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

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Michael Bean

Question 1: This client presented having recently had a diagnosis of COPD which the client related to her use of cigarettes. The client discussed that her parents smoked and that smoking was normalized and even glamorized in the media of the day. Client recognizes that she has smoke a lot and that it was impacting her health and her overall appearance. The counselor reviewed and explored the reasons that the client wanted to take a look at her smoking.

The client identified that she wanted to cut down on her smoking and predicted that she would have a difficult time. She stated that she had tried to cut down/quit before and was unsuccessful. Client identified that smoking had been part of her life for many years. She reported that she tended to smoke more on weekends when she was not working but also recognizes that she had a group of friends that she smoked with at the workplace. In the first video the client agreed to try and cut down her use of cigarettes and document that in writing.

The client was able to cut down a little in the first work but showed some motivation to further reduce her smoking in the coming week. Client had an action plan and started with a change plan while documenting what her experiences were like reducing the number of cigarettes that she smoked. The client appeared to be quite motivated to reduce her consumption and even talks about the possibility of quitting.

The client cut down more and in the last video discusses her plan to quit entirely. I doc discussed medications that might be helpful and their side effects. Overall, the doctor did a good job at supporting this client who was quite motivated and goal directed from the start. He was a good listener and was reflective regarding the client’s intent.

Question 2:The presenting problem for the client was her recent diagnosis of COPD. The client recognized the obvious, that her smoking is the main contributing factor to the diagnosis. The doc did a good job of listening to her COPD report and did some reflective listening and helped the client identify what she liked about smoking and what the consequences of her continuing to smoke moving forward. Client came back the next week and had smoked two less cigarettes a day which gave her some confidence to try reducing her consumption of nicotine a bit more.

The client gained momentum and motivation to further reduce her smoking. The doc offered her advice as she engaged in her change plan and discussed medications that others had found to be helpful. Client recognizes that she needs to keep busy while reducing her smoking and mentioned that she might find a hobby.

Question 3: Asking, listening, performing: the doctor did a good job with all in a very brief period of time. The client appeared to be quite motivated due to her health scare and the recognition of the impact on her appearance. The doctor helped her relax, make her own plans and helped her move toward abstinence by discussing medications which may be helpful. The doc did not mention once the seriousness of a COPD diagnosis or that she NEEDS to quit smoking immediately. He was thoughtful and reflective and guided the client through the change process.

Question 4: I recognize that I have become much more solution focused over the years and this has been a good reminder for me to slow down in my sessions. I recognize that at times I tend to not being the best listener, especially if the client is on probation or need DEEP services. These client’s need to be sober to complete programming successfully and that is the place where I start.

I enjoyed the videos over the last four weeks which I felt were extremely helpful. A review of the MI process has, overall, been very beneficial and I have enjoyed the opportunity reflect on the role it can and should be as part of my practice.