Motivational Interviewing

OARS (Open-ended, Affirmation, Reflection, and Summary) skills and agenda-setting tools are essential when conducting motivational interviews. OARS give the interviewer an opportunity to analyze the information received from the interviewer critically. The latter ensures that the interviewer identifies any unspoken information that a client had provided during the interview. My classmates and I conducted an interview with our client on a healthy lifestyle and incorporated evoking, focusing and engagement process of motivational interviewing. The interview was set to last for nine minutes, and we were required to record the interview. The interview was conducted in a park as we wanted to ensure that the client felt free to express any personal thoughts on the subject of the interview. Marina Shantel was our client for the interview, and her primary concern was how she remained inconsistent in exercising and constant consumption of junk food.

At the start of the interview, I introduced myself to the client and stated my various qualifications so far in life. I also thanked the client for agreeing to undertake the interview and noted the time I intended the interview to last. I then gave the client an opportunity to introduce herself and state her hobbies. She also highlighted the various aspirations she has in life and what she intends to achieve in the next five years. I engaged with the client for three minutes. Next, I focused on the focusing session of the interview where I managed to incorporate the various OARS skills. The client understood the multiple actions they needed to undertake and anything that affected their quality of life. Lastly, I used the evoking stage where I encouraged the client to take the various courses of actions to improve their experience. The evoking stage gave the client the hope they needed and hence motivated them to be the people they needed to be at the time.

I used open-ended questions at the start of the interview to ensure that my client did not feel like I was imposing my answers on him. The questions enabled the client to give their point of view concerning why they worried that they were not exercising enough. Also, the client also explained to me why she consistently fed on junk food despite aiming at living a healthier lifestyle. Moreover, the open-ended questions gave me a chance to direct the conversation that was taking place. I used close-ended questions in few occasions especially when I asked the client to list specific items. The close-ended questions confined the client within the topic of study and made her not to express her personal opinions. When I was later reviewing the interview in my recording, I realized that is used more open-ended questions that lose-ended questions. The lack of balance in the two forms of questions did not adversely affect my interview as I managed to interview within the specified time. Also, I got the necessary and required information from the interview.

I had a hard time getting the important affirmation from my client during the interview. My client was obvious on the various changes he needed to make in her life, and I assumed that she understood every question I asked. At some point, I asked her if she was willing to make the necessary changes and she replied ‘yeah. Sure’. Unfortunately, as we went further into the interview she said that she did not have the capability required to make the necessary healthy eating styles. I later realized that I needed to work with facts is I was to communicate with her effectively. I highlighted the various health specialists that she would need if she were to make the necessary changes. I also encouraged her to seek support from people who were struggling with the same issues as she was at the time. I then continued highlighting facts throughout the interview as this made her respond positively to the questions I was asking. I avoided the affirmation trap by ensuring that I kept my client involved through the interview process.

I used reflection to engage the client throughout the interview effectively. I incorporated both complex and simple reflections during the interview to ensure that the client completely got engaged in the interview questions. I asked my client what made her feel that she is unhealthy and she described that she experiences shortness of breath whenever she undertakes s slight activities. The client went further to describe an occasion where she could not walk for long distances as she would get tired after a short period. I asked the client what made her concerned about her health and she stated that several family members suffered from obesity and diabetes and they seemed to be chronic. The latter made the client afraid that she would suffer from the same if she did not take care of her health.

The simple reflection count behavior during the interview was ten while the complex behavior count was 8. I got a CR percentage of 5%. As the clinician, I gave 29 statements throughout the whole interview, and a total of 30 behavior counts. I gave information five times during the interview. I realized that I did not provide enough information during the interview as I aimed to get the client to find the internal motivation to start exercising on her own. However, I should also have aimed at giving the client on the various ways they could choose healthier lifestyles, especially when undertaking meals. I used 4 persuade with permission, 4 Affirmation, 19 questions, 10 simple reflection, 8 complex reflection, 2 seeking collaboration and 2 emphasizing autonomy. I asked a lot of questions instead of guiding my client to adopt healthier lifestyles. My reflection to question ration was 18:19.

In conclusion, the interview was informative for both the client and I as we all managed to share our desires throughout the interview. I guided my client through the interview and encouraged them to make the necessary changes concerning their health. I highlighted the facts associated with living unhealthy lifestyle and my client gave proof by giving personal experiences that resonated with the facts. The use of both open-ended and close-ended questions provides the client with and me an opportunity to engage and give our views concerning various issues. The reflection provides an opportunity for the client to understand deeper the consequences of not taking what has been said seriously. Reflection also gives me an opportunity to understand the concerns of the client and give her relevant advice. The interactions with the client have ensured that the interview was effective in the best way possible. However, I should have volunteered more information in the interview to guide my client to achieve the optimal healthy lifestyle. I asked many questions and gave reflections which would not effectively guide the client in pursuing a healthy lifestyle. The cooperation my client gave ensured that the interview was conducted effectively and we at most received the information we desired.

Behavior Counts                                                                                                                   Total

Giving Information (GI)

 

IIIII 5
Persuade (Persuade) (MINA)

 

IIII 4
Persuade with Permission

(Persuade with)

II 2
Question (Q)

 

IIIIIIIIIIIIIIIIIII 19
Simple Reflection (SR)

 

IIIIIIIIII 10
Complex Reflection (CR)

 

IIIIIIII 8
Affirm (AF) (MIA)

 

IIII 4
Seeking Collaboration (Seek)

(MIA_

II 2
Emphasizing Autonomy (Emphasize)

(MIA)

II 2
Confront (Confront) (MINA)

 

I 1

 

______44.44__% CR (Number of CR divided by (SR + CR)= 8/18

_____18:19___ Reflection to Question ratio R:Q

______8___Total MIA

_____1____ Total MINA