The differences between the two videos is compelling. As we see within the first video, the provider takes control of the situation and approaches the conversation from a place of “knowing what is best” for Sal. This in turn, creates a scenario in which Sal feels the need to defend his position, squeezing out any opportunities to explore why Sal has not yet made changes to improve his life. Additionally, the provider begins to attack his values and questions his commitment to his family and health. In the second video, the shift is clear. By approaching the conversation from a space of curiosity, the provider creates an open and safe environment that allows Sal to rest his defenses and truly begin to explore some of the reasons for ambivalence. Sal remains in the “driver’s seat” through the entire conversation. Through this open dialogue we discover what efforts Sal has taken thus far and recognizes this progress. The provider names what Sal might be feeling regarding the changes allowing Sal to feel understood and then provider gently provides some education and allows Sal to make the choices that he feels may be best for his life. Throughout the second video, Sal’s values are understood and respected.
“I work well under pressure”
“I do not know how to work differently”
“Procrastinating makes me feel in control of my time”
Other side of ambivalence:
“I often stress about the things that I procrastinate”
“Procrastinating makes me feel rushed to meet deadlines”
“Procrastinating impacts my work quality”
Double sided reflection:
1. You mention that you work well under pressure and at the same time, procrastinating can create additional stress in your life.
2. You mention that you do not know how to work differently and at the same time, when you procrastinate you feel it impacts your work quality.
3. You mention that procrastinating allows you to feel in control of your time but at the same time, procrastinating causes you to feel rushed to meet deadlines.
This exercise really encouraged me to explore my ambivalence about procrastinating on a deeper level. This practice allowed me to explore the topic from both sides of the argument. The reflective listening responses allowed me to better understand the consequences of my actions in a very nonconfrontational manner which allows for a deeper reflection to occur because the need to defend the position is absent.
1. I want to get a job.
2. I want to stop getting in trouble with the law.
3. I want to stop drinking.
Provider target behaviors:
1. Client needs to complete high school.
2. Client needs to resolve legal issues.
3. Client needs to stop drinking.
In reflecting on the two lists, though the differences may not be that obvious, the provider holds the knowledge of the resources and “steps” and approaches from a place of “expert” rather then curiosity. This is evidenced even in looking deeper at the language used, for example, “client NEEDS…”. In completing this exercise, the “righting reflex” definitely came into play. For example, the client would like to obtain a job and as the provider, my reflex is to shift the client’s view to completing school first, as this would offer more opportunities for employment. To approach a conversation with the client utilizing MI strategies, the agenda setting tool would allow the client to remain in the driver’s seat and allow the individual to choose the direction of the conversation. For example, the provider could use a visual agenda with a few different topic areas related to vocational areas and allow the client to pick the area(s) that they feel most comfortable discussing. This process allows the provider to remain a tool in the client’s process rather then the provider directing the process for the client.