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

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#34557
Natalie Lonstein
Participant

Question 1:

I thought this video was a really good example – I think the interviewer did a great job of staying the spirit of MI and leaning into Jim’s sustain talk to develop a positive, trusting relationship; to hopefully get Jim’s buy in. The interviewer “rolled with resistance”. You can hear lots of justifications and minimizations in Jim’s narrative, and the interviewer made a point of reflecting this back to Jim. I felt like there was really a dance between the sustain talk and change talk Jim used, highlighting how we all as humans have these two sides of how we feel about making changes or making choices.

Question 2:

Rounders Sustain Talk:
1.) And I don’t know what the hell she means I need help….And I don’t know where she’s getting all this from.
2.) 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.

Rounders Change Talk:
1.) If I don’t stop drinking I’m probably going to be right back in this mess again. – REASON
2.) Cause, if I get out of this, if I can save my house and my job I’d better do something that’s gonna keep me from doing this again, don’t you think? – REASON

Question 3:

1.) Reflective response (double-sided reflection): So you kind of feel two ways about it. On the one hand, you know, you think you’d like to have a change and you’d like to quit drinking and on the other hand you think you kind of dread it.

The interviewer is highlighting the two sides of Rounder’s feelings about not drinking. Though the sustain talk is coming second in this statement, her using a double-sided reflection names two experiences Rounder is having at the same time. He questions if it is typical to have mixed feelings, so this double-sided reflection serves to normalize this experience for him. This hopefully creates even more buy in.

2.) Strategic response (reframing & autonomy): “What would that be like for you? If you didn’t drink and you were around them?”

The interviewer is asking Rounder to just imagine a gathering with his friends where he doesn’t drink; from this perspective, can he consider what this experience could be like. I think there is a deeper meaning here as well, that in terms of feeling like he has to drink with his friends for various reasons, this question also encourages Rounder to consider what it would be like for him by getting his personal choice to drink in the situation. Rounders response to this shows that this is really difficult for him to even imagine this type of situation at all; drinking with his friends is so engrained for him, it is a part of his being. Though Rounder continues to have some sustain talk, he begins to verbalize a little change talk by naming that this could be something he has to think about more.

Question 4:

Rounder’s statements of change talk and sustain talk interweave. Earlier on, Rounder says:
1.) 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.

Then at the end he says:
2.) As long as I’m putting all this money into it I’d like to come out with something.

In addition to the change talk in Q2: “If I don’t stop drinking I’m probably going to be right back in this mess again,” and “Cause, if I get out of this, if I can save my house and my job I’d better do something that’s gonna keep me from doing this again, don’t you think?” I think my next step might be to try to gather together these statements and summarize what change talk I have heard throughout the interview. I think I would also do some exploration of past successes and what made them successful, particularly how did he did not drink for those two weeks.