Question 1 What are your general impressions of and reactions to the MI interview of Terry Moyers and the “Rounder?”
I loved this because it reminds me of people I grew up with in the South. His expressions, dialect, and the first thing he points out is her hair color. He is immediately on the defensive and trying to put a woman in her place. He’s every defiant. He’s very much in denial. He’s received a nudge from the judge, and everything in his life is everyone else’s fault. She does a beautiful job of building trust and turning the conversation around. I love the scale of 1 to 10 method, and using the scale to ask why he didn’t pick a lower number. Brilliant. That really surprised me. I’ll be using that myself with clients.
Question 2 Give two or three examples of Rounder’s sustain talk:
“I drink a little bit but I work hard. It’s nothing for me to sit down and drink a six-pack or two of beer and still be able to function. I’m not like one of them bums you see laying down there by the bus depot on the lawn selling his blood and stealing hubcaps. I’ve never stoled anything and I’ve worked every day since I got a social security card.”
“And he says, ‘You’ve got a drinking problem.’ Hell, you know I’ve had to take him home a lot of times, that I’ve been the one standing and he been passed out and couldn’t walk.”
“Well, I’m kind of an uptight guy. I have a hard job. I work around a lot of old boys that are pretty rough and tumble. I drive a long ways and I unload big trucks. I get tired sometimes. I like to sit down and have a drink.”
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.
Desire: “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?”
Reason: “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.
“It almost sounds like you don’t even know whether you could stop even if you wanted to.” This is an extremely important moment in the session because he seems almost dumbfounded. It was like he had a moment of clarity when he responded, “That’s a funny thing to say. I can do just about anything but I can’t say yes to that, that I can stop drinking. I think you’re right on that one. There’s a lot of things I can do, but I’ve never tried to stop drinking, I get thinking about it, honestly.” His response was a far cry from his stance when he arrived.
“You know you’ve mentioned that twice already you used to be more hot tempered than you are right now. What do you think caused you to kind of become more…less angry and less violent?” This is brilliant because she’s trying to get him to see that he drinks at people. His drinking has increased as a way for him to control his anger. He begins to reminisce about the times he got into fights and got thrown in jail. She follows up with, “So it looks like that was causing you problems in a lot of different areas, with the law and your family and other people in town.” This brings him back to his current problem – the DWI.
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.
“What would that be like for you? If you didn’t drink and you were around them?” This is the moment where he really can’t even conceive giving up drinking. He admits drinking is who he is. She can’t imagine not being a psychologist, and he can’t imagine not drinking. He says, “That’s a hard thing. 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.” This was a step in the direction of change. Very slight, but he’s getting there. I would probably have asked him what kind of person he might see himself being without it.
“This treatment center thing- is that here at this facility?” This question is his first real step toward a commitment, even if it is because he’s wanting to get off the hook. He begins to ask the questions about living arrangements, so he’s contemplating commitment. I don’t know that I would have done anything differently at this point. I’m tempted to ease into telling him he needs to do this for himself, not anyone else, but at this point, getting him in the treatment center was a huge success. The rest will come.