Coded transcript excerpts, change talk labeled by DARN-CAT, and a MITI-style tally of questions and reflections record one composite COPD patient's shift toward rehabilitation in NU470's Unit 7. Searches like "nu 470 unit 7 assignment example", "nu470 unit 7 sample" and "nu470 unit 7 example" land here.
"Maybe One Session": A Coded Motivational Interviewing Transcript With a COPD Patient Who Twice Refused Rehabilitation
[Student Name]
Purdue University Global
NU470: Regenerative and Restorative Care Spheres - A Wellness and Prevention Focus
Unit 7 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. The transcript is an excerpt; codes follow OARS and change talk categories.
Case
She has COPD and was discharged nine days ago after her second exacerbation this year. She declined pulmonary rehabilitation twice before, although it helps people with COPD breathe more easily, do more and feel better day to day (McCarthy et al., 2015). Her granddaughter is getting married in June.
Transcript Excerpt, Organized by Process
Engaging
Nurse: How have the days been since you got home? [open question]
Patient: Tiring. And I know you're going to tell me about that rehab again. It's pointless for me. [sustain talk]
Nurse: You've heard about it before and it didn't seem worth it. [simple reflection]
Patient: I'm too far gone for exercise.
Nurse: You're worried it's too late to make a difference. [complex reflection]
Focusing
Nurse: Could we spend a few minutes on what getting stronger might look like for you? [open question, asking permission]
Patient: I guess.
Evoking
Nurse: What would you like to be able to do by the summer? [open question]
Patient: Walk to the mailbox without stopping. My granddaughter's wedding is in June. [change talk: desire, reasons]
Nurse: Being on your feet at her wedding matters a lot. [complex reflection]
Patient: I don't want to be the grandmother in the wheelchair. [change talk: reasons]
Nurse: It sounds important enough to think about. And there are good reasons people try rehab: it helps with breathing and... [righting reflex, turn 14; flagged]
Patient: I know, I know.
Nurse: Sorry, I'm getting ahead of you. What worries you most about going? [open question, correcting]
Patient: Being out of breath in front of strangers. [sustain talk]
Nurse: You'd feel embarrassed struggling while others watch, and at the same time you want to walk at that wedding. [complex reflection, double-sided]
Patient: Maybe I could try one session. [change talk: commitment]
Planning
Nurse: What would help you get there? [open question]
Patient: I'll ask my daughter to drive me on Tuesdays. [change talk: taking steps]
Nurse: You've decided to try one session, with your daughter driving. [summary]
The turning point came from her own reason, the June wedding, not from any fact about rehabilitation the nurse offered.
Tally Against MITI 4
Across the full 40-turn transcript: 11 questions, 19 reflections, 10 of them complex, 53 percent. MITI 4 uses the ratio of reflections to questions and the share of complex reflections as markers of practice quality (Moyers et al., 2016); both figures fall within the range described as fair to good.
Frameworks
Engaging, focusing, evoking and planning are the four processes of motivational interviewing (Miller & Rollnick, 2013). The write-up uses sustain talk and discord rather than resistance, following their current terms.
Turns I Would Redo
1. Turn 14: the unasked explanation of benefits, a righting reflex. Better: "What have you heard about how it helps?"
2. Turn 3: my first reflection was simple where a complex one would have reached her worry sooner.
3. The summary: I would add her fear, so she hears that it was heard.
References
McCarthy, B., Casey, D., Devane, D., Murphy, K., Murphy, E., & Lacasse, Y. (2015). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2015(4), CD003793. https://doi.org/10.1002/14651858.CD003793.pub3
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.
Moyers, T. B., Rowell, L. N., Manuel, J. K., Ernst, D., & Houck, J. M. (2016). The Motivational Interviewing Treatment Integrity Code (MITI 4): Rationale, preliminary reliability and validity. Journal of Substance Abuse Treatment, 65, 36-42. https://doi.org/10.1016/j.jsat.2016.01.001
How this NU470 Unit 7 example is structured
The write-up follows the conversation's own order, arranged under the four processes Miller and Rollnick describe: engaging, focusing, evoking and planning. Engaging is short and mostly reflective, since she opens by listing why rehab is pointless. Focusing names one target with her permission, a single trial session, instead of the whole program. Evoking carries most of the transcript and all of the coding interest, because that is where her own reasons appear and where the nurse's complex reflections do their work. Sustain talk is shown rather than hidden, including her fear of being breathless in front of strangers, and the write-up uses the current vocabulary of sustain talk and discord rather than resistance. Planning is brief and hers: she will ask her daughter to drive on Tuesdays. The self-critique names a righting reflex at turn 14, where the nurse began explaining benefits unasked.
Get an NU470 Unit 7 example written to your instructions
Motivational interviewing prompts vary: some require a real conversation from practice, others accept a scripted one. Whatever your section allows, send the Unit 7 prompt, rubric and the behavior you are working with, and a coded model write-up comes back within 24-48h, noting which parts must come from your own practice; the first one is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU470 Unit 7 questions, answered
Can the transcript in my write-up be scripted?
Only where your instructions permit it. Many sections want a real or role-played conversation, recorded with consent and de-identified, because the point is your own practice. The sample's exchange is scripted around a composite patient to show coding and structure. If your instructions require a real encounter, the conversation and its transcript must be yours.
What is the difference between sustain talk and discord?
Sustain talk is the patient's own argument for not changing, directed at the behavior: rehab will not help me. Discord is friction in the relationship, directed at the clinician: you do not understand how tired I am. Miller and Rollnick replaced the older term resistance with these two in the third edition, and they call for different responses.
What reflection-to-question ratio should a write-up show?
The MITI 4 coding manual treats at least one reflection per question as fair and two per question as good, with complex reflections making up a large share. A write-up need not hit the good threshold, but it should report its numbers accurately and explain them. Honest figures with thoughtful commentary usually score better than inflated ones.