sources include the course textbooks, journal articles, books, the Bible, etc. Websites are NOT
preferred sources!
MI’s Concept of “OARS”
In the video MI: Core Clinician Skills – Introducing OARS, the narrator shows open-ended questions to the client, asking questions such as “On a scale of 1-100, how essential is it to implement these changes?” How would you practice these changes if you want to? (Heart Foundation, 2012)”
The video also presents ideas on affirming, first, “It seems you already have the necessary information to make decisions about your diet.” Secondly, “It’s great you have reached this age, and there is a lot to feel good about in your life as well” (Heart Foundation, 2012).
In reflection, the narrator engages the change talk by saying, “It seems like exercise fits to who you truly are, and what has allowed you to feel happy, confident and effective”. Secondly, “you have noted what needs to change; some will likely entail changing norms” (Heart Foundation, 2012).
The first summary is that “it is evident that physical exercise has contributed to your identity such as confidence, happiness, and effectiveness”. Secondly, “it appears that you have already acknowledged that this involves implementing change” (Heart Foundation, 2012).
Reflection of client’s comments
Conflicts make me uncomfortable
- It sounds like you are insinuating that differences in opinions make you feel bothered.
- What do you do when encountering conflict within your space?
- I believe you are saying you do not like things that trigger your anxiety.
I am generally a happy person
- Do you mean that you do not experience moments that make you feel sad?
- What I hear you narrating is that you are always pleased but not contented.
- It seems you are saying that you tend to value maintaining good relationships.
I let people bother me more than I should
- It sounds like you are saying you are a kind person.
- Do you mean that other people have a massive sway over your life?
- I think I hear you say people always take advantage of your kindness.
Avoiding Thomas Gordon’s roadblocks
To avoid roadblocks in your reflections, reflections must remain specific, client-centered, and timely, explicitly focusing on the issue (Passmore, 2022). Similarly, it is essential to avoid instances that would lead to generalization, being defensive, pressuring the client, and blaming, and instead focusing on understanding and identifying the issue to enable the client to implement change. Similarly, using first-person pronouns such as “I” is vital to promote problem-solving and exploration through the feedback generated (Gary et al., 2022).
Difference between complicated and simple reflections
Simple reflections are saying back to the person what they have said to you; complex reflections involve arriving at an underlying assumption of what they are feeling and offering that back to them (Heart Foundation, 2012). An example of a simple reflection is, “It sounds like exercise fits well with who you are or how you perceive yourself”. An example of complex reflection from the video is, “It sounds like you have sort of identified or created a pattern for change”.
Trying reflective listening
An acquaintance came to me this week telling me how his personal beliefs affected his attitudes and how he interacted with a friend who said he felt frustrated with the job. I engaged him in reflection by summarizing what they had already said. I said, “Just to be sure I understand what you have said, you are feeling frustrated because you think the job does not provide enough challenge for you”. He appreciated my efforts to challenge his thoughts to hear their thoughts truly.
My action plan for implementing reflection
To implement reflection in my day-to-day activities, I will strive to ask open-ended questions, listen actively, and sum up what I hear to show understanding. By enhancing reflective communication, I will build stronger relationships based on trust and the needs of people around me.
References
Gary, A., Kiper, V., & Geist, R. (2022). An introduction to motivational interviewing. Nursing made Incredibly Easy, 20(2), 32-39.
Heart Foundation. (Feb 21st, 2012). 5 Motivational Interviewing: Core clinician skills — Introducing OARS. [Video]. Retrieved from:https://youtu.be/-zEpwxJlRQI/Links to an external site.
Passmore, J. (2022). Motivational Interviewing techniques reflective listening. Coaching Practiced, 251-255.
In a good paragraph each, give two sentences from the video demonstrating:
Open-ended questions go further than close-ended. They evoke a conversation that could easily lead to change talk. Using open-ended question words and phrases such as, “what would you …, how would you go about it and what would this entail, etc. go a long way.
Affirmations are used to support positivity, as well as to help the client with realizing his own potential. Effective affirmations are sincere, genuine and specifically apply to the person, a given situation and/or the behavior being addressed.
Reflections are not questions but reflecting on what the client says. Reflecting helps the client feel the need to move away from uncertainty and more toward change; and when used effectively, help clients experience ‘aha’ moments with what they already know and possess.
