Motivational Interviewing: A Powerful Approach for Counseling Diabetes Patients – A Case Study

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MOTIVATIONAL INTERVIEWING

MOTIVATIONAL INTERVIEWING

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`CAT' stands for

1) COMMITMENT,ACTIVATION,TAKING STEPS

2) CONTINUATION, ACTIVATION, TREATING WITH EMPATHY

3) CARING,ACTUALIZING, TAKING STEPS

4) NONE OF THE ABOVE

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MATCH THE FOLLOWING

DESIRE

Select an answer1) IT IS IMPORTANT TO CHANGE2) I CAN CHANGE3) I NEED TO CHANGE4) I WANT TO CHANGE5) I NEED TO CHANGE6) IT IS IMPORTANT TO CHANGE7) I WANT TO CHANGE8) I CAN CHANGESelect an answer

ABILITY

Select an answer1) IT IS IMPORTANT TO CHANGE2) I CAN CHANGE3) I NEED TO CHANGE4) I WANT TO CHANGE5) I NEED TO CHANGE6) IT IS IMPORTANT TO CHANGE7) I WANT TO CHANGE8) I CAN CHANGESelect an answer

REASON

Select an answer1) IT IS IMPORTANT TO CHANGE2) I CAN CHANGE3) I NEED TO CHANGE4) I WANT TO CHANGE5) I NEED TO CHANGE6) IT IS IMPORTANT TO CHANGE7) I WANT TO CHANGE8) I CAN CHANGESelect an answer

NEED

Select an answer1) IT IS IMPORTANT TO CHANGE2) I CAN CHANGE3) I NEED TO CHANGE4) I WANT TO CHANGE5) I NEED TO CHANGE6) IT IS IMPORTANT TO CHANGE7) I WANT TO CHANGE8) I CAN CHANGESelect an answer

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MATCH THE FOLLOWING

Particular emphasis on Language of Change

Select an answer1) Roll with resistance2) Change TalkSelect an answer

Dancing and not wrestling is Therapist job

Select an answer1) Roll with resistance2) Change TalkSelect an answer

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THE SESSIONS IN MOTIVATIONAL INTERVIEWING IS NOT GOAL ORIENTED

1) True

2) False

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Eliciting and exploring clients own arguments for change  is called

1) Evocation

2) Relfection

3) autonomy

4) None of the above

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THE THERAPIST IN MOTIVATIONAL INTERVIEWING PLAYS AN EXPERT ROLE

1) True

2) False

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MATCH THE FOLLOWING

EXPRESS EMPATHY

Select an answer1) BUILD RAPPORT 2) ELICIT PROS & CONS,3) RESPECT CLIENT AUTONAMY4) CLIENT HE/SHE CAN CHANGESelect an answer

ROLL WITH RESISTANCE

Select an answer1) BUILD RAPPORT 2) ELICIT PROS & CONS,3) RESPECT CLIENT AUTONAMY4) CLIENT HE/SHE CAN CHANGESelect an answer

DEVELOP DISCREPANCY

Select an answer1) BUILD RAPPORT 2) ELICIT PROS & CONS,3) RESPECT CLIENT AUTONAMY4) CLIENT HE/SHE CAN CHANGESelect an answer

SUPPORT SELF-EFFICACY

Select an answer1) BUILD RAPPORT 2) ELICIT PROS & CONS,3) RESPECT CLIENT AUTONAMY4) CLIENT HE/SHE CAN CHANGESelect an answer

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Empathy is about not giving so much importance to your own opinions in order to understand someone else.

1) True

2) False

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MI promotes Autonomy Over Authority

1) True

2) False

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MI promotes Education  Rather Than Evocation

1) True

2) False

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MI promotes Collaboration Instead of Confrontation

1) True

2) False

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The MI process is Engaging,Focussing, Evoking and ................

