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

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Caj MacDonald

Question 1
When I initially read the vignette involved a mandated client I anticipated a tenuous interaction (at least at the start of the session).  Because Terry was quick to acknowledge Rounder’s disinterest in attending I suspect it helped diffuse his potential frustration and resistance.  Terry’s responses were genuine and helped to invite Rounder to share. Terry respectfully listened which allowed Rounder to disclose more than I expected.  Rounder also presented with more insight and openness for change than I anticipated in a first session.

Question 2
Examples of Sustained Talk

I drink a little bit, but work hard.
Only reason I’m coming here is so I can maybe save my driver’s license…
None of this makes sense. I don’t know what the hell she means I need help.

Examples of Change Talk
I want something that will help me in court. (Desire)
I wouldn’t mind coming here to live. (Activation)
If I don’t stop drinking I’m probably going to be right back in this mess. (Reason)

Question 3
Well again I think that’s something you need to decide…what kind of treatment you want. (strategic response)
You are not here because you think you have a problem. You’re here because they sent you here. (reflective listening)
It almost sounds like you don’t even know whether you could stop even if you wanted to. (strategic response)
Terry’s use of complex reflective listening and strategic responses acknowledges Rounder’s history and where he is in this process. I believe he has felt heard and perhaps understood. As a result It has provided him the safety to share a variety of emotions (anger, sadness, worry) and explore his ambivalence. Despite his gruff exterior I hear some prior insight and awareness in Rounder’s responses. The interviewer’s style invited that side of Rounder to be heard.

Question 4
This treatment center thing is that here at this facility? What do you all do?
How long do you think I would be here?
As long as I am putting all of this money into it I’d like to come out with something.

At these signs I would summarize his change talk (being sure to answer his stated questions on the facility) and ask for his direction on the next step ex: review program brochures, schedule a tour, schedule follow up appointment to allow time to process).