Reply To: Week 1 Homework Assignment (Applications of MI)

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Adeena Vogel

Question 1: My general reactions to the videos were that they are two completely different styles. I felt as though the first one was far more confrontational and less therapeutically approached. You could see in the non-motivational video that Sal was incredibly defensive, as there was less questioning and what appeared to be more blaming, on the part of the therapist. When you compare to the MI video, Sal is much more relaxed and far less defensive. He is able to explore potential causes of his asthma without feeling attacked for the appropriateness of keeping his dog. I would have to argue that the MI interview style clearly helps Sal move closer to an action plan. In this technique, Sal was able to explore other potential contributors to his asthma and was asked to explore the ways in which he could make changes for himself that he thought would be helpful (e.g. cutting back on drinking). In this technique, Sal was able to create solutions for himself that would be appropriate for his personal, and specific situation. (side note; I would also be very defensive if someone told me I had to get rid of my dog!)

Question 2: The behavior that I feel ambivalent about is exercising in the morning before work. My three statements of ambivalence are;
I feel ambivalent about exercising in the morning before work.

(On the side of ambivalence) I am tired when I wake up and I have limited time to prepare myself before the work day.
(The other side of ambivalence) I know that exercising is healthy for my body and mind and will help get me started and motivated for my day.
(Double sided reflection)
“Adeena, on one hand you are tired in the morning and have a ton of things to do to get yourself ready for the work day, but on the other hand, you know that exercising won’t take that long and it will help you feel better during the day.”
“Adeena, on one hand you don’t have the time to exercise in the morning, but on the other hand, you can just wake up 20 minutes earlier to do it because you know it will help your overall health and well being.”
“Adeena, on one hand you really want to incorporate this behavior into your daily routine, but on the other hand, you are not sure if you will have the time or energy.

I particularly liked this exercise. I was able to really think about how literally one half of me understands that I want to engage in this activity, while the other half avoids it. It was validating to me when I questioned why I do not/do not want to, exercise in the morning. It was a way to help me weigh my options and sort out my discrepancies.

Question 3: One of the clients that I work with has the following 3 consumer generated target-behaviors; engage in daily ADL’s, stay connected positively with family and friends and better manage finances. 3 targeted behaviors on my own agenda for this particular client are the following; process grief and loss, explore barriers to managing day to day life, and discuss and explore unhealthy communication patterns. There are pretty big discrepancies among these lists. What I notice is that even though I have my own opinions on what the client “should” work on, I need to be mindful that it is something that they may not necessarily believe is a problem for them. I feel clearly that I want to help “fix” things that I deem to be a problem, but I need to remind myself that this is not my treatment and if the client is not ready or willing to engage in these targeted behavior changes, than that is something that I will have to accept. By using the MI agenda strategy, I would specifically ask my client what it is that she would like to focus on in the session that day. I could ask her if she would like to talk about relationships or managing day to day life things, such as ADL’s. I would let her set the agenda for the day, while recognizing that even if I have my own, it is not appropriate for the therapeutic process of MI counseling.