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

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Kristin Giguere

Question 1: Watching the confrontational style of interviewing made me feel shut down even watching it – the way she reacted to Sal not having read the materials he had been provided came across as judgmental. In the confrontational style, the provider is driving the session and telling him what needs to change in his life and as a result he seems to be digging in and verbalizes “this is too much”.

In comparison, with the Spirit of MI counseling approach, Sal seems to be driving the session, identifying why he is there and what he is aware of as possible contributing factors. He verbalizes “that feels good” when talking about it being his decision.

The Spirit of MI approach is more likely to help Sal move forward in making changes to better manage his asthma because in that approach he is the driving factor in what changes he wants to make, why he wants to make the changes, rather than being told what he needs to do.

Question 2: I feel two ways about my beverage consumption, specifically my preference of diet soda (Diet Pepsi primarily) over water. “I feel ambivalent about making a change to drink more water than diet soda.”

One side of the ambivalence: “Water doesn’t taste good to me.” “I need to take more bathroom breaks when drinking water compared to diet soda.” “I like the energy that I get from diet soda.”

The other side of the ambivalence: “I know that artificial sweeteners are unhealthy.” “Water is important to healthy body function and weight loss.” “I want to role model healthy behaviors for my kids and my students.”

Double Sided Reflection:
“Kristin, on one hand, you don’t enjoy the flavor of water, but on the other hand you realize that artificial sweetners aren’t healthy for you.”
“Kristin, one one hand, you see the importance of drinking water to have healthy body functions and to lose weight, but on the other hand you have to take more bathroom breaks when you drink water.”
“Kristin, on one hand you like the energy you get from the caffeine in your diet soda, but on the other hand you want to be a healthy role model for your students and your own children.”

When doing the activity, before doing the actual assignment questions, I tried combining it all into one double sided reflection, which was ““Kristin, one the one hand you are constantly tired at night and the caffeine in diet soda helps you get through the day, working, and raising three kids. It can be difficult to make the time to take bathroom breaks when you are already feeling so busy. On the other hand, drinking water fits with your long-term goals of losing weight and being healthier for your children.”

My general reaction to this exercise was thinking about the similarities to doing a pros and cons list, which is an approach that I tend to go toward, even if it is not done formally in writing. The reflective listening responses didn’t have a big impact on my ambivalence but it did contribute to me engaging in some mental problem solving, such as replacing some of my Diet Pepsi with canned seltzer water that contains caffeine.

Question 3:
Consumer generated target behaviors: “Quit vaping” “Get school staff off back” “Be able to reach adulthood with autonomy around life choices”

Target behaviors on my agenda: “Quit vaping” “stop being high on marijuana when it is time for class” “find an approach to learning that fits this individual”

And in my setting, in addition to target behaviors on my agenda, there are also target behaviors that would be on the agenda of my employers; some examples of these would be “attend classes” “complete assignments” “refrain from using marijuana”.

I don’t see a lot of discrepancies between my agenda and the agenda of the consumer; any discrepancies that I do see are ways in which I think the consumer’s agenda and that of my employer can both be met, which is not solely following the individual’s. As for “righting reflex” responses I think that a lot of the ways in which those would be seen in my agenda would be in my desire to help the consumer find a way to still get an education (which the consumer does not want) in a way that would fit their personal learning styles and preferences.

MI agenda setting strategy: I would start by asking them what brings them to meet with me, and if other people told them they need to work on something specific, I would ask if that is a goal of theirs as well. If it was not, I would ask them what they would like to get out of our work together. I would reflect on their answers and ask clarifying questions to work on coming up with smaller steps toward reaching their goal. I would ask permission to make suggestions of strategies that I am aware of that might help them reach their goals. We would then pick a starting point and rate their readiness to make the change according to a likert scale. To conclude the session I would summarize my understanding of why they are there, what they would like to accomplish, their reasons for that and any ambivalence they have, followed by the starting point that they chose to work on before their next meeting.