A medication adherence–enhancing simulation intervention in pediatric cystic fibrosis

Adherence to chronic pulmonary drugs in cystic fibrosis (CF) is suboptimal. We studied the feasibility and effectiveness of a multistep medication adherence–enhancing simulation intervention for pediatric CF, which was embedded in motivational interviewing and education. Product simulation experiments were performed by the children themselves, and they addressed adherence to mucolytics/hydrators and antibiotics. Dornase alfa–treated patients aged 7–13 years were included. We invited each patient and their parents to attend an interview. PowerPoint slides were presented and discussed. The final slide invited the patient to perform the simulation experiments, and, in so doing, they experienced what happens when they either do or do not take their medication. An educational film was applied as a summary tool. A patient-centered empathic counseling style was used. Two months later, the child and their parents each completed a different anonymous questionnaire. Overall, 21 patients were included. Parents rated the means of communication and improvement in their child’s motivation as very satisfactory. Children highly appreciated the experiments they performed. They often answered two questions on dornase alfa correctly and associated knowledge with adherence. Our results suggest that experiential simulation-based learning is extremely appropriate, and that this multistep intervention is feasible and effective in pediatric CF.

The Differences of Counseling Satisfaction Between Counselees With Counseling Style Matches With Their Personalities and Those Who Are Not

This study aimed to determine the differences in counseling satisfaction between counselees who get counseling services in accordance with the characteristics of his personality and get appropriate counseling style and those who do not. The hypothesis proposed in this study was that there was the influence of counselee personality characteristics, counseling style that was in accordance with the satisfaction of counseling.Two hundred and fifty-three men and women who have lived in Semarang for at least 1 year, aged between 18 and 55 years and came from various professions participated in this research. The recruitment of participants was voluntary to participants who were students whereas for non-student participants, there is assignment from the working institutions. The experimental research method was applied by grouping the subjects in the experimental and control groups randomly. A counseling style that matches the characteristics of the participants' personality was given in the experimental group, whereas in the control group it was not. Further comparison of the experimental and control groups was conducted to prove the differences in counseling satisfaction of both groups. Two instruments used in this study were: (1) the Indonesian version of the NEO Personality Inventory-Revised (NEO-PI-R) developed by Costa & McCrae (2) Client Satisfaction Questionnaire (CSQ-8). It was found that in general all participants were satisfied with the counseling service received. T-test analysis was found that there was no difference in counseling satisfaction between experimental and control groups

Exploring the Understanding and Application of Motivational Interviewing in Applied Sport Psychology

The purpose of this study was to explore how sport and exercise psychologists working in sport understand and use motivational interviewing (MI). Eleven practitioners participated in semistructured interviews, and inductive thematic analysis identified themes linked to explicit use of MI, such as building engagement and exploring ambivalence to change; the value of MI, such as enhancing the relationship, rolling with resistance and integrating with other approaches; and barriers to the implementation of MI in sport psychology, such as a limited evidence-base in sport. Findings also indicated considerable implicit use of MI by participants, including taking an athlete-centered approach, supporting athlete autonomy, reflective listening, demonstrating accurate empathy, and taking a nonprescriptive, guiding role. This counseling style appears to have several tenets to enhance current practice in sport psychology, not least the enhancement of therapeutic alliance.

Motivational Interviewing

Chapter 7, “Motivational Interviewing: Theory and Practice,” provides the theoretical and practice foundation for motivational interviewing (MI). MI employs a client-centered counseling style for achieving behavior change by facilitating exploration and resolution of ambivalence. The trans-theoretical model of change is discussed, as is the “spirit of motivational interviewing,” which highlights the practitioner’s way of being with clients. The chapter presents skills and techniques to enhance older adults’ ability to work through ambivalence and develop a sustainable plan for action. In addition, later-life problems in functioning that benefit from the use of motivational interviewing are summarized, including substance abuse/misuse, chronic disease management, smoking cessation and diet, exercise and weight control. Contextual issues related to clinical practice, and special considerations for use of MI with older clients, are discussed. The chapter includes a case example of motivational interviewing with an older woman with alcohol misuse issues.

