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.
I think the counselor used some MI strategies that seemed to work for client. The client spoke with the counselor as if he felt as though they were on the same team in developing a plan. There were times that it seemed that the counselor was struggling to not jump in with the righting reflex, particularly when it came down to getting to developing a specific plan (I can identify with that struggle!)
At 2:40 the counselor gave a long complex reflection that also included some ideas about planning that were delivered in an MI manner rather than instruction.
At 6:38 He provided a reflection about church after the client offered resistance that highlighted the parts of church that he enjoyed (social interaction) and also offered some concern about how he’d tolerate the God talk at church.
At 8:06 The counselor engaged in teaching that was not MI about AA. I was surprised how well it was tolerated.
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?
There were occasions that the counselor used close ended questions and I think I might have used more open ended ones or reflections. I like that he used and open ended question at 2:30 to explore a plan for what the client might want to do on the second day of not drinking. I appreciated that by 6:45 the counselor asked permission before teaching about AA and I really would have liked to see him ask permission in the earlier video as well. In the swimming video, the counselor asked the client to repeat and clarify the plan and I believe I would have tried that technique. I have also “taken dictation” from a client at the end of an appointment so they left with a copy of the typed plan they just explained to me.
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? This has reminded me how useful it has been to have the client tell me what to type out for them in patient instructions, since working at home and having sessions over zoom, this has not been possible. But I believe that there is a way that we could adapt this.