My general impression is that the therapist never challenged or confronted the client. She did a good job of reflecting what he was saying and staying in a positive frame. She used open ended questions, good body language , a pleasant tone and was never attacking or challenging.
She was very attentive to what he was saying and always respectful and empathic.
Examples of sustain talk included:
a. He was speaking about how he was not one of those bums ,Desire, not to be like a perceived alcoholic
b. I’ve settled down and drink a little, Desire, shows a desire to be a more responsible adult while still maintaining alcohol ,still able to drink
c. I have never hurt one of those kids Reason ,speaks about being able to continue as he has thus far never done damage to his grandchildren
d. I drive a long way and need a drink to relax, Reason, this is why I need to drink it helps me with my work and relaxation
Examples of change talk:
a. I think you are right on that on I have never tried to stop drinking , activation, speaking about beginning the process
b. I don’t know how my buddies would feel if I stopped drinking , Ability, how would he be accepted and would he fit into his group
c. I would not mind coming here, Commitment, speaks about going to the place he is in and beginning recovery ,how he would do it
a. When Jim speaks about the accident and how it was not his fault the therapist reflects and it leads to Jim for the first time asking for help. Even though it is about court he opens the door for collaboration and change.
The next step would be to discuss other ways we could help Jim with the problem he is facing opening the door to his drinking This was a nice lead in
b. He comments about how he has changed and settled down and is not as rowdy as he used to be This is another example of what his goal may look like in his life and how does this OUI reflect on his goal of settling down and being more responsible
This begins the process of Jim beginning to speak bout the extent of his drinking . I would follow up with and reflect on what he thinks would help him with his goals and how he could achieve them
a. Jims inquires about what they do at the treatment center indicates a readiness to change and also questions his ability to change next step would be to discuss what is done and address his concerns. I would use reflection and examples of how what they do can help JIm achieved what he wants and also a good opportunity to define some of Jim’s goals.
b. Jim speaks about wanting to do something that will help him indicates reasons to change. I would follow up with reflection of what Jim feels are some of the things that would help him change
both of these show Jim may be searching for both how to change and what are the problems he is facing if he continues drinking. I t may be also a good opportunity to use both sides of the ambivalence JIm is feeling.