Reply To: Week 1 Homework Assignment (Applications of MI)

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#24292
Colleen Drake
Participant

Homework Question #1:
In video #1 Sal became increasingly uncomfortable and defensive, as noticed in his body language, word choices and tone of voice. In video #1 he became a bit argumentative, as did the interviewer, and seemed to be annoyed by her pushiness. In video #2 Sal appeared more open to the discussion about his asthma. He seemed more relaxed, as noticed in his body language, and he seemed to be more willing to explore his options about what to do to improve upon his situation. The wording he used and the tone of voice he used in video#2 suggested that he felt understood by the interviewer. Sal seemed to have benefited more from the MI approach due to his increased engagement and the thoughtfulness that occurred when he was asked clarifying questions. At the end of video #2 he was more willing to explore options and to start problem solving his situation, for example he stated he plans to now weigh the pros and cons of the situation.

Homework Question #2:
“I feel ambivalent about getting my notes done by the end of each work day.”
One side of the ambivalence:
“By the end of the work day I am tired and have a difficult time focusing on typing notes.”
Another side of the ambivalence:
“I feel better about what I have done if I finish my notes by the end of each work day, instead of waiting until Friday to complete all of them.”
Double-sided Reflection:
“Colleen, on the one had you feel tired and have a difficult time focusing on completing your notes at the end of each work day. On the other hand, you feel more accomplished and less stressed about getting them done if you complete them daily instead of saving them all to complete on Fridays.”
“Colleen, on one had you find it challenging to complete your notes daily. On the other hand, you seem to be aware of the stressful impact it can have on you when you wait until Friday to get them all done.”
“Colleen, you’re expressing some ambivalence about getting your notes done daily and you indicated that you have a difficult time focusing by the end of the day. You are also expressing that you feel more accomplished and less stressed if you do them daily.”
I found this exercise helpful in trying to come up with the wording for reflection statements instead of jumping to suggestions. I think it can be easy at times to let our desire to help people impact how quickly we jump to giving suggestive feedback, which can sometimes let the listening piece get lost in the mix. At this end of this exercise I found myself thinking about my schedule and how to better fit the time to get notes completed, like doing some between meetings instead of waiting until the end of the day.

Homework Question #3:
Client generated target behaviors: To not smoke inside the home, to yell less and to try not to get caught up in other people’s drama
Provider generated target behaviors: To quit smoking, to use more positive feedback and to increase family routines
There are some discrepancies between the lists. The client would like to stop smoking inside the home, however the provider would like her to stop smoking altogether. The client would like to yell less, and the provider would like her to practice increasing the use of positive feedback. The client would like to avoid getting caught up in other people’s drama and the provider would like the client to focus on building stability and positive relationships within her family. The knee-jerk react to try and provide solutions (from provider to client) would include the provider saying to the client things like; “Quitting smoking would be more beneficial for your health and your family’s wellbeing that just smoking outside of the home.” “Yelling less would be nice but wouldn’t it be better to work on increasing your positive feedback responses?” or “It isn’t helpful for you to get caught up in other people’s drama, as your focus really should be on increasing positivity within your own family.”
To use the MI approach in this situation the provider might say to the client; “I hear you saying you want to stop smoking inside the home. It seems important to you that you reduce your smoke exposure to the other people in your home. Do I have that right?” “You are saying you want to yell less. Are you thinking that you would be more effective in your communication with others if you were to yell less?” “You are noticing that you want to avoid getting caught up in other people’s drama. Are you feeling stressed out by involving yourself in things that other people are having difficulties with?” These types of reflective statements followed by questions that elicit a feeling-related response from the client would likely result in less confrontation and more collaboration between client and provider. There is validation involved and openness to discuss the situation from the client’s point of view.