Motivational Interviewing: Evoking Commitment to Change

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In this video clip, the Physician works together with the patient to develop a specific focus. The provider does this by asking open-ended questions, providing affirmation, using reflective listening and summarizing for the patients (OARS). He also helps the patient to scale the importance of the issue and the patients confidence level for change behavior.

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30 сен 2024

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Комментарии : 72

@adamlowe7038 5 лет назад

"Boy do I love that OJ"

@erikrostamian8668 9 лет назад

I'm surprised at some of the negative comments. I have seen and participated in a lot of MI role plays, specifically in medical setting. This one is actually very well done.

@carolinespec 8 лет назад

+Erik Rostamian I really liked how the doctor asked his patient so many questions and also how he asked permission to discuss the issues with his patient. What I also noticed that seemed different (not better or worse, necessarily) was that it felt a little sales-ish when the doctor was asking several times for the patient's level of commitment. It wasn't the words as much as the sort of high-energy, aggressive manner. I agree with someone else's comments that this sort of pressure can likely lead someone to tell the doctor what they think the doctor wants to hear rather than expressing doubts and fears. This, to me, means that if a person "fails," they are more likely to feel ashamed and not want to return. I think it would be preferable to be very encouraging (which the doctor was) and positive (which he was), but also a bit less emphatic and aggressive. That is the MI quality that I think people were commenting on. Then again, maybe I'm wrong. Definitely possible.

@timmcmahon7 11 лет назад

I feel his pain. "Boy, do I love that OJ!"... his face is priceless!

@petehaggard8539 3 года назад

Hahahahha

@Olan09 3 года назад

You could always make orange juice from fresh oranges. That's what we do in my house, any time we have orange juice.

@pharmacyroyalty 12 лет назад

Be careful using the words "I understand," even if you do understand exactly what the patient is going through, try to use more reflective listening.

@amanda.jan3767 3 года назад

What would a better phrase be?

@brendareed5050 3 года назад

@@amanda.jan3767 it’s reflecting back using the persons words.

@WithFlavorCrystals 4 года назад

1:56 "How Many Fruits and Vegetables?" is mislabeled in the text on the screen as being an Open Ended Question. It is closed.

@bobbystrom 5 лет назад

This is brilliant. Clear and Concise thank you both.

@frederickwhiteside6415 5 лет назад

To sum MI up in a few words: Motivational Interviewing is an effective way of talking with people about CHANGE. The doctor practiced a great deal of good peer support practices with his patient. Practicing Peer Supporters are open minded, empathetic, respectful, honest and direct. Peer Supporters facilitate change as well provide a natural place for social connection and social support.. At some points the doctor could have paced himself a bit more, but at least did not sound like he was reading from a poorly written script.

@MrMitchjos000 8 лет назад

2:16 is where this becomes doctors opinion (fact) and not motivational interviewing.

@AllthingsRocco 6 лет назад

so the doctors shouldn't offer any facts to his patients?

@kathlynnnorthrup-snyder1041 10 лет назад

Sorry, this has some elements of MI, but many non-adherent MI elements and I agree with one of the comments from the UK- this conversation is much longer than needs to be and could have much higher MI adherent skills.

@kevinl960 8 лет назад

Like what?

@knowhub 6 лет назад

I think the idea of this is not to determine the validity of fruits and juice, but the process. Yes, too much fruit juice is not good. Also, yes, you can gain weight with too many fruits. They are all sugars and when you have any type of sugars, you release insulin. If you take in more than what the body can keep up with, then what is not stored will convert to fat. Also, he does focus entirely on the juice and not the other meals nor talking about exercise, stress, sleep, etc. See, there is a lot that needs to be covered but that's not the intent of the interview. The intent is to show how to use the MI techniques to evoke a response.

@MissNairLovesHair 12 лет назад

Wow the Physician did an awesome job! This helped a lot. Thanks!

@1111Paiste 11 лет назад

This IS a terrible example of MI. The spirit of MI is totally out the window. He sounds judgmental, DOES NOT ask for permission when educating, the list goes on and on...

@gingerobyn 10 лет назад

Even though 'the patient' offered a detailed response, 'how many servings of fruits and vegetables do you have per day?' isn't exactly an open-ended question. I'm also getting the sense that motivational interviewing in a medical context does not have the same purpose or flow as MI in a therapeutic context.

@michaelaconley798 5 лет назад

this one really is pretty good.

@mjscarousal 8 лет назад

Great example of motivational interview, just wish the doctor was a bit more empathetic, he kinda comes off harsh at times and his body language could be better.

@Songmorning 7 лет назад

I think a more realistic goal would have been for the guy to reduce his intake of orange juice to one or two glasses a day, rather than trying to cut it out completely. For one thing, he said he really likes orange juice, so going cold turkey would probably result in a rebound. For another thing, I don't think one or two glasses of orange juice would have a negative effect on his health--in fact, orange juice contains many nutrients and antioxidants that would be quite good for him in moderation. The doctor also could have explored what KIND of orange juice he's buying and consider whether there are more healthy options that he could buy. For example, he may be getting a brand of orange juice which contains added sugars, and he might be able to switch to one without that extra sugar.

@petille007 13 лет назад

In real life, the patient is not so collaborative or may say yes to please the physician but will feel burden by what he has to do and remain unsure as which strategy would really work for him. Resulting on skipping the next appointment if failed. Also, in this example the physician dismissed muscle building (patient increased walking) as weight gain factor That could have been encouraging.. Could also have suggested water with lemon; also propose support or accountability partner/group

@zarglox 13 лет назад

he is larger because he is eating too much meat not oranges, and children.

@teresagraney2680 11 лет назад

Natural fruit juice without the sugar or artificial sweetener will not make you fat, but fruit juice loaded with sugar and other sweeteners like those cans of sodas CAN!

