Pic 4: A slide appears with the title “Talk with Ethan and His Mom” and an image of a woman and a young boy.
Scenario: A health coach is seeing 10-year-old Ethan and his mother. Ethan’s BMI is at the 95th percentile, but the coach’s past attempts to talk about his weight have fallen flat.
The health coach’s goals: Use MI to motivate this family to change Ethan’s habits and then develop a plan that works for them. They will use the techniques you learned:
In this conversation, you’ll watch the health coach work through the four phases of MI.
As the health coach progresses, the simulation will keep track of which phase they’re in and explain what that means.
Pic 5: The screen transitions to a new one titled “Ethan’s Chart: Diet and Activity History” with an image of a filled-out document which contains the following information about Ethan:
Client: Ethan Smith
Pic 6: The screen changes to a scene in a children’s exam room, where a female health coach sits talking to Ethan and his mom, with Ethan sitting on the exam table.
Health Coach: So it looks like Ethan’s doing really well. And all his vaccines are up to date, so no shots today!
Ethan: Yay!
The health coach and Heather laugh.
Health Coach: And we have about ten minutes left, so there’s something I’d like to talk a little bit more about. Would that be okay?
Heather: Okay.
Coach: The health coach is currently in the engage stage of the conversation. Her goal is to raise the subject of Ethan’s BMI, build rapport, and learn about the family’s perspective.
Health Coach: We need to talk about Ethan's weight.
Heather: Oh? Well, he's big-boned, like the rest of us. I think he's fine just the way he is.
Heather’s Thought: And I bet you don't like my weight, either.
Health Coach: Okay, well, we measured his height and weight today, and we calculated his body mass index, or BMI. And he's in the 95th percentile. That means if you looked at 100 kids his age and height, he'd be heavier than 95 of them. That means he's considered obese.
Heather: But he's a growing boy, of course there's going to be times when his height hasn't caught up with his weight. Is that really so bad?
Health Coach: Research does show that kids who stay overweight for longer periods of time tend to have more health problems later in life. So it can be an issue eventually.
Heather: Well, I'm not putting him on a diet. I mean, a boy his age? No. It's out of the question.
Coach: The Health Coach provided information, which was good, but she also pushed her own interpretation (that Ethan is overweight). If she had provided just information, without opinion, Heather might have focused on the facts instead of arguing with her.
Health Coach: There are several possible reasons why Ethan is overweight. He's drinking a lot of soda, he's not getting much exercise, and he's spending a lot of time in front of the TV and computer.
Heather: Look, I do the best I can. We both work full-time and we're taking care of my mother-in-law, so I just, I don't know what else I can do.
Health Coach: I know it's hard and you're doing your best. But you'll need to make some changes to keep his weight under control.
Heather: Hmm.
Heather’s Thought: What do you know about it? Look at you, Skinny Minnie, telling me how to run my family.
Coach: The health coach took a very directive approach, which provoked resistance from Heather. Now she seems to be tuning her out.