focusing

Question 1

focusing

Answer 1

ongoing process of seeking and maintaining direction

Question 2

3 sources of focus

Answer 2

client: has a states goal

setting: the program or service that may dictate/limit the focus

clinician: provider expertise might identify the source of an issue as different than the manifested problem

Question 3

3 styles of focusing

Answer 3

directing

following

guiding

Question 4

directing

Answer 4

clinician provides the focus (agenda) based on clinician expertise or setting

telling client what to do

• use if you don’t have lots of time but still be empathetic and asking if its okay with client

ex: thanks for filling out the form, I noticed from what you wrote that we should discuss diet, how does that sound to you

Question 5

following

Answer 5

(listening)
client is in charge of agenda

ex: what are some things you would like to talk about today? what ideas do you have?

Question 6

guiding

Answer 6

(asking)
client-practitioner partnership

• usually the best strategy for agenda mapping
• used mostly in MI

Ex: thanks for completing the intake form. I notice that from what you have written, diet is the of interest to you. I am also wondering what other topics might interest you to discuss today

Question 7

focusing scenarios

Answer 7

1. focus is clear
2. several options
3. focus is unclear

Question 8

focus is clear

Answer 8

can go straight into planning, don’t need MI if the client is ready to change

avoid traps:
- righting reflex
- premature focus
- expert traps

confirm focus, ask permission, evoke/plan

Question 9

several options

Answer 9

need to sort through using agenda mapping

client can’t really identify what’s going on in their life and what’s wrong

avoid traps: righting reflex, premature focus, assessment/question-answer trap, expert traps, chat trap

Question 10

focus is unclear

Answer 10

need to use core MI skills to move from general to specific goals

avoid traps: righting reflex, premature focus, assessment/question-answer trap, expert trap, chat trap)

Question 11

agenda mapping

Answer 11

good way to find the focus

structuring
–tell the client you are offering a structuring statement

considering options
–allow client to list and reflect on options
– use affirmations and support autonomy
– use reflective listening

zooming in (provisional)
– client-clinician agreement on focus
– use summary before moving on

using visual aids
– bubble sheet