C3293924-Analysis of the Motivational Interviewing Session – Medical Science Assignment Help

Assignment Task


What issue was the client ambivalent about?

The issue the client has been described is Mr. Smith who is a 60-year-old man and has come over to the GP for the medication review. The case describes Mr. Smith who has been taking verapamil (160 mg three times a day) and has been taking ramipril (5 mg daily). At present, his health shows a high BP of 138/88 mmHg and he weighs 110 kg and has been 172.2 cm tall, with around a BMI of 37. In this case, as the GP wants to highlight weight and how to lose it realizes how due to the issue of the weight has caused Mr. Smith to react and even as felt incapable to manage it necessarily (Motivational interviewing in brief consultations, 2018).

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GP has mentioned that the blood pressure has been on the higher side, which can be controlled by reducing weight and doing some amount of moderate exercise. But Mr. Smith has shown reluctance and has mentioned the time issues and inability to manage the exercise and the weight time. He even mentions that we can forgo the weight and exercise management; instead, he is more okay to change the current medication to reduce the weight. Mr. Smith has even mentioned that he is aware of the weight, life problems and not being able to manage time consultations, for which GP has even apologized for letting him wait in his clinic. 

 What stage of change was the client at?
The change stage has been the client the evoking and the GP has already transitioned from the stage of engaging, focusing and planning. As Mr. Smith has been unable accept the engage in the conversation, where he knows about his weight and the rising blood pressure. Both the GP and the client are able to focus on the issue of the blood pressure and the rising weight issue, but in order to find a solution, even if the GP has been evoking the solution either Mr. Smith accepts or resists. Both the GP and Mr. Smith are not at present in the planning stage, but in the Evoking stage, where both of them know the problems and are unable to find a solution to the problem.  

In the motivational technique, both the GP and the Client have to focus on the brief motivational technique in the interview, where Mr. Smith is able to understand the GP’s direction of weight management and having an active lifestyle. The Evoking stage in the change is one of the competition needs that requires more adaptability and ability to prevent and create a thought proving stage, in the prevention stage and requires a patient centred-interaction that can promote the healthy behaviours (Miller & Rollnick, 2019). Through the motivational technique used between the GP and the patient, the importance of keeping the patient engaged and understanding how to find out a problem engagingly with one another, can help in the better lifestyles. 

Counselling strategies used appropriately to the client? Stage of change?
The transtheoretical model of behaviour or the stages of the changes has been described with the readiness and acceptance of the change and bringing in the process dynamic. It is all about the pros and cons that have been changing in the generation of ambivalence (Miller & Rollnick, 2018). By experiencing the ambivalence it is the attitude or the feelings as Mr. Smith has shown and having an ongoing coexistence in the wanting to change and at the same time not bringing a change. Ambivalence is all about the situations that would bring in the conflict between an immediate reward and experiencing a long term adverse consequence. Like in the case the patient has shown the signs of not managing weight and facing health issues due to this like Blood pressure, but at the same time resisting the change and not willing to accept weight and time management.

Identify the counselling strategies (OARS and DARN)
OARS are the counselling strategies that are all about open questioning, by having an affirmation, reflection and even the ability to summarize.  Open questioning is all about using the open questions and having the right clients in the opportunity that would help in creating the important information. Through the open questions, it is all about the skill demonstrating the client’s ski land bringing in the life about the behaviour change. Affirmations are all about the motivational interviewing technique that would help congruent and present the over the top. Reflective listening is all about the primary skill to bring in the demonstration of the sympathy, interest and understanding and bringing in the providing affirmation. Summarizing is all about reinforcement in listening carefully and adopting such technologies (Miller & Rollnick, 2019). DARN Counseling is all about reflecting on someone as to how one can think and change, in the way it would create a decision to change. 

Identify change and sustain talk.
In this case, Mr. Smith needs to be more motivated through the motivational technique interview and skills that would help in making more of the clinical care environment, competing in the needs of the rapid patient-centric interaction that would help to bring the healthy patient centred-interaction in creating the suitable behaviours. 

 What could the counsellor have done differently?
The counsellor should have explained the consequences of not being able to prescribe high doses of the medicines and what effects it could have been on the patient (Motivational interviewing in brief consultations: role-play focussing on engaging, 2018). The counsellor should have been assertive and helped the patient understand the repercussion of the weight and time mismanagement.

What did the counsellor do well?
The counsellor had patience and has been able to understand the patient’s issues like time management, lack of discipline and rigidness to bring a change. The counsellor has even apologized (which he should have not done) for the patient having to wait for a few minutes.  The counsellor has been calm during the entire conversation and remained engaging and focused in the conversation.

Comment on the counsellor’s verbal and nonverbal behaviour
The counsellor in the video has been more actively engaging and at the same time has been less assertive or dominating. The counsellor has been able to establish good eye contact, sit patiently and interact with the patient from the time through the positive synergies. Not only the patient has been influenced in understanding the weight management cause, but even the patient arguments and rigidness has been handled with calmness. If at all the counsellor has been assertive and could have dominated the conversation, it could have helped Mr. Smith about the benefits of weight and time management instead of taking high doses of the medicine. The counsellor should have explained the negative sides of the high medicinal doses and changes. 

Critique your analysis of the motivational interviewing session
The video is about motivational interviewing in the vocational rehabilitation setting and identifies how the VRC would be interviewing the client to demonstrate agenda setting. At first, the VRC has encouraged the client to speak about his thoughts on the past and how the session has happened which has helped to remain connected with one another (MI in a VR setting,2014). The Client firstly has been appreciative of the meeting and even has been able to discuss from the records but by bringing in the positive synergies, he has also mentioned the inability to concentrate and overthink. The entire conversation and the engagement have been slow and yet remain engaging, it could have to speed up with devising the work-based problems and the solutions to the problems. 

What issues did you identify well?
The client faces emotional and mental health problems, inability to concentrate and overthinking have been of the problems. The challenge has been seen in the VRC’s unable to devise a solution to the problem, bringing in the momentum thinking by identifying the client’s strengths and overcoming their weakness. For example, if the client faces overthinking problems and can take Marijuana out of the stress, the VRC could have provided him with techniques to control and deviate his mind, do some activity or suggest some rehabilitation motives.

What issues weren’t identified so well?
Issues that have been identified are the lack of engaging interactions and the incapability of the VRC to fully understand client weaknesses. Like if the client has been unable to find a solution to overcome the emotional problem, then the VRC should have allowed the client to remain engaged in some other activity.

Comment on the structure and format of the critique
The setting arrangement has been facing to face, where the VRC and the client have been interactive and trying to find a solution to the problem. Through the motivational technique used between the VRC and the client, importance of the keeping the patient engaged and understanding how to find out a problem engagingly with one another, can help in the better lifestyles.

Were the arguments clearly stated and well set out?
The client has mentioned repeating the marijuana and the other repetitive drugs even after leaving them, due to the repeated episodes of the overthinking, which the VRC has been patient and yet not been able to identify the suitable solutions to the problems (MI in a VR setting, 2014).

What would you need to change in your critical analysis?
Motivational interviewing should be changed in the counselling method, which should be assertive and active, not passive, that can keep the patient’s motivation to change and bring in the guiding principles of like resistance and acceptance and by understanding the patient’s motivation, in listening to the empathy and empowering the patient.

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