studies have shown that patients desire to be perceived and cared for as individuals. Lying in that bed waiting on a nurse for 20 minutes for pain medication may just translate into lack of care on the nurses’ part to the patient but in reality the nurse was caught in another room with a different patient with a situation he or she couldn’t walk away from. Often nurses are stressed which can also convey a certain harshness to patients. In other cases maybe the job has become so repetitive that the nurse

Motivational Interviewing (MI) refers to a client centred counselling approach, which is directed to enhance motivation in an individual for behaviour change Miller & Rollnick (as cited in Christopher & Dougher, 2009). MI as a method understands and accepts that the clients are at different levels of readiness to change their behavior. It consistently focuses on goals to prepare the client for transformation by providing motivation for commitment to change (Bricker & Tollison, 2011) in the domains of substance abuse, addiction and risky health problems. It proceeds to make the client aware of the causes, consequences and risks that could be a result of the behavior. Through this, the client foresees the possibilities of enhancement and becomes motivated to achieve it (Jenson, Cushing, Aylward, Craig, Sorell & Steel, 2011). MI is coherent with the