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a. I could meditate 3-4 days a week because I felt I needed a change in my life to control my stress and start having a higher quality of life, making me happier and healthier. The second reason I meditated was due to being aware of meditation’s positive effects on different aspects of my life (personal and professional). However, I was not successful in meditating 5 days a week due to a lack of ability in managing my stress when I had to handle so many different tasks at the same time.
I used to participate in a self-realization class for 2 years, and that helped me a lot to recognize the importance of meditation. Therefore, one of the main reasons that I was able to follow through with my meditation sessions at least 3-4 days a week is that it had been my goal for a while, and I was aware of its positive mental and physical effects from my experiences in self-realization classes back in Iran.
Secondly, I was aware of the negative consequence of not meditating. I felt that my stress level was higher than it should be, and it sometimes affected my performance and my relationships with others. I recognized that when I became stressed out because of exams or school assignments, I couldn’t talk to any family members or friends and felt very mad and frustrated, which could reflect on how I treated my loved ones around me. Also, I had gastritis for a while due to the stress levels I had tolerated all these years, mostly during school. Therefore, reducing my stress became one of my main goals since it was affecting all aspects of my life, such as my mental and physical health, and sometimes my relationships. I found meditation extremely helpful in decreasing my stress level by keeping me in the moment or on a positive thought, preventing me from worrying about the future or regretting the past for at least 10 minutes. Hence, I decided to keep doing it.
Although my stress level has significantly reduced compared to last year, the reason why I was only partially successful in meditating 3 or 4 days a week rather than 5 days a week was still stress. For about 2 weeks, I was worried about my health, and for the rest of the weeks, I was anxious about my schoolwork. On those days that I was nervous, I could not convince myself to meditate and relax. This is the issue that I should still be working on, to not let stress prevent me from performing my meditation sessions.
b. Meditation helped me gain insights into my thoughts and understand and manage my reactions to different situations. In other words, in response to the project, I learned that the only reason which prevents me from meditating is my stress, which comes from a lack of confidence in finishing and doing well in my tasks. Therefore, it helped me find the root cause of my problem.
Secondly, I learned that usually I have 10 minutes a day to meditate or promote any other good habit. Therefore, I recognized adding meditation to my schedule is not about having time but mostly about prioritizing it. I learned I should prioritize a good habit such as meditation in my mind compared to other activities like browsing social media to follow it regularly.
c. I believe I can improve my outcome to change any behavior by following the steps of behavioral change. First, I should recognize the benefits and effects of that good habit to feel motivated. Second, I should do goal setting, identifying my expectations and goals by making this change. Then, I should identify my possible barriers, such as stress or lack of time, and try to solve the problems and think about some solutions (positive self-talk, time management, setting up an alarm, etc.), and how to minimize or handle those barriers. After that, I should set up a structure for the change and make the decision. Lastly, I should try to maintain my good habit to the point that there is no interruption in following the habit.
d. I believe I’m in the action step based on the transtheoretical model, in which an individual progresses through 6 stages: pre-contemplation, contemplation, preparation, action, maintenance, and termination. I’m in the action step because I have made specific modifications to my lifestyle within the last 6 months to make meditation a habit for myself. Therefore, the next step I should take is to try to maintain it and go all the way to the termination step in which I have 100% self-efficacy in meditation 5 days a week without any relapse in between.
e. I believe my response to my therapist’s coaching style has been positive. Hayle has been a good listener in all sessions. The affirmations, reflections, and open-ended questions that he provided for me during our sessions, such as this complex reflection “It seems like this week, rather than tests or quizzes, being your stressors, your medical tests with your health were giving you stress,” made me feel understood, supported, and validated in my emotions and experiences. His simple reflections, such as “You feel like focusing on one thing, like water, helps you feel more grounded,” provided a safe space for me to explore my feelings and thoughts more openly. Moreover, he tried to make me more committed to my behavior change by providing eliciting change talk, such as “On a scale of 0-10, how confident do you think you’ll be able to meet your goals next week?”, “Why not 0 and why not 10?” to make me recognize my weaknesses and my strengths regarding meditation.
3. From being a patient, I learned how the listening skills of a therapist are essential in their therapeutic sessions with their patients. I could observe how active listening enhances the therapeutic relationship between my therapist and me, leading to enhanced outcomes.
Secondly, I learned that making a behavioral change is not that easy and requires a lot of patience and support from the therapist. Therefore, I cannot expect all my patients to immediately follow their treatment plans regularly. Some patients, depending on their lifestyle and physical and mental health, might need more time, motivation, and support to adhere to their programs.
Moreover, I felt sad and vulnerable during those weeks when I had some health concerns that had prevented me from enjoying studying and doing my homework on time. I recognized that receiving empathy and compassion in my conversation with Hayle made me feel better. Therefore, the experience of being a patient helped me understand the importance of empathy and compassion in providing quality care to my future patients.
As a patient, I recognized that being aware of the benefits and positive effects of a change, and the negative consequences of not making that change, has been very motivating for me to adhere to my meditation habit. Based on my experience as a patient, I will educate my patients about their conditions, treatment plans, and its benefits as a PT in the future before providing them with any plan.