1) Planning

2) Prioritizing

3) Perception

4) None of the above

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MI has four fundamental processes. These processes describe the “flow” of the conversation although we may move back and forth among processes as needed

1) True

2) False

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WHICH ONE OUT OF THE FOLLOWING IS NOT PROPER EXPANSION OF `OARS'

1) OPEN QUESTIONS

2) AFFECTION

3) REFLECTIONS

4) SUMMARIZING

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IN OARS OF MOTIVATIONAL INTERVIEWING, `S' STANDS FOR SUMMARIZING

1) True

2) False

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IN OARS OF MOTIVATIONAL INTERVIEWING, `R' STANDS FOR REFRAMING

1) True

2) False

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IN OARS IN MOTIVATIONAL INTERVIEWING, `A' STANDS FOR AFFIRMATION

1) True

2) False

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IN OARS IN MOTIVATIONAL INTERVIEWING , `O' STANDS FOR OPENNESS IN COUNSELLING

1) True

2) False

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Motivational interviewing core skills are called OORS

1) True

2) False

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Which one out of the below is not Motivational interviewing Spirit as envisaged by Miller and Rollnick

1) Partnership

2) Acceptance

3) Compassion

4) Evocation

5) Directing

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Compassion ->The MI practitioner actively promotes and prioritizes clients’ welfare and wellbeing in a selfless manner.

1) True

2) False

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Acceptance ->The MI practitioner takes a nonjudgmental stance, seeks to understand the person’s perspectives and experiences, expresses empathy, highlights strengths, and respects a person’s right to make informed choices about changing or not changing.

1) True

2) False

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Evocation -> People  does not have within themselves resources and skills needed for change. Therapist draws out the person’s priorities, values, and wisdom to explore reasons for change and support success.

1) True

2) False

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Partnership ->MI is a collaborative process. The MI practitioner is an expert in helping people change; people are not the experts of their own lives.

1) True

2) False

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Motivational Interviewing (MI) is not an evidence-based approach to behavior change

1) True

2) False

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“MI is a collaborative, goal-oriented style of communication with particular attention to the language of change. .

1) True

2) False

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MI is designed to empower people to change by drawing out their own meaning, importance and capacity for change.

1) True

2) False

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Match the following

What’s an example of when you used your anger management skills?”

Select an answer1) Query Extreme2) Looking forward3) Using change rulers4) Looking back5) Asking for examplesSelect an answer

Before your drinking became a problem, how were things better? or Different?

Select an answer1) Query Extreme2) Looking forward3) Using change rulers4) Looking back5) Asking for examplesSelect an answer

How would you like your life to be different one week from now?

Select an answer1) Query Extreme2) Looking forward3) Using change rulers4) Looking back5) Asking for examplesSelect an answer

What is the worst thing that could happen if you dont change?

Select an answer1) Query Extreme2) Looking forward3) Using change rulers4) Looking back5) Asking for examplesSelect an answer

On a scale from 0 to 10,how important / confident is it to you to make (target change),where 0 is not at all important and 10 is extremely important/confident?

Select an answer1) Query Extreme2) Looking forward3) Using change rulers4) Looking back5) Asking for examplesSelect an answer

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MATCH THE FOLLOWING

“Why would you want to make this particular change?”

Select an answer1) Evokes Reason2) Evokes Desire3) Evokes needs4) Evokes Ability5) Evokes Commitment6) Evokes ActionSelect an answer

How might you go about it,in order to succeed?

Select an answer1) Evokes Reason2) Evokes Desire3) Evokes needs4) Evokes Ability5) Evokes Commitment6) Evokes ActionSelect an answer

What might be some reasons to quit if you were to do so?”

Select an answer1) Evokes Reason2) Evokes Desire3) Evokes needs4) Evokes Ability5) Evokes Commitment6) Evokes ActionSelect an answer

How important is it for you to make this change (01-to 10) , and why?

Select an answer1) Evokes Reason2) Evokes Desire3) Evokes needs4) Evokes Ability5) Evokes Commitment6) Evokes ActionSelect an answer

So,what do you like to promise to yourself on this now?

Select an answer1) Evokes Reason2) Evokes Desire3) Evokes needs4) Evokes Ability5) Evokes Commitment6) Evokes ActionSelect an answer

What are you ready or willing to do now

Select an answer1) Evokes Reason2) Evokes Desire3) Evokes needs4) Evokes Ability5) Evokes Commitment6) Evokes ActionSelect an answer

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In MI , The therapist doesn’t impose their viewpoint on the patient but helps the patient consider multiple viewpoints.

