Reply To: Week 2 Homework Assignment (Applications of MI)

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#24346
Melissa Ivey
Participant

Melissa Ivey

Question 1

What are your general impressions of and reactions to the MI interview of Terry Moyers and the “Rounder?”

I enjoyed watching the video. Jim appeared to be very resistant to change at the beginning of the session. It was interesting to watch how Terry was able to help him shift his language from sustained speech to change speech. I believe the use of this language would benefit not only those struggling with substance use, but also those struggling with mental health issues. This whole set of modules provided me with examples of how to slowly move a client forward without coming across as being too pushy.

Question 2

Give two or three examples of Rounder’s sustain talk and two or three examples of Rounder’s change talk, and identify whether each is a Desire, Ability, Reason, Need, or Commitment, Activation, or Taking Steps type of change talk.

Sustained speech regarding his ability: “that’s just kind of the way things have been going, you know.”

Sustained speech regarding his ability: “My daughter she you know, she uh… (sigh) won’t let me see the kids.”

Sustained speech regarding need:” And I don’t know what the hell she means I need help.”

Change speech regarding desire: “I wouldn’t mind coming here to live”

Change speech regarding commitment: “As long as I’m putting all this money into it I’d like to come out with something.”

Question 3

Give two or three examples of the interviewer’s use of complex reflective listening and strategic responses to Rounder’s sustain talk. What impact does the interviewer’s use of complex reflective listening and strategic responses have on Rounder’s sustain talk and change talk? Be specific and elaborate.

In the exchange below, Terry use the strategic response that focuses on his autonomy.

Jim: What’s… you said people come here to live. Do you think I’d have to come here to live?
Terri: Well I think, you know you’re the one that really needs to make that decision about what’s the right kind of treatment for you. I couldn’t decide that for you.

By reminding Jim that it is his treatment and he is the only one that knows what will be the most beneficial, she is reminding him that it is his choice. He’s not being forced into treatment. And I believe that this makes it easier for him to begin talking about entering the program. If she told him he had to come and took any his autonomy, I think it would take him longer to make that change.

It continues below

Jim: I wouldn’t mind coming here to live, but I wouldn’t want to be in one of them places where you sit around in pajamas a bunch of longhaired hippie types crying and bitching and stuff like that. That ain’t my style you know.
Terri: So you’re kind of wondering what it would even be like here.

Terry is being reflective and using the strategic response of reframing what he said. It allows him to state his hopes and his concerns. This will also help him clarify his concerns and solidify his goals. It will continue to help him move forward.

The last quote is one of reflection.

Terri: So you kind of feel two ways about it. On the one hand, you know, you think you’d like to have a change and you’d like to quit drinking and on the other hand you think you kind of dread it.

It also helps him move and continue to use the language mobilization. Again by using these responses and reflections, Terry is able to move him forward

Question 4

Give two or three examples of Rounder’s signs of readiness to change. If you were interviewing Rounder and you noticed these signs of readiness to change, what would your next step be in this interview? Be specific and elaborate.

The following two quotes are signs of Rounder being ready for change. “I wouldn’t mind coming here to live,” and “as long as I’m putting all this money into it I’d like to come out with something.”

If I was in the interview with him I would begin to ask questions and use reflective listening skills to help him continue on the path of deciding to move in and begin the process. I would start talking about different steps he could take. I may ask him what some of his goals are while he was at the treatment center and ways for him to reach the goals. I would also try and help him verbalize that he is ready to take the necessary steps. I would want him to verbalize his commitment to the process knowing it may it will not be easy and it will take time. Overall, I would want to focus on the mobilization language of commitment, activation, and taking steps