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Table 1 Types of reflection of students as indicators of transformation

From: Teaching health science students foundation motivational interviewing skills: use of motivational interviewing treatment integrity and self-reflection to approach transformative learning

Reflection

Definition

Example

Content

Learning with present meaning by thinking back to what was done

I found some principles such as empathy and supporting autonomy came almost intuitively while other concepts like open ended questions and complex reflections proved to be more difficult to adopt. (PT7, female)

Overall the interview-reflection experience provided me with an opportunity to apply theoretical principles of motivational interviewing and then reflect on the process (OT4, female)

During the interview I gave my client the responsibility to discover different strategies he could use to improve his motivation and also the tools and strengths he already had that he should emphasize. (PT7, female)

Process

Learning with new meaning by considering actions and related factors

Equally, I need to work on my questions to make them more reflective and open-ended. (OT7, female)

As a next step, I will focus on restructuring the interview in a way which will benefit power sharing, collaboration and self-efficacy especially during goal setting and working through the decisional balance sheet. (OT2, male)

Instead, due to inexperience, I feel as though I was too focussed on planning what I could say next, rather than actively listening to her responses and incorporating them in my interview (OT6, female)

Throughout the MI I should have sought to evoke his ‘change talk’ ………… and I could have responded better with reflective listening (PT1, male)

I would make a mindful effort to the clients control and highlight their power within their ability to decide their goals and course of action. (OT8, female)

If I were to perform this task again I would make a concerted effort to probe further into the patient’s responses and reasoning. This would promote a greater understanding of the patients health barriers and barriers to change and ideally would result in more detailed goals, more structured health plans and better outcomes. (PT5, male)

I believe that I made it clear to my client that he was free to make his own choices, I wasn’t there to dictate to him, and he was required to self-direct in order to discover answers and ways to change his behaviour. (PT7, female)

Considering this interviewer did not meet the beginner’s threshold proficiencies (Moyers et al. 2007), it’s worthwhile concluding by reflecting on how skills in motivational interviewing can best be developed ….. (OT5, female)

Premise

Learning through meaning transformation by considering a broader perspective

Providing reflective responses to interviewee’s statements would allow not only greater collaboration and direction but also allow the interviewee to walk away feeling more empowered. (OT2, male)

To further develop client discrepancy, it is important why change may not be a good idea, or consequences of not changing in addition to why change is a positive factor. (OT4, female)

It is vital that the interview support the client in their decision and to ensure that questions are not being repeated as this can cause resistance and / or friction with the client (OT3, female)

It has educated me that people are often ambivalent about health behaviours and that resistance and change are two sides of a coin (PT1, male)

While motivational interviewing is difficult to master, it is a very important skill to enable effective communication between a practitioner and client. This is a skill that I intend to practice for my career as an Occupational Therapist (OT6, female)