Homework Question 1:
First Video: Sal appears defensive and certainly does not agree that his dog may be the major cause of his asthma symptoms. The provider appears incredulous that Sal will not get rid of the dog as a way to potentially reduce his discomfort.
Sal seems to want to try to address his illness with medication management and does not support the counselor’s premise that the pet is the cause of his current symptoms. The counselor does not appear to recognize the importance of the dog within the structure of the family unit as a whole.
The counselor appears to be saying: “this is what I think” and “this is what I think you should do about it.”
In the second video the counselor allows Sal to frame the narrative and discuss/review potential outcomes to reduce his symptoms. The counselor clearly is listening to Sal and encouraging to explore his options without her having an overt opinion.
I want to be healthy and try to walk every day.
One side of ambivalence: walking is great exercise and certainly helps my overall emotional wellbeing.
Other side of ambivalence: When it is dark, cold, snowy and rainy, I dread getting out there.
Double sided reflection: Walking is great for overall good health and it sounds like it is an important part of your day. You live in Maine. If poor weather contributes to dread and overall discomfort is getting out there everyday helpful or a hinderance to overall good health?
Target behaviors of client:
Stay out of jail (is on probation).
Parent his children.
Financially support his family.
My target behaviors for client:
Be a good role model for children.
Be a good employee.
Main discrepancy is the abstinence piece. Using substances would disrupt this man’s freedom and impact all areas of his life. Realistically, my target behaviors are a reflection of probation restrictions already in place and substance use would impact all behaviors client is targeting. Whether client wants to stay sober or not, hopefully we can both agree that it is a priority. MI would involve recognizing the interrelation between the client’s goals and abstinence.
Hopefully, through MI techniques I could help the client realize that his goals hinge on his ability to stay sober and all areas of life would be enhanced simply by not going to jail. Client will be heard and encouraged to embrace abstinence and recognize that my target of his abstinence is also a reflection of his place in the criminal justice system. MI would also help the client recognize that we both are focused on positive outcomes for him and we can work together to chart a path to give him the best opportunity to succeed.