1) True

2) False

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The self-efficacy of the client can be brought to awareness to the client by talking about future

1) True

2) False

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Motivational interviewing posits that clients possess the strength and ability to grow and change

1) True

2) False

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Motivational Interviewing can not used with children behaviour problems

1) True

2) False

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Motivational interviewing is used in health related problems like Hypertension ,Diabetes etc

1) True

2) False

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Motivational interviewing is  a collaborative, person centered form of guiding to elicit
and strengthen motivation for"change.

1) True

2) False

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In the Preparation Stage, The client is aware of  his problems, but does not accept it.

1) True

2) False

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In pre-contemplation stage, the client is aware of the problem

1) True

2) False

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The first stage in `THE STAGES OF CHANGE' IS CONTEMPLATION

1) True

2) False

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Motivational interviewing aims to encourage the patient’s autonomy in decision making where the clinician acts as a guide

1) True

2) False

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Open-ended questions encourage clients to think deeply or differently about a given problem.

1) True

2) False

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Reflections involve listening to the patient and reflecting back a response

1) True

2) False

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In MI, The first goal is to increase the person’s motivation and the second is for the person to make the commitment to change.

1) True

2) False

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In action stage people are actively involved in taking steps to change their bad behavior by using a variety of different techniques.

1) True

2) False

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In Action stage  people are not motivated to change their behavior

1) True

2) False

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“I’ve got to do something about this — this is serious. Something has to change. What can I do?” - This question is raised by client when he is in

1) Pre-contemplation

2) contemplation

3) preparation

4) relapse

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In the preparation/determination stage, people have made a commitment to make a change.

1) True

2) False

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In the contemplation stage, people are on a teeter-totter, weighing the pros and cons of modifying their behavior, they aware of the problem but not ready to take action

1) True

2) False

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In the precontemplation stage, people are not thinking seriously about changing and are not interested in any kind of help

1) True

2) False

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Relapse is Resumption of old behaviors: "Fall from grace" abandoning the new changes

1) True

2) False

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In Maintenance stage, client is  being able to successfully avoid any temptations to return to the not so good habit.

1) True

2) False

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CONSIDER THE LARGER CONVERSATIONAL CONTEXT MEANS

1) Looking for specific inputs

2) Concentrating on the positives of the conversation

3) Considering all the aspects from 360 degree

4) None of the above

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What is the primary focus of motivational interviewing techniques in healthcare?

1) Facilitating behavior change

2) Conducting surgeries

3) Prescribing medication

4) Diagnosing diseases

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EXPERT TRAP' MEANS UNCONCIOUSLY GETTING INTO THE EXPERT MODE DURING COUNSELLING BY THE THERAPIST

1) True

2) False

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People are generally more persuaded by reasons they have discovered themselves than by reasons presented by others.

1) True

2) False

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Motivational Interviewing does not involve negotiating plans with patients.

1) True

2) False

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Motivational Interviewing aims to engage clients through sustain talk

1) True

2) False

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Motivational interviewing is primarily focused on providing direct solutions to clients without exploring their feelings.

1) True

2) False

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Motivational interviewing is a client-centered method aimed at enhancing intrinsic motivation to change.

1) True

2) False

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Compassion in healthcare involves empathy and a commitment to act in the best interests of the client

1) True

2) False

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In the context of client care, autonomy refers to the authority of healthcare providers to make decisions for the client

1) True

2) False

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In the Spirit of MI, motivation for change is believed to reside within the patient.

1) True

2) False

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Collaboration in the Spirit of MI emphasizes confrontation over partnership.

1) True

2) False

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The Spirit of MI emphasizes a directive and therapist oriented approach to client interaction.

1) True

2) False

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Good eye connect is an important aspect of expressing empathy.

1) True

2) False

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Empathy is important in Motivational Interviewing because it helps to communicate acceptance.

1) True

2) False

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Empathy involves judging a person's feelings and perspectives.

1) True

2) False

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One of the basic principles of MI is to express empathy.

