Motivational Interviewing Transcript Analysis: HLSC111 Assignment

This document presents a transcript of a motivational interviewing session between a healthcare professional and a client struggling with smoking. The professional employs various motivational interviewing techniques to understand the client's perspective, address their ambivalence towards quitting, and explore strategies for change. The transcript highlights the use of open-ended questions, reflective listening, and empathy to build rapport and encourage the client to consider the negative consequences of smoking. The professional guides the client to explore their own motivations for change, focusing on the impact of smoking on their health and family. The analysis reveals the healthcare professional's strengths in effective communication and understanding the client's condition, while also pointing out areas for improvement, such as deeper exploration of underlying emotional issues. The reflection section provides insights into the interviewer's self-assessment, including confidence levels and challenges faced during the session, and offers suggestions for enhancing the motivational interviewing process. The assignment covers the stages of motivational interviewing, from pre-contemplation to determination, highlighting the importance of client-centered collaboration and evoking intrinsic motivation. The transcript also explores various methods, such as nicotine replacement therapy, music therapy, and social support, to assist the client in quitting smoking and adopting a healthier lifestyle.

Running head: MOTIVATIONAL INTERVIEW
MOTIVATIONAL INTERVIEW
Name of Student
Name of University
Author note

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MOTIVATIONAL INTERVIEWING TRANSCRIPT
Professional – ‘Hello, David. I am Steven. How are you doing today?’
David – ‘I am fine [smiles]. A bit nervous to be honest’
Professional – ‘But there is nothing to be worried about. David. We are here just to talk freely
and understand the reason because of which, you are visiting me today. So David, at first tell
me something about you.’
David – ‘Yes. Well I am a media person, a journalist to be precise. I actually belong from
Melbourne but in Sydney, currently for my job. News and news is all I strike for. Quite a
stressful life. You know. Have to run from here to there for a story or a scoop.’
David coughs, looks outside and looks back at the professional.
Professional – ‘David, I do understand your concern. Every job has its intricacies and media,
I do understand what you are trying say. So, David what do you do to reduce stress
generally?’
David – ‘I smoke [looks tensed]. And listen to music.’
Professional – ‘I think given the nature of your job – you hardly get any time to listen to
music until you are at home. So we can consider the fact that your main stress reliever is
smoking.’
David – ‘yes.’
Professional – ‘Do you think smoking is a healthy habit?’
David – ‘But still, I cannot do anything about it. Smoke is like fresh air to me.’
Professional – ‘I understand, David. [Smiles]. How many smokes do you have in a day?’
David – [Thinks] ‘May be. About 35 – 40 cigarettes a day.’

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Professional – ‘Oh! Is not that too much a day?’
David – ‘Yes. I know [looks guilty]. But I do not have any other option.’
Professional – ‘Oh, you have many options, more than you can actually think of. How long
you have been smoking David?’
[David coughs and pulls out a handkerchief. Drinks water from the glass.]
David – ‘Since my university days. Almost 13 years now.’
Professional – ‘Quite a long time. Smoking can cause lung cancer and high blood pressure.
Do you know? David.’
David – ‘Yes, I have seen the television advertisements but I am fine.’
Professional – ‘I am sure you are but you must know that chain smoking can lead to not only
lung cancer but oral cancer as well and hypertension which is high blood pressure that can
cause stroke. I am sure you do not want any of it. You have such a prospective career of a
journalist.’
David – ‘Yes, I do enjoy my work.’
Professional – ‘That’s wonderful. And I know you will have a long successful career but
don’t you think you must have healthy and fit life to support a long career.’
David – ‘Yes’
Professional – ‘Do you think David that by any chance – you can change your habit of
smoking?’
David – ‘Yes, I think.’
Professional – ‘Great. Who else is there in your family?’

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David – ‘I live with my daughter and wife. My wife is a journalist too and daughter, Mary, is
in fourth standard.’
Professional – ‘Lovely David. It appears you have a very affectionate and caring family.’
David – ‘yes, thank you.’
Professional – ‘So, you have a lot of motivation already to start with the habit change and of
course, we will explore the other interesting options that would reduce your stress and
anxiety related to work. Should we proceed?’
David – ‘Okay’.
Professional – ‘Thank you for your affirmation, David. Now, we are together going to
explore the other ways of countering your stress by not smoking. What do you like the most?
As in your hobbies?’
David – ‘Listening to music, spending time with my family. Playing with my daughter.
Meeting my friends at a bar.’
Professional – ‘Here it is then, what we can do. You can gradually limit your smoking and
then shift to nicotine replacement therapy. You can surely go for a music therapy, after your
office hours and before you go to sleep, And David, the interesting part is that you can
practice mindfulness while associating the pattern of music with progressive muscle
relaxation.’
David – ‘Really. How? And how would this going to help quit smoking?’
Professional – ‘I would tell you. Once you listen the tunes and chords of music in the self-
therapy session – you can close your eyes and with every changing chord of mellifluous
music – you can relax from muscles gradually from your foot to lower limbs to upwards and
you will visualize the stress leaving your body with each relaxation. And the best part is,

