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

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Natalie Lonstein

Question 1:

I was really struck by the aggressive nature of the non-MI video, the telling to someone of what they “should do” about their life, and felt a real “power over” dynamic. Sal became defensive, annoyed, and frustrated. In the Spirit of MI video, there was a collaborative tone and what felt like a true understanding on the part of the counselor around how difficult of a decision there was to make, where the non-MI video portrayed Sal’s circumstances as if the answer were easy, no big deal to give away a family pet. In the MI video, Sal was open, interested in the conversation, appeared help seeking and invested, calm, and had a willingness to be more honest and forthcoming. You can see that the style of the MI video moves Sal closer to action because a culture of safety and trust is established by validating his ambivalence, and again, the tough decisions he has in front of him. In the MI video it felt as though Sal was eager for support and help in shedding light on a path for him of what he should do, though this was not named for him. He was interested in processing his opposing feelings to see what the ‘right’ decision could be for him.

Question 2:

Behavior: Working Out More

1.) “I want to spend time with my son after work since we only get a hour in the mornings together and a couple hours together after work before his bedtime.”
1.) “I have no time to work out in the mornings because I would have to wake up earlier, and therefore go to bed earlier and would have less tv/reading/on the couch time.”
2.) “I haven’t noticed a change in my weight or overall appearance.”

Other side of Ambivalence:
1.) “I know physical activity is important for my overall health”.
2.) “I enjoy many forms of exercise, have fun exercising, and feel it is an important part of my self-care.”
3.) “I like how I feel and look when I am exercising regularly.”

Double sided:
1.) “You know that exercise is important for your health. And yet finding time to exercise right now is particularly hard because spending time with your son is the priority.”
2.) “You enjoy relaxing and having time to yourself to read and watch tv shows, and yet you also have fun working out in many different ways.”
3.) “On one hand, you haven’t noticed much of a change in your body since you haven’t been working out as much as you used to. On the other hand, you have noticed that you like how you feel better when you are regularly working out.”

I really liked this exercise – I try to do this type of exercise with myself a lot around decisions that I have difficulty making or moving forward with (social relationships, eating habits, etc.) The reflective listening responses really feel validating around how hard it can be to make decisions you aren’t sure about when things ‘aren’t broken’ (for me at least). It feels supportive to have someone sit with you in that gray space for as long as you need.

Question 3:

1.) I want to get my driver’s license.
2.) I want to get a job.
3.) I want to move out and get my own apartment.

My target behaviors:
1.) Make a plan with client to register for driver’s ed, get their permit, complete driving hours, and go for the test.
2.) Look for openings, apply for positions, and go to interviews.
2.) Get a job/keep working, start saving, and create a budget.

My target behaviors or responses to these client’s goal statements appear like quick, concrete, easy solutions. Like the provider is saying “Ok great! I know all the answers for you, just do these 80000 things.” It downplays how hard some of these things could be to accomplish for the individual; a lot more exploration around any values or beliefs underlying or driving the wants could be helpful to get a sense of the whole person. Its important to stay curious – use of open ended questions! My ‘righting reflex’ comes from a place of wanting to help and provide resources and information, without knowing the full story. Using the Agenda Setting strategy, I could write down overall topics identified like ‘work/employment’, ‘living situation’, ‘transportation’, etc. and see if there were additional life domains the client felt would be important to add to their priority list. We could use index cards to write the different areas, then shift them around in the order the client identifies by using a rating scale or comparison of one topic to the other. Using reflective listening around any ambivalence to the way goals are prioritized would be important and validating their perspective of where each topic is placed in their list. Summaries would be important as well to make sure I am understanding what they are expressing.