I believe confrontational interviewing created a barrier to not only the client working on what he identified he wanted to work on in session but also the therapeutic relationship. The confrontational interviewing was judgmental and made the client have to fight for their autonomy which closed off parts of the conversation that would have been accessed through motivational interviewing.
In the confrontational interviewing clip Sal starts out the conversation with the counselor openly. As the conversation progresses Sal is confronted, he becomes defensive, offended, argumentative and at one point is genuinely flabbergasted/overwhelmed due to the stance the therapist was taking. Sal repeatedly attempted to communicate his confusion as to why the dog he has had for 12 years is suddenly the cause for his increased health issues but was not permitted to explore these feelings and concerns.
In the Motivational Interviewing video Sal is able to fully participate in the conversation and not focus on defending one stance over the other. Sal is able to explore both sides of his ambivalence and get to a place where he can contemplate there might be a situation where he has to give his dog up (something he was not able to consider in the confrontational interview). Sal is able to feel heard, not feel judged, express his own expertise, and explore both sides of the ambivalence.
Motivational Interviewing would clearly allow Sal to explore both sides of his ambivalence as he is not feeling defensive, is given room for autonomy, and is not overwhelmed by the conversation or flabbergasted by the therapist’s stance.
I feel ambivalent about my son attending in person classes due to Covid19 and family members at increased risk.
One Side of the Ambivalence
My son does better with in person learning.
My son is struggling with his academics more then he would with in person learning.
My son is feeling the effects of not being able to interact with his peers in person.
The Other Side of the Ambivalence
I worry about the impact on people’s health should he catch Covid19 while attending school in person.
My son struggles with hand hygiene on his best day.
The school does not respond to positive Covid19 cases in a way I believe to be sufficient.
April, on the one hand you recognize that your son does better with in person learning. On the other hand, the thought of your son bringing home Covid19 to family members worries you and it sounds like keeping everyone safe is very important to you.
April, on one hand you see that your son Is struggling with his academics but on the other hand you recognize his hand hygiene could use some work in order to make you feel comfortable with him going to in person learning .
April, on one hand you feel like your son is feeling the effects of not seeing his peers in person but on the other hand you do not feel confident in the schools handling of Covid19 cases.
This exercise was able to highlight my main ambivalences in considering my son returning to in person learning. I think this style helps maintain the client working toward the goal of conflict resolution while maintaining autonomy. I have had clients who have spoken about the only work done with their therapist is the therapist trying to solve their problems for them. The client never follows through with the ideas because they are not invested in the idea and it is not relevant to the client’s life.
Reduce chronic suicidal ideation, attain social security disability, increase physical health.
Exercise and healthy eating, medication management and therapy, stay on top of denials/appeals/questionnaires and attain an attorney to help in the court process.
The client does not want to participate in therapy and feels that medication is what they need, the client does not want to utilize an attorney despite being repeatedly denied, and the client’s current mental health is a barrier to increasing physical activity or eating healthy.
My righting response is to educate in hopes to sway them. Internally I struggle with the idea that this client could get additional benefits from doing treatment through these additional resources. I explore with the clients the reasoning for not wanting these services. This client feels that taking on too much would derail her which is good insight. I also explore willingness to relook at services at a further date when they might be able to take on more than they were able to before.