Motivational Interviewing Developing the Professional Self Paper

Published: 2021-09-03 07:00:10
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Category: Mental Health

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Motivational Interviewing: Developing the Professional Self

Heather Vaughn
Dr. Tricia Mikolon
University of the Cumberlands
COUN 641 Motivation and Change
Author Note
Heather Vaughn, Graduate Student, Department of Counseling, University of the Cumberlands.
This paper is submitted in satisfaction of the course requirement.
Correspondence concerning this paper should be addressed to Heather Vaughn.
Email: [email protected]
This paper is a reflection on the observation of my clinical skills of utilizing Motivational Interviewing (MI). It is aimed in assessing my own MI skills, it will identify what MI skills have been used, and will identify personal challenges to uses MI. This paper will reflect on my own score from the Motivational Interviewing Treatment Integrity (MITI) rating scale. It will look inward and discover my strengths and limitations while sharing thoughts of improvement for my professional self. This paper represents the reflection and findings from a personal perspective.
Motivational Interviewing: Developing the Professional Self
Motivational Interviewing (MI) is a person-centered counseling style that is also “a collaborative conversation style for strengthening a person’s own motivation and commitment to change” (Miller & Rollnick, 2012, p. 12). It allows for guidance and encourages an individual to address their ambivalence about change. This paper will reflect on the MI skills utilized and its affect on developing the professional self while assisting the individual to make changes.
Overview of MI Video
In the motivational interview video, the interview takes places in my office at Center for Behavioral Health between myself and my good friend and colleague. Mr. Todd, is a 36-year-old African American male, retired Army Veteran, married, and a Substance Abuse Counselor. During the course of the interview it was revealed that Mr. Todd was ambivalent about making changes to cope with his anxiety and depression.
Assessment and Reaction of MI Skills
MI is a great opportunity to help an individual see their potential. As the counselor/interviewer I tried to implement the MI skills set by Miller and Rollnick. During the interview I felt that my body language was open and I made great eye contact to demonstrate more attentiveness to Mr. Todd. To further demonstrate affirmation and active listening I made sure to lean forward and nod. I noticed I said “umm” and “okay” a few times and came across as being unprepared. Potentially showing Mr. Todd I was nervous. It was not that I was nervous with him, but that I was on video.
I felt like I was engaged with utilizing open-ended questions and reflecting on what Mr. Todd said. I felt I could have engaged more on empathy throughout the interview. I acknowledged with affirmations and reflections; however, I could have emphasized more on his history of anxiety and depression when he mentioned it. With affirming, I felt that I did not ask permission as I should have. I summarized often, however, when prompting for change talk, I could have limited my own advice and over reflectiveness.
I maintained focus on his anxiety throughout the interview. I utilized engaging techniques such as open-ended questions. When maintaining the therapeutic approach, I was able to sharpen the focus of the topic. I felt that I evoked and focused on bringing the conversation back to his original topic. I felt that I assist Mr. Todd in identifying his goal for change and amplified that through utilizing open-ended questions, affirmations, reflections, and through summarizing (Miller & Rollnick, 2012).
When I used the confronting technique, I prompted Mr. Todd to discuss more about his medication and asked him about if he takes his medication as he should. I did so in a supportive manner, but in a respective way. I tried to come from an engaging perspective. I was able to give feedback and provided information including different techniques to cope with the existing anxiety and ultimately initiating change.
Reflections of Scores
After utilizing the Motivational Interviewing Treatment Integrity scale, I noticed I asked 17 open-ended and closed questions in total. Even though there was a significant amount of open and closed-ended questions, I felt these questions still encouraged the Mr. Todd to continue on topic. During the interview, there were a total of 3 simple reflections and 5 complex reflections provided to the Mr. Todd. Throughout the engaged conversation I provided information at least 4 times including information about the STAR technique. I sought collaboration and emphasized autonomy at least 7 times each. I was confronted Mr. Todd at least 5 times in the discussion. I affirmed thoughts and feelings of Mr. Todd 9 times in the engagement. When persuading him, I persuaded him at least 10 times without permission and only once with permission.
My thoughts on my score revealed that I need to work on asking for permission prior to acting on persuasion. I felt that I needed to back away from appearing too pushy to prevent discord. In doing this I feel this will allow more opportunities for change and empowerment. It will also allow Mr. Todd to take the next step forward change. When reviewing the behavior counts, I feel that I also need to work on building rapport and provide a more therapeutic atmosphere where he was able to be more comfortable. Giving the time limited I felt that there was some progress to building rapport.
Strengths and Limitations
During the interview, I felt that I assisted Mr. Todd in finding a direction towards making the changes needed with his anxiety by helping him identify coping skills. I feel that I utilized open-ended questions, and reflective responses well. I demonstrated active listening by summarizing and repeating back the information. Even when my phone rang during the interview, I was able to redirect my attention to Mr. Todd. He appeared tense at the beginning of the interview, but responded in a calmer manner towards the end. I gaged this by asked him to identify his mood towards the end and at the beginning of the interview. I feel that I did assist him reaching toward the thought of change and to me that was a successful interview. I feel that a strength that I displayed was the empathetic affirmations that I provided and how I engaged in active listening. I feel that was more natural throughout.
My limitations were the easiest to pick out from the video. During the motivational interview, I noticed I had a difficult time hitting all the points of MI. I feel this is because I had the thought of being videoed and critiqued in my mind. I feel that my open-ended questions were more on the generic side. When reviewing the video, I did manage to keep myself from going on a small tangent and could have been my own personal bias to the discussion. I do feel that this assignment would be more interesting if I was not interviewing my friend but an actual client. I feel I did have more bias due to knowing Mr. Todd very well.
Room for Growth
Although I was able to utilize and implement MI skills, I believe that there is always room for improvement. I feel that as a counselor it is important to always practice and seek guidance from supervision. I feel that working on my MI skills daily will become an essential technique and a core value in my counseling career. I will make sure to work on engagement, focusing, evoking and planning skills. I want to make a conscious effort to be more mindful in being person-centered.
This assignment allowed me the opportunity to push my abilities as a counselor. Being able to evaluate my own MI skills helped with my professional self and my clinical awareness. Utilizing MI is effective in assisting an individual change, but it also in a way cause me to change how I engage with clients. Utilizing MI has increased the motivation to move towards change and it allows for the clinician and therapeutic approach to be more client driven.
Miller, W., & Rollnick, S. (2012). Motivational Interviewing, Helping People Change (3rd Ed). New York: The Guilford Press. (p.12)

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