Health Coach: Do you mind if I share an observation about grandparents that some other parents have shared with me?

Samantha: (small laugh) So, I'm not the only one whose mom drives her up a wall?

Health Coach: (sympathetic) A lot of grandparents do struggle with how parenting advice has changed. But it's important for your mom to still feel like you value her experience. If you ask her advice on other topics, like what foods you liked when you first started solids, or what your favorite songs were as a baby, it might set her at ease enough to listen to you about current breastfeeding advice. What do you think about that?

Samantha: Exactly. She doesn't think I trust her. And just showing her more stuff about why breastfeeding is great just makes it worse.

Coach: By using the elicit-provide-elicit technique, the Health Coach was able to share information about grandparents while still respecting this mom's autonomy.

Health Coach: It sounds like one goal you have is to help your mom understand why you're choosing to breastfeed.

Samantha: Yeah, I guess so. I mean, she's the one giving Zoe the bottles.

Health Coach: What would have to change for her to feel included in your plan?

Samantha: I don't know. (thinking) Hey, maybe you could talk to her? Or that lactation lady from the hospital?

Health Coach: Oh, of course! I can help you set up an appointment with our lactation consultant. She can spend as much time as you need to talk to your mom. Anything else that would help?

Samantha: I think she really needs to see it's not just me. Or some crazy rants I read online. There's really a reason.

Samantha’s thought: Maybe this'll actually work.

Coach: The health coach did a good job using an action reflection ("One of your goals is to help your mom understand"). By involving this mom in making a plan for getting the grandmother's buy-in, he made it more likely that she'll stick with the plan.

Health Coach: Zoe's health and happiness are so important to you, I know you'll do the best for her.

Samantha: Of course I will.

Health Coach: She's already benefited so much from your commitment to breastfeeding.

Samantha: I'll try to keep going. I really was kind of sad about giving it up.

Health Coach: Is there anything else you want to talk about?

(A baby’s cry comes from the car seat).

Samantha: Oops. I think we’re good. Do you, uh, mind if we stay in here for a few minutes? I want to nurse her before we get on the road.

Pic 3: The exam room disappears and the screen returns to a close-up on Eva.

Eva: In this conversation, the mom had a lot of ambivalence about her decision to stop breastfeeding, and reflecting those feelings was the best way to help her resolve them. Now let’s look at the dashboard, which will analyze the Health Coach’s choices and offer some suggestions for how to best use MI in your practice.

Client Motivation: Overall, the Health Coach did a great job. By using reflections, he helped this mom realize that she could continue to breastfeed while still addressing her problems with pumping.

Feedback on Technique

• Using Simple Reflections
  • The Health Coach did a nice job using simple reflections to build a strong rapport and support this mom’s positive feelings about breastfeeding.
• Using Complex Reflections
  • The Health Coach did a great job using complex reflections to help this mom work through her ambiguity to realize that pumping is the problem for her, not nursing. He was really sharp to pick up on this mom’s communication issues with her mother. By addressing that emotional reason, he made it much more likely she will stick with the plan to continue breastfeeding.
• Using Action Reflections
  • The Health Coach did a great job using action reflections to help this mom realize that changing her pumping schedule could allow her to keep breastfeeding on her own terms. And he did nice work using an action reflection to help the mom develop a plan for how to deal with her mother’s negativity about breastfeeding.
• Avoiding Directive Tone
  • Finally, the Health Coach did a great job avoiding a directive tone! When you use these techniques with actual clients, try to examine your own words with the same discretion the Health Coach used here. When you avoid telling clients what to do and instead let them guide the conversation, they are far more likely to follow through with change.

• ❮ Go back to page 16
• Go to page 18 ❯