This video showed how smooth a process MI can be; it was obvious that Terri is comfortable with the technique, as she was able to elicit valuable information, help bring Jim to some self-reflection, and normalize his responses. It was good how Terri didn’t make promises and she kept bringing things back to him, how the results would vary according to what Jim is willing to do and what changes he is willing to make. Even though Jim was a reluctant attendee at the appointment, he was becoming more open to the idea of making changes and engaging in treatment by the end.
Examples of Sustain Talk:
“It’s nothing for me to sit down and drink a six-pack or two of beer and still be able to function.”
Talking about his friends, “Yeah and I don’t know how they’d feel about me quitting drinking. I don’t know what they’d call me.”
“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.”
Examples of Change Talk:
“I think one time I quit for a week or two just to show people I could stop drinking.” (Ability)
“I wouldn’t mind doing some of this stuff may if there was anything in it for me.” (Reason)
“If I don’t stop drinking I’m probably going to be right back in this mess again.” (Need)
Terri’s use of complex reflective listening and strategic responses helped put Jim at ease and reduced his use of sustain talk, increasing his use of change talk.
“What would you like to do with the time that you spend with me here? What would be helpful for you?”
“It almost sounds like you don’t even know whether you could stop even if you wanted to.”
“There’s just all-different kinds of ways to do it. There’s definitely more than one right way.”
“Right, you were successful in changing that in the past and sounds like you’d kind of like to be successful changing this.”
“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.”
Some of the signs that Jim was moving toward being ready to make a change include Jim saying “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?” and “As long as I’m putting all this money into it I’d like to come out with something.” His asking about treatment options and what it’s like at the center also indicate readiness for change, with him even saying ” I wouldn’t mind coming here to live”.
My next step would be to ask him to measure where he is at on a scale of 1 to 10 with regard to his readiness, ask what puts him there, and try to find out either what step he is ready to take if his response is indicative of being at that stage, and if not, I would ask what he thinks would increase his readiness.