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

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#24396
Colleen Drake
Participant

Question #1:
Jim seemed to be very guarded through most of the session, taking the defensive and making it clear that he was there due to a court mandate. The interviewer took a patient approach and validated what Jim was expressing about his lack of desire to be involved in treatment. It was clear that Jim was not really ready to consider quitting drinking until further through the interview when he was able to identify some of the reasons why it may be beneficial for him. I would wonder if Jim would have been willing to engage in any of the change talk if the interviewer had taken a different approach with him. I think she created a comfortable space for him to voice his opinions and to provide feedback.

Question #2:
Sustain talk: “…the only reason I’m coming here is so I can maybe save my driver’s license so I won’t lose my job and so I won’t lose my house. It’s not because I want to do any of this crap you know.” “It’s taking a lot of time that I don’t have. It’s taking of money I don’t have for the court and the fines and all this stuff.” “I wasn’t too happy. Really I didn’t know why in the hell I stopped anyway.”
Change talk: “Maybe that’s something I need to think about before I even do any of this stuff that you’re, or that they’re, talking about.” DESIRE “You know there was another thing I was thinking about. If I don’t stop drinking I’m probably going to be right back in this mess again.” REASON “Yeah. Cause, if I get out of this, if I can save my house and my job I’d better do something that’s gonna keep me from doing this again, don’t you think?” NEED

Question #3:
Complex reflective listening: “Yeah. You’re not here because you think you have a problem. You’re here because they sent you here.” So, it’s kind of the same thing you were saying before which is that it feels like everybody’s looking at your drinking but it’s just not as bad as everybody things it is.” “It almost sounds like you don’t even know whether you could stop even if you wanted to.”
Strategic responses: “I’m hearing you loud and clear that being here is not something that is really a high priority for you.” “So it seems to you like I might try to push you around and make you do a whole bunch of things you don’t want to do” “Kind of a mystery to you why she’d even be worried about that.”
The interviewer’s strategic responses and use of complex reflective listening seemed to have an impact on the ability for Jim to feel comfortable being honest and opened up the door to a bigger conversation of considering why he may benefit from quitting drinking. This brings the conversation, toward the end, to a place where Jim starts seeking more information about treatment and what it would be like. He starts identifying, on his own, what impacts there will be if he doesn’t quit drinking (such as loss of his job and/or home). Jim started the interview being on the defensive and making it clear that he had no desire to change and ended the interview considering entering a treatment facility and talking about the things that may help keep him motivated toward change.

Question #4:
Jim showed a readiness to change when he; mentioned that he was unsure if he would be able to quit drinking, started asking for more information about the treatment programs and started identifying the pieces of his life which may improve/resolve should he quit drinking. If I were interviewing Jim I would continue the conversation and ask him if he would like more information about treatment options. I might also ask him to elaborate on what some of the positive outcomes he might experience if he were to quit drinking. I might ask him what steps he would be willing to take within the next day, week or month towards and action plan for change.