Becoming a mirror is the key to getting your patients to see themselves.
To see the other parts of this reflection series, please use these links
Cognitive Functional Therapy Online Course June 2021 Part 1
Cognitive Functional Therapy Online Course June 2021 Part 3
If you’ve done any study of motivational interviewing (MI), you will know this. And MI is the most useful skill you can acquire, way more useful than manipulation, mobilisations, kinetic this or that, core stability, Pilates etc. etc. Because everyone has a psychology and that’s what drives their behaviour and their coping with pain and disability.
MI divides reflections into simple and complex. Both are important and we saw Peter doing examples of each.
- Simple “You fell over and hurt your wrist..”, in response to someone describing the incident. It’s a kind of repetition, just letting the person know you are paying attention.
- Complex, where you interpret what the person has been saying and suggest things about the situation they may not have explicitly expressed. Peter does it by this kind of example “What I’m hearing is that after your MRI you were told a bunch of things and since then you’ve been very worried your discs are black, they have squashed down and have the consistency of cheese”.
- If you do a complex reflection, there is a risk you’ll get it wrong. It’s vital to check this with the patient and correct the details.
When someone suggests they want their life back, ask them what “life back looks like” so you get a clear idea of their goal, which will vary hugely and often encompasses activities which will surprise you and which you wouldn’t otherwise be aware of.
If people adopt an unhelpful coping style or behaviour, you can ask “How successful has x been for you?” to get them to reflect and perhaps become more open to a new approach.
By these kinds of open questions you open up the agenda for the patients to tell you what they need and want.
If you let them, our patients will tell us how we can help fix them. All we have to do is listen.
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