Motivational Interviewing Tool for Health Recovery

Motivational interviewing is a directive, client centered counseling style that aims to help client explore and resolve their ambivalence about behavior change. Motivational interviewing plays pivotal role in improvement of health condition although primarily it was developed for fighting with addiction problem but now it shows its contribution in clinical setting to promote weight reduction, dietary modification, exercise thus having a potential profound impact on heart disease, hypertension diabetes mellitus prompting to use safe sex practices and protecting from the risk of HIV and other STD diseases. Motivational interviewing stresses on way of communication from traditional advice giving to reflective listening. Principles of motivational interviewing are Express empathy, Avoid arguments, Develop discrepancies, Roll with resistance and Support Self efficacy. As, it has been seen that motivation plays key role in any person’s life and many diseases flourishes due to our lack of motivation to change behavior and our life style that used to exacerbate morbidity. Motivational interviewing technique used to act as a catalyst to accelerate our activities through behavior change and protecting us from health related problems in future.

International Students’ Likelihood to Seek Counseling while Studying Abroad

International students experience significant stressors while studying in American colleges and universities, yet they use psychological services far less than domestic students (Misra & Castillo, 2004). Factors such as previous experience with counseling, perceived effectiveness of counseling style, and nationality were found to be factors affecting international students’ use of counseling services (Dadfar & Friedlander’s, 1982; Mori, 2000; Hyun, Quinn, Madon, & Lustig, 2007). This action research study adds to the literature by presenting suggestions about the manner in which international students may be most effectively served by their campus counseling centers, using information drawn from a focus group and a survey.

Applying motivational interviewing strategies and techniques to psychiatric pharmacy practice

Motivational Interviewing was developed to address patient resistance or ambivalence. As a directive, patient-centered counseling style for eliciting behavior change through patient exploration of ambivalence, it can be widely applied to the treatment of patients with mental health conditions.

Action Reflections: A Client-Centered Technique to Bridge the WHY–HOW Transition in Motivational Interviewing

Background: When using Motivational Interviewing (MI), once resistance or ambivalence are resolved and motivation is solidified, many practitioners struggle with how best to transition the discussion toward action planning, while still retaining the spirit and style of client centeredness, i.e., moving from the WHY phase to the HOW phase of counseling in a style that is MI-consistent. For many, there is a perception that the counseling style, skills, and strategies used to build motivation are distinct from those used in the action planning phase. The WHY to HOW transition does not, however, necessitate abandoning a client-centered style for a more overtly educational or directive style. Goal setting, action planning, provision of advice, and relapse prevention can be implemented from an autonomy supportive, MI consistent framework. Method: To this end, this article will present a new class of reflection, which we have termed “action reflections”, that can be used to help bridge the WHY-HOW gap. Action reflections (AR) allow the clinician to maintain a tone and orientation that are consistent with MI, i.e. autonomy support; guiding versus directing, during the action phase of counseling. They differ from reflecting change talk as they focus not on the WHY of change, but the HOW, WHEN, or WHERE. Action Reflections (ARs) also differ from the more common type of reflections such as those that focus on client feelings, rolling with resistance, or acknowledging ambivalence as ARs usually contain a potential concrete step that the client has directly or obliquely mentioned. Like any type of reflection, ARs represent the clinician's best guess for what the client has said or, more apropos here, where the conversation might be heading. Conclusion: This article describes the various types of ARs and provides examples of each to help clinicians incorporate them into their behavior change counseling.

Motivational Interviewing by Podiatric Physicians

Foot ulceration and lower-extremity amputation are devastating end-stage complications of diabetes. Despite agreement that diabetic foot self-care is a key factor in prevention of ulcers and amputation, there has only been limited success in influencing these behaviors among patients with diabetes. While most efforts have focused on increasing patient knowledge, knowledge and behavior are poorly correlated. Knowledge is necessary but rarely sufficient for behavior change. A key determinant to adherence to self-care behavior is clinician counseling style. Podiatrists are the ideal providers to engage in a brief behavioral intervention with a patient. Motivational interviewing is a well-accepted, evidence-based teachable approach that enhances self-efficacy and increases intrinsic motivation for change and adherence to treatment. This article summarizes some key strategies that can be employed by podiatrists to improve foot self-care. (J Am Podiatr Med Assoc 101(1): 78–84, 2011)