1) True

2) False

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Motivational Interviewing (MI) is a way of tricking people into doing what you want them to do.

1) True

2) False

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Which principle is NOT one of the four principles of motivational interviewing?

1) Express empathy

2) Develop discrepancy

3) Support self-efficacy

4) Provide direct advice

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What does the 'righting reflex' refer to in motivational interviewing?

1) The tendency to listen actively

2) The ability to empathize with clients

3) The inclination to advise clients on the best health path

4) The process of encouraging client autonomy

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Introduction

Motivational interviewing is a collaborative and goal-oriented counseling approach that helps individuals explore and resolve their ambivalence towards change. It is particularly effective in healthcare settings, where patients often face challenges in adopting and maintaining healthy behaviors. In this article, we will delve into the concept of motivational interviewing and explore how it can be applied in counseling diabetes patients through a real-life case study.

Understanding Motivational Interviewing

Motivational interviewing is rooted in the belief that individuals have the capacity for change and that they are more likely to commit to change when they feel empowered and autonomous. It is a person-centered approach that focuses on building a strong therapeutic alliance and guiding patients towards self-motivated change.

The Principles of Motivational Interviewing

There are four key principles that guide the practice of motivational interviewing:

1. Express Empathy: The counselor should strive to understand the patient’s perspective and communicate genuine empathy. This helps establish trust and creates a safe space for open and honest discussions.

2. Develop Discrepancy: The counselor helps the patient explore the discrepancy between their current behavior and their desired goals. By highlighting this discrepancy, the patient becomes more aware of the need for change and is motivated to bridge the gap.

3. Roll with Resistance: Rather than confronting resistance head-on, the counselor acknowledges and respects the patient’s autonomy. By avoiding arguments and power struggles, the counselor can maintain a collaborative and non-confrontational approach.

4. Support Self-Efficacy: The counselor fosters the patient’s belief in their ability to make positive changes. By highlighting past successes and strengths, the counselor helps the patient build confidence and self-efficacy.

Case Study: Counseling a Diabetes Patient using Motivational Interviewing

Let’s consider a case study to understand how motivational interviewing can be applied in counseling a diabetes patient.

Patient Profile:
– Name: John
– Age: 45
– Diagnosis: Type 2 Diabetes
– Challenges: Poor diet, sedentary lifestyle, non-compliance with medication

Counseling Session:
During the initial counseling session, the counselor establishes rapport with John and expresses empathy towards his challenges and struggles. The counselor actively listens to John’s concerns and validates his feelings of frustration and overwhelm.

The counselor then helps John explore the discrepancy between his current behaviors and his desire for better health. They discuss the potential consequences of uncontrolled diabetes and how it aligns with John’s personal values and goals. This discussion helps John realize the importance of making positive changes in his lifestyle.

As the session progresses, the counselor rolls with John’s resistance to change. Instead of lecturing or imposing solutions, the counselor engages in reflective listening and open-ended questions to help John explore his own reasons for change. This approach allows John to express his concerns and reservations without feeling judged or pressured.

The counselor also supports John’s self-efficacy by highlighting his past successes in managing other aspects of his life. By emphasizing John’s strengths and capabilities, the counselor instills confidence in his ability to make positive changes in managing his diabetes.

Throughout the counseling process, the counselor collaborates with John to set realistic and achievable goals. They work together to develop an action plan that includes specific steps John can take to improve his diet, increase physical activity, and adhere to his medication regimen. The counselor ensures that the goals are aligned with John’s values and priorities, making them more meaningful and motivating.

Conclusion

Motivational interviewing is a powerful approach for counseling diabetes patients, as it helps them overcome ambivalence and enhances their motivation for positive behavior change. By expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy, counselors can empower patients to take control of their health and make sustainable lifestyle changes. Through the case study of John, we have seen how motivational interviewing can be applied in a practical setting to facilitate meaningful and impactful counseling sessions.

Remember, each patient is unique, and it is important to adapt motivational interviewing techniques to suit their individual needs and circumstances. By embracing this person-centered approach, healthcare professionals can foster a collaborative environment that promotes positive health outcomes for diabetes patients and beyond.