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

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April Archibald

Question 1
I really enjoyed watching this video. It was exciting to see Jim’s transformation in the video. He began as gruff, stubborn, and somewhat obstinate. Near the end, you could see him soften, hear him become less guarded and more willing to share his vulnerabilities. I thought Terri excelled at remaining calm, despite what seemed like Jim’s attempt to start conflict when he commented about the likeness between his probation officer and Terri. Terri reflected his statements accurately and reframed his sustain talk with ease.

Question 2
Sustain talk:
1. “So a lot of what I’m doing here or you know why I’m coming here.. the only reason I’m coming here is so I can maybe save my driver’s license so I won’t lose my job and so I won’t lose my house. It’s not because I want to do any of this crap you know.”
2. “There’s no need in me lying to you because you know unless you go down and tell the court that you know I’m not motivated to be here or anything, but I don’t like any of this I’ll be honest with you. It’s taking a lot of time that I don’t have.”
3. “Well she says she’s afraid that you know I’ll do something to hurt the kids. But I never hurt them kids and never have in my life done a thing to hurt them.”

Change talk
“People keep saying that you need to stop drinking and I ain’t never done that either. I think I could. I’ve tried a couple of times and I wasn’t very… I think one time I quit for a week or two just to show people I could stop drinking. I wasn’t too happy. Really I didn’t know why in the hell I stopped anyway”

“You know there was another thing I was thinking about. If I don’t stop drinking I’m probably going to be right back in this mess again.”

“I wouldn’t mind coming here to live, but I wouldn’t want to be in one of them places where you sit around in pajamas a bunch of longhaired hippie types crying and bitching and stuff like that. That ain’t my style you know.”

Question 3
Terri’s responses to Jim are neutral and non-judgmental. She reminds Jim that he gets to chose what treatment might be the most beneficial for him.
“Well I think, you know you’re the one that really needs to make that decision about what’s the right kind of treatment for you. I couldn’t decide that for you.”
Terri reflects Jim’s ambivalence about his drinking, iterating his sustain talk, “Yeah. You’re not here because you think you have a problem. You’re here because they sent you here. ”
Each reflection from Terri encourages Jim to explain himself a little more and disclose more vulnerabilities. You can hear him drop his defenses with nearly every statement from Terri. It is clear her reinforcement of his autonomy also helps him move toward change talk.

Question 4
Jim slowly moves toward change talk when he begins asking about his treatment options. “What’s… you said people come here to live. Do you think I’d have to come here to live? ”

I appreciated how Terri pointed out to Jim that he was able to manage his anger in the past which solidified his own concept of his ability to change.
It appears Terri has built enough rapport with Jim that he feels comfortable asking more detailed questions and how he might get the help he is considering he needs. If I were interviewing Jim, I would continue to elicit his understanding of what treatment he might want to pursue. I would provide information about the program, specifically the different options for treatment, reminding him that it was up to him to make the decision. I would ask if he had any questions, how he feels about pursuing treatment, perhaps the pros and cons of such a decision. I might offer him a pamphlet about the program, maybe show him around the facility and allow him to ask questions. I might further ask him to look ahead and envision how his life might be different without alcohol. I would most likely encourage him to take a day or two to think about what he might want to do, further cementing his autonomy.