@DavidHernandez-oc1oz 7 лет назад

He shared information about fruit juice vs whole fruit without asking permission or asking if the patient knew about any differences in calories between fruit juice and whole fruit to see what the patient might have known. If he didn't know the doctor could then ask permission to share the information with the patient. Still a good video

@BouncinBudda 8 лет назад

definitely going to incorporate the grading scale into my next MI! gReat video, very practical!

@ThePsychology2010 12 лет назад

2 weeks later..

@italianlessonsnyc1176 Месяц назад

I want him as my Dr lol

@janiscrawford7757 4 года назад

The screen text mislabeled at least two language behaviors. A question that starts with "how many" is closed, not open and "I understand" would not be coded as an affirmation.

@xaniaris 13 лет назад

@Ricordato88 Pray tell how they are bad for your body? If he is at risk of NIDDM (and considering his age, sex, lifestyle it seems to be highly possible), then sugar free drinks are the way to go.

@aimeelecours9101 4 года назад

Hello. I am creating an e-learning for doctors and therapists. We do not charge for our trainings. I would like to request permission to use this video. Do I need any special permissions to utilize this video in an e-learning?

@cozygamingandvideos3914 4 года назад

John should switch from fruit juice to Mountain Dew. John also needs to exercise more. I suggest boxing.

@StoicScape219 Год назад

Definitely one of the better interviews I had to watch. It could had been more painfully scripted with a bunch of other nonsense in the mix where it looks like it was written by someone who never worked with a patient before but read a lot of text.

@bruceberger7140 11 лет назад

Tons of directing, yes but communication...patronizing.

@RussABryan 13 лет назад

Funny that they only focused only on drinking fruit juice and not the fact that he needed to continue exercising or he won't lose wait no matter what he eats or drinks

@1111Paiste 11 лет назад

This MI example sucked! It was NOT MI.

@szt1964 14 лет назад

Good exemple. Always a good idea to increase motivation to change dysfunctional behaviour. Just be aware that M I is not a magic wand. Emotional eating is a strong motivational force.

@audreylouise123 4 года назад

A lot of 'righting reflex' used here.

@BlessedByGodsLove 10 лет назад

GREAT ! This is the format in a medical setting with regard to time! I loved it. Thank you!!

@Jakerocksteady 3 года назад

3:11 Sunny D's next slogan.

@katec1 13 лет назад

Thank you thank you!! I know it's hard to "role play" MI skills - but I've been practicing, and this helps give me more ideas for wording some good questions. I hope to find some more vids! :)

@fitdre9079 12 лет назад

God, if only all doctors were like this...

@Kingricky76 10 лет назад

wow if i was the patient I would be freaking annoyed at my doctor!

@EurekaLiveTV 8 лет назад

He needs to slow down on the OJ!

@MaureenDelage 9 лет назад

very good

@angel-amenet 5 лет назад

This Was excellent

@urgoingonzo 14 лет назад

OMG!! That was ssoooo coool!

@peacefuljourney4858 7 лет назад

I loved how he ended the session.

@TIGHTChannel 12 лет назад

Thanks for the post!

@bmadccp 14 лет назад

Well done, great MI example.

@timmcmahon7 11 лет назад

I hear ya, but this is an MI example. It elicits change in a therapeutic and empathy filled way.

@bruceberger7140 11 лет назад

This is awful.

@myoldvan119 Год назад

You're awful Bruce Berger

@bruceberger7140 Год назад

@@myoldvan119 this is not my video

@ewelsby1 11 лет назад

Oh My God! Fruit does NOT make you fat!

@MrMitchjos000 8 лет назад

The doc had a lot of "I" statements. Agreed with him at one point.

@MrMitchjos000 8 лет назад

I disagree that this is motivational interviewing. I thing the beginning is good. "I have a hunch" not quite motivational interviewing. Good skit though. Keep practicing.

@chucktrain11 11 лет назад

I am a Medic in the UK. This guy must be being paid by the word and not have many patients. Over here it would be fill out a food diary, cut out the juice and clamp down on your wifes shopping. 30 secs tops. Natch!!

@Ricordato88 14 лет назад

Great Example of MI but drinking sugar free drinks should not be encouraged because they are bad for your body!

@rkbrown2092 7 лет назад

"Substitute with sugar free drinks!!!!" Why did the doctor not correct this statement by the patient. Sugar free drinks contain hormone disrupting chemicals. The fact that this doctor doesn't show any red flags to that... I would say he's working for the opposition. Good example of helpful questioning with hidden propoganda. Be discerning.

@1974GJH 7 лет назад

I caught that as well. 4 glasses of diet coke daily will insatiate his hunger and probably exacerbate his weight issues

@JasonJarred 7 лет назад

RK Brown lol wot

@littlethuggie 6 лет назад

The goal of the video is influencing change in the patient vs what you just did. A good Dr. doesn't "correct" the patient every time they say something false. You would never get anywhere, and no one wants an egotistical, pretentious Dr. (AKA, a dick).

@littlethuggie 6 лет назад

@ Greg H: Sugar-free drinks are generally not "healthy", but one is definitely exacerbating his weight issues (excess juice, fruit), and the other could make him hungrier and "probably" exacerbate his weight issues. One is definite, one is not. So, if your goal is weight loss, ditching the fruit will unequivocally work; ditching the sugar-free drinks depends on the patient and how it affects them, and whether or not they increase their caloric intake. You can be hungry all day, that's never made anyone gain weight; calories do.

@Butterflybabexoxo 13 лет назад

@Tyrtle12 But they can. This falls under patient education and is reimbursable by insurance companies. Under the new changes to health care there is going to be much more accountability for outcomes and you will see more of this.