Q1-Initially it felt familiar. I have worked with various individuals who are/were similar to ‘Rounder,’ specifically the level of ambivalence to change. It was interesting to witness the course of the discussion and how change talk started to occur.
Sustain Talk examples:
-“the only reason I am coming here is so maybe I can save my driver’s license…” (Reason)
-“I drink a little bit, but I work hard,” (Need)
-“yeah, the court sent me here.” (Reason)
Change Talk examples:
“I wouldn’t mind coming here to live…” (Commitment)
“As long as I am putting all this money into it I’d like to come out with something.” (commitment)
Q3-Complex reflection: “This accident is what caused you to have to come in here and got you in all that trouble at work and now they’re thinking about taking your driver’s license away and that’s why you gotta come here.”
Strategic Response (emphasizing personal autonomy): “Well I think, you know you’re the only 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.”
The use of strategic responses, specifically emphasizing personal autonomy, seemed to shift the conversation to more change talk. Also, Rounder started to present with more curiosity about what his options could be for treatment vs. being told what he needs to do. The use of reflective listening in the conversation provided client with validation and some normalizing of thinking differing ways about something.
Q4: Some examples of Rounder’s readiness to change were towards the end of the interview. He started to ask some questions about the treatment facility and what being there entails, he reflected on how if he does not stop drinking, then he will continue to have problems with the law/ “be right back in this mess again.” He identified a behavior that he had been able to change (fighting) and how it was able to change it. He shared how other aspects of his life might improve if he stopped drinking and how that is a motivator.
If I were interviewing Rounder and I noticed signs of readiness to change, I would summarize the highlights from the change talk and request feedback/clarification from the client to make sure it is accurate and then ask a key question. I would probably ask a question along the lines of: “Where do you go from here?”