Reply To: Week 2 Homework Assignment (Applications of MI)

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Adeena Vogel

Question 1: My general impressions of this interview is that it was a great intervention to help facilitate the client in bringing about his own awareness to a perceived issue (e.g. “if I don’t stop drinking, I’ll be in this same mess again.”). Generally, I like how the therapist was calm and collected throughout despite the initially “grumpy” client. She was able to meet him where he is at and offer him autonomy in his choices. I think her validation in her summarizations was most of the reason why he was able to open up and reflect more freely.
Question 2: Rounder provided several examples of sustain talk and change talk throughout this interview. An example of change talk, specifically commitment, was towards the end of the interview when he spoke about how he would be willing to attend treatment, but set his limits about wearing pajamas and singing kum-bah-ya. Rounder express desire in change talk when he processed feeling like he wanted this “mess” to go away and be done with. In change talk, Rounder at one point emphasized “maybe I need to think about this.” In change talk, Rounder used reasons when he reflected on going camping with friends and not being able to consume alcohol with them. Sustained talk with Rounder was more evident in the beginning of the interview. Rounder initially was unwilling to take accountability for his drinking and their consequences. He identifies several times that he did not have a problem with drinking and that it was just a perception from everyone else. Towards the end of the interview, Rounder was able to process his ambivalence, which I believe was an example of change talk.
Question 3: I think that the interviewer did a great job at utilizing complex reflective listening and strategic responses throughout the interview regarding Rounder’s sustained talk. Initially, she was able to identify, “you are not here because you think you have a problem.” She was able to reflect on his anger with “it looks like this was causing a lot of problems for you,” which helped Rounder see the potential parallel of that situation. Through listening and responses, the interviewer was able to meet Rounder where he was at and give him an opportunity to open up more and explore the reasons as to why he was currently at the place that he was at. She was validating, while also being able to be dialectical with him. I do believe that these particular skills allowed Rounder to be more open and exploratory throughout the interview process.
Question 4: There were a few signs that Rounder gave regarding his readiness to change. Towards the end of the interview, he said, “If I don’t stop drinking, I’ll be in this mess again.” In this part of the interview, he was able to reflect on how his drinking may create further consequences for him. When Rounder started to ask more questions regarding the treatment center, I believe that this was also an indication of his readiness to change. He was able to look at how this could be a helpful intervention for him. He processed his ambivalence towards the end of the interview regarding not wanting things to change, but knowing that it would be helpful for him if things did change (regarding his drinking). If I were the interviewer with Rounder, I would likely do what the therapist in the clip did; I would encourage him to make his own decisions about the treatment he needs, while offering any information that I could about the treatment itself or the effects of substance use (but again, only if he identified that this was something that he was interested in).