Homework Questions 3
What are your general reactions to these two video role plays of a counselor using MI strategies to help a client develop a change plan to stop drinking? Overall, how effective is the counselor’s use of MI in evoking Commitment, Activation, and Taking Steps change talk? How effective is the counselor’s use of MI to help the client develop a specific change plan? Be specific.
The counselor appeared to successfully utilize MI techniques; i.e. open-ended questions, simple and complex reflections, summaries and information after asking permission. The Ct’s presentation indicated that he has a history of willingness to make changes, but lack of success in following through. When asked, “Where do we go from here/where are we at now?” Ct. inquired as to what were his available options and acknowledged a need to stop drinking followed by a lose commitment to try. The Ct. acknowledged that he has a loose support network of church friends, but he admitted that it could be better and also admitted that he was not much of a church goer. After asking permission, the counselor provided information on Alcoholics Anonymous. The Ct. admits that he has little information about AA, but has a colleague from work who regularly attends meetings. The counselor advises that many people find AA helpful but some newcomers are scared off by the God talk. After being asked where he wants to go from here, Ct. appeared to make a commitment to change – to strengthen his support network. Ct. made a commitment to talk to his AA coworker later that day and that he expected that he would be willing to help as this is part of the AA program. The Ct. previously admitted that he has an upcoming social gathering and a football game that he had planned to attend in the near future. He admitted that he would drink at both of the events in the past and h could not see himself not drinking at either event. Ct. was asked how he planned to handle these and he replied that he would be better off not attending either. Also responding to the where do we go from here question, Ct. committed to attending an AA meeting.
What, if anything, would you have done differently if you were the counselor in this role play? Would you have used different MI strategies for change planning? Which ones? Why? Be specific. If you would have used the same MI strategies, how would you improve on what the counselor in the video did? Why? Be specific?
The interaction seemed to work out on both sides. The counselor appeared to go out of his way to be non-confrontational and the Ct. presented as being ready to make changes in his lifestyle and open to whatever suggestions the counselor offered. That being said, even if the Client did offer resistance or attachment to his status quo, I would have still tried to remain non-confrontational; asking open-ended questions and asking permission to provide feedback or information. One thing I would do different is, after soliciting permission to offer information, told the Client about other peer-support networks that are available like SMART Recovery, Life Ring, Refuge Recovery and area treatment center based Outpatient recovery groups.,
How do you or would you envision using some of the MI strategies for change planning discussed in this lesson in your own work with consumers/clients/patients?
I find that if I ask a Client what they need and how I or my agency can help them, they usually have a pretty good idea of what they need and how they want to get there. In my case the Client is usually experiencing consequences of substance use which present as legal, physical, and medical issues or a combination. They don’t always want to cease the behavior. Sometimes they are looking for a way to moderate it to the point where there are little to no consequences. Based on the experiences of passed Clients, this is a difficult, if not impossible goal to achieve, but I try to meet the Client where he or she is at and not immediately void their idea. I have found through experience that it is belter to hear them out and ask about their experiences with trying to use moderately in the past. This can be time consuming, but if I listen to what they have to say and honor their experiences, I usually find them circling back to the idea that there is not a way to use safely and look for ideas and suggestion on how to go about staying clean.