An ambulatory care physician is utilizing advanced Motivational Interviewing (MI) techniques to counsel several patients with chronic diseases who are exhibiting resistance to behavior change. Match each physician statement with the specific MI communication strategy it most accurately demonstrates.
- "You feel absolutely certain that there is nothing you can do to improve your asthma, and that no medication could ever possibly work for you."Amplified reflection
- "You view your past unsuccessful attempts to lose weight as failures, but those attempts actually demonstrate a significant amount of persistence and dedication to your health."Reframing
- "On the one hand, you are worried about the weight gain associated with quitting smoking, but on the other hand, you are very concerned about your worsening chronic cough."Double-sided reflection
- "It seems like discussing the dietary changes is causing frustration right now, so let us set that aside for today and focus on managing your joint pain."Shifting focus
Answer
The physician statements correctly match to their respective Motivational Interviewing strategies as follows: the absolute, exaggerated statement represents an amplified reflection; highlighting persistence in past failures represents reframing; comparing conflicting patient feelings represents a double-sided reflection; and tabling a tense topic represents shifting focus.
Each statement aligns with a core tenet of Motivational Interviewing for handling resistance. Amplified reflection overstates the barrier to elicit pushback. Reframing recasts a negative as a positive. Double-sided reflection highlights ambivalence by pairing conflicting patient statements. Shifting focus circumvents dead-ends to maintain rapport.
Step-by-Step Solution
Key Concept
Advanced Motivational Interviewing techniques for navigating patient resistance and ambivalence.