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

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Kelly Colbath

Question 1: In the confrontational video, Sal seems overall disengaged from the conversation. When he does speak, he is more prone to a “defensive” approach where he seems like he feels the need to justify his feelings about the situation. Sal also seems to become increasingly frustrated/agitated as if he feels he isn’t being heard or understood by the interviewer. During this video, Sal expresses that this is “too much” which leads me to believe this approach is causing him to feel overwhelmed and stressed out which causes him to shut down. Another observation is that Sal does not lead the conversation in the confrontational video. He sits and listens to the interviewer and speaks when he feels the need to justify or defend himself which brings on a more “hostile” tone to the interview and he is not offering much information.
In the second video, the Spirit of MI interview, Sal’s tone is very different and much more positive. In this video, Sal leads the conversation. The interviewer prompts open ended questions which Sal seems to offer more information in response to than in the first video. Sal seems more comfortable answering and offering up personal information with this method. Another observation is that Sal is more agreeable and engaged in this video. He is willing to explore different options, share his thoughts and feelings about the situation, and move towards possible solutions that he has identified he might feel comfortable with.
Ultimately, the Spirit of MI style helps Sal move much closer toward some kind of action to improve the management of his asthma because he is in the “driver’s seat” of the conversation. He is asked open ended questions which allows him to have more control over what he chooses to share. With this style, Sal seems to be much more engaged with the interviewer and offers more information regarding his situation which leads to him exploring/identifying different solutions he would be comfortable pursuing to address the situation. This interview, overall, seemed to be much more positive and productive because the interviewer took time to listen to Sal’s perspective on the situation and less time putting him in a position where he felt the need to be defensive or disengage (as in the confrontational video).

Question 2: Behavior: procrastination:
i. “It allows me to prioritize other tasks”
ii. “It helps reduce stress momentarily”
iii. “I work well under pressure anyways and always meet the deadline”

i. “It also causes more stress when I have to prioritize the things I procrastinated”
ii. “causes me to feel less organized”
iii. “makes me feel like I have to rush those tasks to get them done and might reflect in the work”
c. Double sided reflection-
“On one hand, procrastination allows you to take the time you need to focus on some other tasks/responsibilities that you feel are more pressing. On the other hand, when you do have to come back around to the other tasks you procrastinated, you tend to feel disorganized which can cause you a lot of stress.”
“On one hand, putting some things off makes you feel like you have more time to relax and feel less stressed when you know you will get to those other things later. On the other hand, when you get around to those things again, you may be feeling more stressed about those specific tasks than you did the first time around.”
“On one hand, procrastination isn’t that big of a deal to you because you have always done well working under pressure and putting certain tasks off just provides you with that added layer of pressure you thrive under. On the other hand, even though you do well under pressure and always meet the deadline, procrastinating puts you in a position where you feel you need to rush to get it done which you worry affects the work”.
This exercise challenged me quite a bit. It kind of forced me to look at things from both sides and reflect on the pros and cons of a topic which is sometimes difficult to do. This allowed me to look a little deeper at this topic and weigh out which “side” of the topic I felt caused me the least amount of stress or better feeling overall. However, it also allowed me to see the struggles with ambivalence because each side of the statements identified some of the habits I might be used to and the “decision” about which approach might be best may result in changes in lifestyle habits which I think can be daunting to many. The exercise also sort of helped me identify the difference between a comfort zone and a preferred outcome; which again, requires lifestyle changes.

Question 3: Target Behaviors:
i. Cut back on smoking weed and vaping
ii. Go to school more often
iii. Get my diabetes levels lower throughout the day/more consistently
Provider agenda:
i. Cut back on smoking weed and stop vaping
ii. Go to school daily
iii. Take prescribed diabetes medications routinely to keep levels safe at all times

Primarily, the discrepancies among these two lists lie in the expectations. The client may be open to cutting back on smoking weed and vaping but I (as the provider) am tempted to want this youth to stop vaping completely due to health concerns. The same with the schooling… the client might identify that he wants to try going back to school a few times a week but I am tempted to advocate for him to begin going back to school every day so that he can be accessing developmentally appropriate academic resources.

These discrepancies challenge me to look at my own perception of what “healthy behaviors” might look like to me versus this client and remind me that I am not in the “driver’s seat” of this youth’s life; they are. In order for there to be change, the client needs to be the one who identifies what they want that change to look like, otherwise, they will feel like they have no control or choice in their own life. As the provider, I need to always step back and remind myself that my job is not to determine what is “best” for the client, but to meet the client where they are at and support them reach their identified vision of what is best for them. In order to do this, I can use the MI Agenda Setting strategy because it allows me to outline (generally) different topics or areas of the client’s life that they may want to identify wanted changes in or struggles with. The agenda allows for both myself (as the provider) and the client to start the conversation on the same page but allow for the client to take the conversation in the direction they feel comfortable with which will result in more open conversation, more comfortability, and more “buy in” to the proposed lifestyle changes.