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while at work when you feel stressed – you can close your eyes, imagine the music and you
will be automatically stress as the learned relaxation sets in.’
David – ‘That’s wonderful but I still do think, even if switch to nicotine replacement therapy
or go for this music therapy that you have talked about – I would not be able to leave it fully.
I mean I tried it once but suffered badly from nicotine withdrawal.’
Professional – ‘Yes I understand. That is why you have switch on to nicotine replacement
therapy. Did you try it last time?’
David – ‘No. But I still do not it would make a difference.’ [Looks disappointed]
Professional – ‘I am sure self-will is the most amazing weapon we have got and with it, one
can surely shift even the most inevitable course of events and smoking is just a controllable
habit. Right?’
David – ‘Right.’
Professional – ‘Does it concern you that your father died due to lung cancer which was
caused by smoking itself and you might be affected by the same? I am sure you love your
wife and daughter and want yourself to live in a fit and healthy manner for them?’
David [thoughtful, determined] –‘I can surely start with the therapies you told but is there is
quick and easy way to stop the craving for a smoke?”
Professional – ‘Surely. There is. You can chew a gum. But most importantly, you can meet
your friends outside the bar, somewhere peaceful so that you can get yourself out the
smoking scenario. So, can we agree on these measures now, David?’
David – ‘yes, I will start from next week itself.’
Professional – ‘Right you can start with the gum and nicotine replacement therapy from next
week itself and the music therapy, the week after.’

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David – ‘Okay’ [smiles].
Professional – ‘You can self monitor your progress and tell me after a month how the quitting
of smoking experience has been.’
David – ‘Sure, I will. But what if the craving come back?’
Professional – ‘Chew gums and communicate with your loved ones. You are free to come
and see me as well.’
David – ‘Okay, Thank you. I will start the quit smoking mission right from next week.’
[Stands up, shakes hand with the professional, throws the cigarette box to the dustbin and
leaves]
Reflection
Two good things I was confident about the interview was my effective
communication and right understanding of patient’s condition. Two things I was under-
confident of was that I found it hard to decipher David’s underlying emotional problems and
at times, transitioning the MI stages smoothly. Overall, I was very much concentrating in the
communication with David and trying to listen as actively as possible. Overall, I
communicated the ideas about the bad and life threatening effects of smoking and as he was
tentative whether he will be able to leave smoking or not, this made me a bit under-confident
initially. The good part was that through my efficient communication – I made him cognizant
of the fact that smoking is harmful and he decided to quit smoking for his loving family -
imparted me a lot of confidence personally. I could assess the patient condition well and
effectively communicated with David right from the opening pre-contemplation and
contemplation stages. It was the ambivalence resolution process (Lindson‐Hawley,
Thompson & Begh, 2015), the confusion and disarray got me again when I failed to decipher
what David has been feeling and thinking. I was unable to transition the stage of motivational

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interviewing completely and was caught up in panicking. I felt almost helpless for not being
able to help David with the underlying emotional problems. It was my duty to resolve the
internal conflicts of David and loosen up his cognitive disorders which I did partially and as
matter of fact, I believe it was the most positive point in the MI process. This was again a
very good thing about the MI process that I tried. I felt complacent that towards the end of the
motivational interviewing process - I could activate his covert willingness to an attempt to
quit smoking. As we moved towards and into the determination stage of motivational
interviewing – I was able to identify the overall problems and right change strategies. In this
stage he looked a bit confused to me but before panicking again, I told him new ways of
leaving the smoking habit. The overall interview went well but the only drawback was that I
could not breach through his guarding as psycho-social effects of chain smoking is associated
with emotional problems. The negative part of the motivational interviewing process was that
I was sometimes unable to understand his exact thought process sometimes and the situation
appeared difficult for me. I had mixed feelings about the MI process and as the session
progressed to action, maintenance and recurrence coping phases of MI (Lundahl et al., 2019)
– I have spent enough time with him to assess his situation better which added to my
confidence and problem solving approach. I found it difficult sometimes to deconstruct his
feelings about the smoking behavior which was bad but on the overall, I facilitated decision
making in the patient to decide against smoking and taking up a healthy lifestyle. The good
part of the MI was that finally, I would communicate him the importance of progressive
muscle relaxation, gum chewing, music therapy, strengthening of family, social support and
switching on to nicotine replacement therapy, through client directed, collaborative behavior.

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References
Lindson‐Hawley, N., Thompson, T. P., & Begh, R. (2015). Motivational interviewing for
smoking cessation. Cochrane Database of Systematic Reviews, (3).
Lundahl, B., Droubay, B. A., Burke, B., Butters, R. P., Nelford, K., Hardy, C., ... & Bowles,
M. (2019). Motivational interviewing adherence tools: A scoping review investigating
content validity. Patient education and counseling.

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