The first video seemed very confrontational, defensive, and reactive. Sal reiterated his position that his dog is not the problem whereas the counselor maintained the position that the dog is the problem. Other possible causes or potential solutions were not addressed. Neither the client nor the counselor was receptive to what the other was saying. Both were adamant to maintain and defend their positions. They were at an impasse and could not progress forward. There was no open-ended dialogue trying to find the underlying reasons or trying to find a solution or change agent.
The second video seemed conversational, exploratory, and receptive. The session felt more like a conversation exploring possibilities. Both the counselor and client seemed actively engaged listening to each other. The client was providing possible answers and describing what potential solutions could look like. Sal is more likely to move toward some kind of action to improve the management of his asthma with the Spirit of MI style of interviewing. Sal feels more empowered to take control of his actions with this style.
I am ambivalent about exercise.
On one hand I am told exercise will better help with mental and physical wellbeing.
On the other hand, finding the time to exercise tends to not happen with everything else I need to do.
Bobby, it sounds like you understand the benefits of exercise, though you are having trouble finding the time to exercise due to other commitments.
Bobby, it sounds like promoting mental and physical health is important to you, but you are having difficulty allocating time for yourself to realize the benefit.
Bobby, it sounds like you are aware of the benefits of exercise to promote better mental and physical wellbeing, but you are struggling to set aside time for yourself amidst all your other commitments.
Saying the person’s name personalizes and humanizes the ambivalence. Practicing the reflective statements makes me more aware of my word choice and perceived meaning. The reflective listening statements provides the client the opportunity to talk and think out loud. The perceived affirmation and understanding might help client pinpoint the change agent. Change can occur only if the client is willing. I am responsible for change. Questions: How can I progress? What do I need to do?”
Consumer generated list: cut back on smoking, cut back on drinking alcohol, don’t skip meds, need to visit doctor/dentist
Counselor list: reduce cigarette use, reduce alcohol intake, take medication as prescribed, schedule appointments with doctor/dentist
The wording discrepancy is a “righting reflex” which can denote different meanings for client. The client’s list is more vague and uses informal wording. The counselor’s list uses more formal wording Questions: “What do you think you need to do? What does the goal look like? How do you know when you reach goal? How do you know when to make new goal?” Basically, the counselor is the sounding board for the client where the client can talk and think out loud and receive reflective responses. I would provide structure and flexibility. If I already have some background info, I might generate a concept list or visual and ask client where they want to start while also indicating the client could talk about something else. Things might be interconnected or flow from one topic to the other. It may not matter where we start as long as we start and try to make progress instead of being stuck identifying the change and desire to change.