Summarizing is the clinician selectively choosing statements the client has already made, summarizing them and repeating them back to the client in such a way to facilitate change. In this video, (Heart Foundation, 2012) the clinician emphasizes ‘the need for change’ as a way of summarizing.
Conflict makes me uncomfortable:
What I think I hear you saying is that you have a hard time with conflict.
Am I understanding you correctly that you don’t do well with confrontation?
It sounds like you’re saying you’re a peaceful person.
I am generally a happy person:
Do you mean you prefer to have a good disposition?
You mean that you’re happy more than you are unhappy.
I think I understand you to mean you prefer happiness over sadness.
I let people bother me more than I should:
I think I hear you saying it is important to you how others view you.
Am I correct in thinking you mean you let people get to you to the point that it becomes a problem.?
Wait, am I hearing you say you might be a little sensitive?
What steps can you take to ensure that your reflections do not become one of Thomas Gordon’s “roadblocks”?
One way to avoid any of the roadblocks mentioned in the Miller & Rollnick text is to remain silent; however, reflection requires response from the interviewer. Giving advice is one of the twelve roadblocks of which a clinician can face during reflecting. Not getting caught up in ‘giving advice, making suggestions or providing solutions’ is one way to avoid roadblock. When the interviewer engages in such activity, she robs the client of the opportunity to tell his narrative and explore his own “experience and wisdom” (2013, p. 55).
Discuss the differences between a simple reflection and a complex reflection? Give an example of each from the above Youtube video.
A simple reflection is repeating back to the client what he says. Complex is an attempt to understand what the person means or feels. A complex reflection is more likely to produce a revelation. An example of a complex reflection as shown in the video is the clinician elaborating for the client how exercise is working for him and putting into words the male client had difficulty doing for himself. Example of a simple reflection is the clinician repeating back what the female client stated about changing habits to effect change in her life (Heart Foundation, 2012).
Because reflective listening can be challenging to practice at first, it is a learnable skill. Give an example of how you were able to try it with a real person this week. This could be a spouse, child, co-worker, acquaintance, etc. (no names or personal information!).
I was able to ‘practice’ engaging in reflective listening while listening to a young female tell me about the struggles she’s having with a job she recently accepted that might be above her level of competence. She stated she might consider going into an altogether different field and she might enjoy doing it (different work) I used my best guess with how the labor market is willing to hire people for the sake of numbers to help her to see the challenge of not being able to live up to the demands of a job above her competence level, but I did not encourage her to make the change.
Close out your post with a “plan of action” of how you can implement reflecting more into your day-to-day life when communicating with others.
Firstly, one can learn the art of nonverbal listening. It is not easy and requires skill. I have noticed when I intentionally ‘shut up’ and allow people (professional and non) to talk for minutes at a time – especially if over the phone – they will call my name because they are not sure I am still there. My reply is usually, “I’m here,” and I enjoy a good sense of self-discipline. Miller & Rollnick (2013) mention the importance of feedback as an aid in learning effective reflective listening. Receiving feedback for how I am doing when engaged in the process is one way to know what is needed – or not. Audio or video recording is a way to do it. I can view for myself and also offer to trusted colleagues for their trusted critique.
References:
Heart Foundation (2012). Motivational Interviewing: Core Clinician Skills – Introducing OARS [YouTube].
Miller & Rollnick (2013).Motivational Interviewing (3rd edition). Guilford.
3. Fe D Posted
Hello Everyone,
Video Demonstration
In response to the video demonstration related to OARS, the first is open-ended questions. Miller & Rollnick (2012) describe these questions as an open door. A helper may not know what or how a person may answer a question since it could range from many responses. Asking open-ended questions instead of closed questions, such as the person providing a yes or no response, can be very insightful. This allows a person to think deeper about their response, which may trigger something they never thought of before. Several of the examples used in the video were excellent. What stood out to me the most was asking the client why they did not choose a 0 on a scale of 0-100 (Video). I have used the scaling method but never thought to ask why not the lowest number. Doing so opens the dialogue up to additional thoughts.
Affirming, defined by Miller & Rollnick (2012), is to accentuate the positive. Sometimes, we get down on ourselves and see only the negative, but focusing on their strengths, for example, is a great way to encourage the client to realize their strengths. The video demonstration concentrate on listening to the female regarding how she reached 30 and stopping to focus on achievement. His pitch and delivery were to the same degree as her demeanor.
