Reply To: Week 4 Homework Assignment (Applications of MI)

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Melissa Ivey

Melissa Ivey

Question 1

I enjoyed watching these videos. I think he did a great job reflecting her thoughts and feelings, especially during the first video. He acknowledged that there were benefits to smoking and why she started. He was interested in her telling her story. I also liked how he changed his scaling questions from numerical to percent, mimicking the language she used. It was also beneficial in the third video that he summarized what she had accomplished and what her goal was going forward. In the third video, I may have tried presenting the medication options differently. It seemed to temporarily change the dynamic of the relationship.

Question 2

He did a great job using complex reflections, both in the first video about her confidence and the second about her progress. He also used scaling questions and had her explain why she chose 35-45% confidence level. This helped her acknowledge that it was not at a 10-20%. He helped her focus on what it would look like, why it was not a 100%, which helped her identify possible barriers. He also had her determine the importance of reach her goal of quitting smoking. This allowed her to state that it was important to her, not others. I also think that by asking what was different it helped her move forward in a way that asking how was your week does not.

Question 3

In the first video, he appeared to do a lot of asking and listening which helped her tell her story. At the end, he informed her about the strategy of mindfulness and taking small steps towards her goal. The patient appeared to respond to these tactics very well.

In the second video he continued to ask questions and listen to her responses. He ask what she could do not help move forward with her goal (I can postpone it and not smoke in house). Be listening and asking questions, he helped her establish her own goal of cutting back, not fully quitting.

In the third video, you see her solidify her goal to quit. He revisits her confidence level (80%), which helps her acknowledge her progress and increase the chances of her success. The only part that I did not agree with was the switch to discussing medication. It did not seem to be a smooth transition. He provided information after asking permission, but the conversation did not appear as productive.

Question 4

I have learned that I do not consistently implement these strategies. Over the past few weeks, by being more mindful of their implementation, I have seen more movement with my clients. I work with those that struggle with substance abuse and by helping them create SMART goals, it puts them more in charge of their recovery verses me trying to dictate a goal that I believe would be beneficial. I have also found that be asking what was different this week, I elicit more information from the client at the start of the session. It also allows me to meet them where they are at and not make assumptions.

Overall, I enjoyed the course and the videos. I look forward to learning more about MI and implementing the techniques, not only with those that struggle with substances, but also those who struggle with other mental health issues.