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

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#34400
April Archibald
Participant

Question 1
The provider in the Non-MI confrontational approach was shaming and judgmental. I came away feeling as though she was a bully, coercing Sal into giving up Oscar without genuinely understanding how difficult it would be to make such a decision. She reflected on what he said but with little genuine empathy. In the second video, Sal appeared to disclosure more about how he truly felt about his health and his goals. He was not as defensive nor did him seem so exasperated. This was most assuredly due to the provider’s reflection and her genuine interest in how Sal felt. She expressed more investment in his health and his goals that in the first video. The second video helps Sal move closer to making a change. The therapist affirms that Sal is in the driver’s seat and even Sal acknowledges how important that autonomy is.

Question 2
I feel ambivalence about putting away the laundry

One Side of the ambivalence
I can easily take my clothes out of the laundry basket and find what I need quickly

The Other Side of the Ambivalence
If I put my clothes away, I will spend less time ironing and my room will be neater

Double-Sided Reflection
April, on the one hand putting your clean clothes away can be time-consuming and tedious. On the other hand, if you put your clothes away you would spend less time ironing and digging through the laundry basket looking for matching socks.

April, on the one hand, you have quick access to your clean clothes in the laundry basket. On the other hand, if they were put away, you would also have the other clothes in your closet to choose from and perhaps not feel so frustrated with your “limited wardrobe”.

April the clean clothes are in a small, neat area that isn’t taking up too much space. On the other hand, the laundry basket full of clothes makes the room look untidy and cluttered. A tidy room will make you feel more at ease and proud of your accomplishment.

This was more challenging that I thought it would be. It was intriguing to explore the various rationales for changing versus status quo. The internal conflict can be overwhelming and frustrating. I have a clearer understanding of how hard to it can be for humans to change behaviors.

Question 3

Consumer target behaviors: Clinician target behaviors:
Decrease my drinking to a set amount/frequency Complete abstinence from alcohol
Attend AA meetings weekly Attend 90 meetings in 90 days
Find ways to address my symptoms of ADHD Discuss ADHD medication with doctor

While there are some discrepancies between my goals and those of my client, our goals are similar. It is clear my client intends on moving in a more controlled and manageable (to them) pace than mine. As a provider I tend to think and plan far in advance and focus on the long-term goals rather than really narrowing down how to address the short-term goals. Ultimately, I want my client to feel healthy and satisfied with their journey. Walking alongside them on their journey will be more productive and effective than pushing them from behind. To align with my client, I will ask them their ideas about how they might moderate their alcohol use. Perhaps they want to enlist family for help. How many meetings are they comfortable attending each week? Are there barriers to attending? Are there techniques they’ve used before to help manage their symptoms of ADHD? Are there others they might use? Do they want to brainstorm alternative techniques or discuss other options?
I once had a judge ask me why I did not encourage my client to stop smoking marijuana. I responded, “because it wasn’t their goal.” The judge was dumbfounded.