Lastly, from being a patient, I learned how receiving emotional support and encouragement from my therapist such as “I am proud of you for being able to meditate even when you’re stressed and busy.” or “ I think you did great, it’s understandable that you could not meditate when you had medical complications.” could motivate me to be more focused on my goal. I recognized that as a physical therapist in the future, I will have a crucial role in providing emotional support and encouragement to my patients. Therefore, I will encourage my patients, using the techniques we’ve learned in this class, to motivate them, enhance their adherence, increase their effort, and reduce their anxiety.
4. From coaching my classmate, I learned how to be a good communicator as a therapist. I recognized that improving my ability to communicate effectively with patients is crucial and helps me to understand my patient’s goals, motivations, and challenges to provide them with better support.
Also, as I listened to my patient’s challenges and barriers in meditation, I recognized that making a behavioral change can be very challenging and requires a lot of active listening, patience, and empathy from the therapist.
Moreover, my coaching experience made me recognize the importance of tracking progress. Monitoring and evaluating my patient’s progress allowed me to track her improvement and identify her obstacles. This experience made me understand that as a future PT, tracking my patients’ progress helps me ensure that my interventions are effective for my patients’ needs or if necessary, make necessary adjustments to their plans. Tracking progress not only fosters trust and collaboration in the treatment process but also leads to more successful rehabilitation experiences.
Furthermore, as a patient, I experienced how my coach’s body language, such as maintaining eye contact and nodding, made me feel heard and understood and could create a sense of trust and empathy. This made me understand that a therapist’s body language plays an important role in signaling their engagement and active listening, making patients feel more comfortable sharing their thoughts and emotions.
In addition, it was challenging for me to resist giving advice to my patient, especially at the beginning because I wanted to help her and see her successful in developing her positive habit. However, based on what I’ve learned in the class, I recognized effective communication involves actively listening to my patient and collaborating with her to find the best solutions for her barriers. Based on this experience, I will remember not to offer any unsolicited advice to my patients and instead allow them to take an active role in their care and respect their autonomy.
5. As I mentioned above, one of the challenges I experienced in helping my patients was resisting advice-giving. It was a little bit challenging for me to overcome the urge to provide direct advice. However, gradually I learned to roll with resistance through active listening and giving reflection to help my patient discover her own solutions. I only gave her advice once or twice by permission as we learned in MI techniques. For example, I asked her “Can I give you a recommendation?”. After she was ready to hear my advice, I gave her advice by saying “ I think it’s a good idea to meditate in your car 10 minutes before going to the gym, and followed that up to respect her autonomy by asking “Do you think that work for you?”
Also, in the first 3 sessions, eliciting change talk was difficult for me. However, gradually I learned how to do it. For example, I tried to elicit change talk to help my patient see meditation as a productive activity by asking her, “What benefits should you receive from meditation to see it as a productive activity?” I also asked her, “On a scale of 1 to 10, how confident are you to meditate next week regularly?” to make her commit to doing her mindfulness practices. In addition, I elicited change talk by asking her, “Why didn’t you choose 1 instead of 5?” to make her talk about her strengths and elicit her ability to change.
I asked open-ended questions to gather useful information to identify my patient’s goals, needs, and challenges regarding her meditation practices. Some of those questions include, what time of the day did you find it easier to meditate? How did you feel after the meditation? And, “What prevented you from meditating?”
Furthermore, it was very challenging for me to keep my patient motivated. It was because she couldn’t see meditation as a productive activity, so it was not her priority. Therefore, I tried to be patient and did my best to provide her with plenty of affirmations every session, such as “I’m happy that you found a new way to silence your mind and have better meditation.” Or saying, “I appreciate your effort in trying to meditate although you are still having difficulty meditating.” To encourage her and keep her on track.
Moreover, I provided my patient with plenty of simple and complex reflections to make her feel understood and comfortable with me talking about her emotions and barriers in developing her meditation habits. Some of the complex reflections I provided her include, “I totally understand how you feel. It’s not easy to manage both stress and having regular meditation sessions at the same time.” Or “It seems stress is still one of your main reasons for not having a good meditation.”
Some of the simple reflections that I used to guide her to finding solutions are, “It seems when you look at people and keep your focus on observing them, meditation works better for you.” Or “It seems the only thing that prevents you from having a good meditation is thinking about your tasks like schoolwork and basketball.”
In addition, I used positive body language such as nodding, eye contact, warm tone of voice and smiling to provide feedback to my patient, making her feel comfortable and supported during her treatment.
In general, I believe I’ve made significant progress compared to my first week of coaching. I provided my patient with open-ended questions and closed-ended questions to better understand her experience with meditations during the last week. To ensure she felt heard, I offered both simple and complex reflections. Employing eliciting change talk, I helped her discover reasons to view meditation as a productive activity. I applied positive nonverbal communication to make her feel supported. Additionally, I used plenty of affirmations to encourage and keep her on track. Finally, at the end of each session, I summarized everything to organize my patient’s mind and maintain her commitment to meditation for the next week.”