Reflection is an important skill in MI, which requires the person to listen with intent and understanding (Miller & Rollnick, 2012). This requires active listening on the part of the helper to be able to not only listen to words but the meaning behind them. Reflections could be simple or complex (Miller & Rollnick, 2012). In the video demonstration, the helper honed in on what the gentleman used to do when he was younger regarding exercising. When the helper brought this up while reflecting on what he said and how it made him feel, a connection occurred between how he used to be and where he would like to be now. This approach was a perfect example of a segue way into change talk.
Lastly, summarizing requires active listening as well. However, it requires more effort to take what the client has been saying and put it in a way that utilizes their own words of what has been stated either in the same session or over several sessions. It is like piecing a puzzle together. Miller & Rollnick 2012, define this process as a long reflection. The video demonstration did not speak about summarizing in detail; however, when speaking with the gentleman about exercising, it seemed he was summarizing to some degree.
Three Reflections Examples
The three examples for each of the statements are as follows:
Conflict makes me uncomfortable.
- Please help me understand if I heard you correctly; you get uncomfortable when conflict arises.
- You mean you are uncomfortable when there is conflict.
- What I am hearing you say is that conflict makes you uncomfortable.
I am generally a happy person.
- It sounds like you are saying that you usually are a happy person.
- What I am hearing is that normally you are happy.
- Based on what I understand you are saying is that you are generally a happy person.
I let people bother me more than I should.
- What I understand from what you are saying is that you let people bother you more than you want to.
- I think I hear you saying is that you are letting people bother you more than you like.
- It sounds like you are saying that you prefer not to let people bother you to the degree you are currently experiencing.
Sharing
What steps can you take to ensure that your reflections do not become one of Thomas Gordon’s “roadblocks” (Miller & Rollnick, ch. 5)?
What steps can I take to ensure my reflections do not become one of Thomas Gordon’s roadblocks? After reading the 12 roadblocks, a couple jumped out, which I am guilty of doing. Giving advice and suggestions from a personal standpoint is something that I have been working to stop. I now ask people, “What do they think they should do.” This allows me to stop my brain from thinking and listening to how they approach a situation. Interpreting and analyzing is the other roadblock item that flows into my not thinking. I attempt to understand the connecting parts of a story, which causes me to ask questions. The questions make sense; however, from their point of view, they may not have anything to do with the information they are relaying. Self-awareness is the first step in changing this behavior. I am still determining how to change this, other than notice the behavior when it occurs and go from there.
Discuss the differences between a simple reflection and a complex reflection. Give an example of each from the above Youtube video.
What are the differences between simple and complex reflections? Simple reflections are a form of parroting back what the person said with little to no change (Miller & Rollnick, 2012). Simple reflections do not go deep into what the person is feeling, whereas a complex reflection is about guessing what the person may be feeling (Miller & Rollnick, 2012). A simple reflection example from the video is when the helper repeated what the woman said about changing habits. This was a simple reflection based on what the client already stated. No further reflection seemed necessary. An example of a complex reflection from the video is when the helper “Stated that exercise is about who you are and how it has been a part of his life” (Video). Complex reflections are about putting the words people say and wrapping them up into how the person may be feeling.
Because reflective listening can be challenging to practice at first, it is a learnable skill. Give an example of how you were able to try it with a real person this week. This could be a spouse, child, co-worker, acquaintance, etc. (no names or personal information!).
Reflective listening is a challenge but is a learnable skill. Trying this reflective listening skill with my daughter proved to be challenging. I tried reflective listening skills, which worked at the onset of the conversation because I allowed her to talk without interrupting or asking questions. However, I could have done better when I gave her a suggestion about what she was doing regarding an earlier point she made. I should have paused and reflected on everything she stated since it was a concern about safety regarding the suggestion I gave. I should have just asked her questions.
Closeout your post with a “plan of action” of how you can implement reflecting more into your day-to-day life when communicating with others.
As I think of a plan of action to implement reflecting listening in my day-to-day, what comes to mind is the focus on feelings instead of analyzing the problem at hand. I could ask myself why this person is telling me this information. Understand my role in the interaction. Ask if I can do a listening check and provide them with my understanding of what they said. Doing these things will allow me to be a reflective listener first and then act or analyze when necessary.
References
Miller, W. R. & Rollnick, S. (2012). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press. ISBN: 9781609182274.
Video. Motivational interviewing: Core clinician skills, introducing OARS.https://www.youtube.com/watch?v=-zEpwxJlRQILinks to an external site.