Motivational Interviewing & Reflective Listening Part 1 PDF

Motivational Interviewing & Reflective Listening Part 1 Matt Mara DMD, EdD Expectation for Written Assignment #1 In Written Assignment #1 you goal is to elicit all information necessary from the patient to be able to provide counseling in Written Assignment #2. You should not be providing any counse...

Motivational Interviewing & Reflective Listening Part 1 Matt Mara DMD, EdD Expectation for Written Assignment #1 In Written Assignment #1 you goal is to elicit all information necessary from the patient to be able to provide counseling in Written Assignment #2. You should not be providing any counseling until Written Assignment 2- we will start to learn about that today. Check out the FAQ for more information and questions from your classmates. Written Assignment #1 due Sunday 4/7 at 11:59pm. Learning Objectives 1. Describe the role of motivation in health behavior change. 2. Describe effective communication strategies (directing, guiding, and following) for facilitating behavior change. 3. Define the acronym OARS (Open questions, affirmations, reflective listening, summarizing) as it applies to patient counseling and motivational interviewing. 4. List the four principles of motivational interviewing: 1)express empathy, 2) develop discrepancy, 3) roll with resistance and 4) support self-efficacy and optimism 5. Apply the elicit-provide-elicit method for providing information. Motivation the reason or reasons one has for acting or behaving in a particular way. Approaches to motivation should be tailored to each patient. Using the DISC System to Motivate Dental Patient Scarbecz, Mark. “Using the DISC System to Motivate Dental Patients.” The Journal of the American Dental Association, vol. 138, no. 3, Mar. 2007, pp. 381–385, https://doi.org/10.14219/jada.archive.2007.0171. Do not like wasting time. Dominant Style Patients Want to know what they need, why they need it, and what happens if they do nothing. May be inpatient or overwhelmed with too many details. Favor innovation, may like new treatment modalities, techniques, or products. Influencing Style Patients Appreciate undivided attention. Particularly attuned to feelings and emotions. Personal anecdotes may be especially effective (patient testimonials, how others have benefited done from treatment). Like dominant style patients, may be enthusiastic about new ew treatment modalities, techniques, or products. Steady Style Patients Often very friendly and agreeable but may be more guarded and introverted than an influencing patient. Trust is an essential component of doctor-patient interaction. Often risk averse. Appreciate when providers close attention to dears and concerns. Favor tried-and-true procedures over new techniques. Cautious Style Patients Generally approaches all situations as threats. Could have more dental anxiety than other styles. Logical, systamatic and data-driven. Prefer the evidence-based approach to treatment. When explaining options, provide all details and the rationale for all options. Can be paralyzed by analysis. Communication Styles Directing Following Guiding Involves the delivery of expert advice and help. Directing Traditionally the dominant approach in healthcare settings. Works best when there is good rapport between provider and patient. Well timed Must be Personally relevant Delivered in an engaging way. Listen first. Following Often best in situations where sensitivity is required. The goal is not to solve the problem immediately, rather provide support and encouragement. Works best when discussing bad news or working with an upset patient. Guiding Dentist and patient work together to help the patient establish goals and plans of action. Most appropriate when talking to patients about making health behavior changes. How to Implement Guiding Communication Style: OARS OPEN QUESTIONS AFFIRMATION REFLECTIVE LISTENING SUMMARIZING Open Questions Draw out and explore the person’s experiences, perspectives, and ideas. Evocative questions guide the client to reflect on how change may be meaningful or possible. Demonstrate appreciation for the patients' efforts Reinforce positive acts Affirmation Encourage perseverance Helpful in maintaining rapport Reflect on what the patient said Serves two functions: Reflective Listening o Enables the listener to check what they have understood from the speaker. o In the process, it makes the speaker feel understood. Consider two purposes: o Content o Meaning Reflective Listening Summarizing Before moving on it is helpful to summarize and demonstrate to the patient that you have listened, understood, and considered what they have said. Moving from Summarizing Pertinent Information to Providing Patient Counseling Elicit Provide Elicit First explores what the person already knows Then seeks permission to offer new information in a nonjudgemental way. And then explores the person’s response about the new information. Motivational Interviewing (MI) MI is based on the assumption that individuals are motivated to change when it is something they value. A strong doctor-patient relationship is essential for MI to be effective. Four Principles of MI 1 Express empathy 2 Develop discrepancy 3 Roll with resistance 4 Support selfefficacy & optimism Express Empathy Develop Discrepancy Involves exploring with patients the gap between their goals or values, or how they ideally would like things to be, and their current behavior. Roll with Resistance "Pushing back", arguing , persuading often increases resistance. In MI dentists roll with resistance to deflect or minimize its effect. Support Selfefficacy & Optimism Research suggests individuals who have confidence in their behavior are more likely to engage in that behavior. Dentists work to increase optimism and confidence in their ability to change. In reviewing your patient Jim's medical history, you notice the patient indicates they have high blood pressure, but you also notice they did not indicate they take any medications. When you get into the room you say, "I'd love to start with updating your medical history. Could you tell me a little bit about your high blood pressure?" What type of communication style did this provider employ? A. Guiding B. Resisting C. Directing D. Following Sample Provider Script Directing High blood pressure needs to be controlled or your heart can be overworked. Did you know that? Following Could you tell me a little bit about your blood pressure? Guiding What goals could we work on together to help improve your blood pressure? Resisting Not one of the 3 provider communication styles- part of MI. :) Announcements Written Assignment #1 Eliciting Information Due Sunday 4/7 at 11:59pm.