Overall, my reaction is that the counselor asked a good mix of open and closed ended questions as well as engaged in solid reflections that helped the client move forward with a change plan and commit to action steps. The counselor was effective in evoking commitment, activation and change talk. Initially, the client started out with resistance to considering AA, particularly when he talked about not wanting to have anything to do with church. Then the client moved into activation and taking steps change talk by saying that he would call a friend to inquire further about AA. By the end of the second video, the client was considering next steps for engaging in counseling and was committed to steps to rid his home of alcohol and to begin the process of becoming involved in AA. The counselor’s reflections helped the client to reduce his resistance to the process. The counselor also provided good information that helped the client to understand what the process would look like.
I’m not sure that I would have done much differently in this situation. I would like to think that I would have used a similar combination of reflection and providing information to engage the client in the commitment to the change process. I may have asked more scaling questions to understand how committed the client was to the process and to rate his resistance earlier on. I also may have tried to get the client to commit to additional action steps with regard to relapse planning. The counselor offered good reflections to assist the client with understanding situations that may be problematic for him moving forward. I may have engaged the client in more action steps relating to these situations through using more information and reflections on what client may experience.
I often use MI strategies for change planning. I most frequently use these to identify ambivalence to change initially. I then use reflections to understand the resistance to change and what would move clients further into the commitment process. Sometimes, I struggle with being clear about the action steps and I need to continue to ensure that these are more concise and reflective of the commitments that clients are making. I often have clients that are contemplating motivation to engage in exercise or healthier lifestyle choices. I use MI to move them forward in the process.