In the Non-MI confrontational approach to counseling, Sal’s body language is more animated. His tone is somewhat aggressive, and he sounds more defensive. In the Spirit of MI approach to counseling, Sal seems more open and interested in finding a solution that he can buy into. He seems more relaxed and even excited about a plan. The Spirit of MI style moves Sal closer toward some kind of action. He recognizes the stress, and he doesn’t feel good about it. She asks him more open ended questions about how, when, and if he would know when to make a decision about keeping the dog. He concludes that if having the strongest medicine doesn’t work, then he will have to make some hard decisions.
One Side of the Ambivalence
“I am sad that we never speak anymore, and I want to tell her again how sorry I am.”
The Other Side of the Ambivalence
“I know that taking care of myself and not engaging will help me with my shame and guilt.”
“Gigi, one the one hand you are missing your ex and feeling really sad about the breakup. On the other hand, working on your shame and guilt fits into your overall plan for emotional sobriety, and I know that is very important to you.”
Her agenda: Smoke less, save more money, focus on re-entry from incarceration.
My agenda: Stop smoking in order to save more money, and work on a realistic budget for re-entry expenses.
Discrepancies: Our concerns are immediate, but I feel mine are more grounded in the realities of re-entry. For example, stopping smoking could save her $200 per month. Smoking less isn’t saving enough money fast enough.
Righting Reflex Responses: The cost of your smoking is equal to a car payment.
MI Agenda Setting strategy: I would ask this person to talk about their ideal living situation when they get out. I would work with them on a budget and put it all down on paper, asking open ended questions about their needs and wants. I would then ask about how much they have saved in their prison account, and how much they plan to make upon release. I would then show them on paper the budget we built, and ask her where she can cut expenses. What would be the additional benefits of smoking less, or even quitting smoking all together?