Pic 4: The screen transitions to one titled “Talk with Samantha” which contains information on the scenario and the goals of the conversation.
Scenario: The health coach is seeing Samantha and her four-month-old Zoe. Samantha has been breastfeeding exclusively, but now she wants to stop.
The health coach’s goals are to use reflections to help Samantha explore her ambivalence and amplify her positive feelings about breastfeeding. In the conversations, the health coach will use the techniques you learned:
Pic 5: The screen transitions to a slide titled “Phases of MI.”
Normally, MI has four phases. But in this conversation the client has come in with an agenda, so the conversation will skip the focus phase.
As the health coach progresses, the simulation will keep track of which phase they’re in and explain what that means.
Pic 6: The screen changes to a scene in an exam room, where a Health Coach sits across from Samantha.
Health Coach: Well, Zoe looks great. She’s just over 14 pounds, so almost double her birth weight. Right on track. Is she starting to babble?
Samantha: (slight laugh) A little bit. Still mostly shrieks, but we get a few “ba-bas.”
Health Coach: Great. And how’s the breastfeeding going?
Samantha: (hesitates) Actually, I was wondering if you could recommend a brand of formula? I’m, uh, back at work now, so.
Coach: The health coach is currently in the engage stage of the conversation. His goal is to build a rapport with this mom and understand her situation, especially her reasons for wanting to stop breastfeeding.
Health Coach: We recommend exclusive breastfeeding until Zoe is six months, and then breast milk plus solids until her first birthday.
Samantha: Eight more months? I don't think I can get through eight more weeks.
Pic 7: The screen changes to a close-up of Dr Schwartz.
Dr. Schwartz: The Health Coach needs to be careful. For sensitive topics like this, using a direct tone and imposing an agenda tends to backfire and make families less likely to change. Instead of telling this mom what to do, he should try listening to how she feels about breastfeeding and what barriers are preventing her from continuing. Then he should use reflections to highlight her change talk and help her start thinking about solutions.
Pic 8: The screen returns to the Health Coach and Samantha in the exam room.
Samantha’s thought: I just told you, it’s not working. And now you think I should do it for a year?
Coach: While it's easy to give families recommendations and let them choose what to do, that rarely results in behavior change. This mom's issue isn't a lack of knowledge, it's the conflict breastfeeding creates in her life. The Health Coach needs to try to find a plan that will work for her, even if that means a compromise.
Health Coach: Do you want Zoe to have the best food possible? Food that helps protect her from ear infections and allergies?
Samantha: Of course I do!
Health Coach: That food is breast milk. The best food in the world for her.
Samantha: It's more complicated than that. I work. I can't just quit my job to stay home and nurse all day. I’m just trying so hard and none of it seems to matter. (breaks into tears) I always wanted to be a reporter and now that I have my shot, all I want is to be home with my baby.
Health Coach: It’s okay. Please don’t cry.
Samantha: I just feel like I can’t do anything right. When I try to pump for Zoe, I’m messing up at work. If I don’t, then I’m shortchanging my baby. I can’t win.