Reply To: Week 3 Homework Assignment (Applications of MI)

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Adeena Vogel

Question 1: Well, these two videos were honestly very difficult for me to get through. I really did not feel like there was a whole ton of MI techniques done throughout the clips; in fact, I felt as though the therapist used a lot of closed ended questions, was interruptive, and redundant (e.g. “what are you going to do?” essentially being his only open ended question). I felt as though the therapist was great at putting in his two cents and offering information (sometimes he was given permission to do so by the client), but it almost felt as though the therapist geared the conversation and did not allow the client to make his own decisions impacting his care through guided questions. I think that the client was able to create a change plan, however I do think that the counselor had significant influence on that. Would he have come to those conclusions without the therapists input? I am not sure. Do I believe the client would have identified AA or Church as part his plan without the counselors influence? Honestly, it doesn’t really feel like he would; he was able to articulate that Church was not really his thing, but the counselor glazed over that, like he did throughout much of the session. The counselor kept reiterating the “plan” which evoked a sense of commitment, activation and step taking on behalf of the client, but I do not see the client following through with this plan, because it didn’t really feel like it was his idea.

Question 2: If I were to do things differently, I would start by not asking so many closed ended questions. The point of MI is to work collaboratively with the client and help them uncover their own needs, plans and commitment without our influence. We are walking with them, not in front of them. For instance, when he talked about his desire for social activity, I would have asked something like, “what ways can you better meet your needs for social activity?” without quickly interjecting the idea of Church or AA. Instead of saying things like, “you could at least try,” I might phrase things like, “what do you think that experience would be like for you if you tried?” Honestly, I would avoid doing much of what that counselor did. He was interruptive, used closed ended questions, and I felt like he disregarded what the client was saying. For that, I do not think he effectively utilized MI techniques. I lost count of him asking “what are you going to do?”

Question 3: I can definitely see myself utilizing the MI strategies with my clients, because it is something that I already incorporate into the work that I do! I think it is always important to first assess where a client is on the readiness for change (if they do not want to change, how can we enable that?)/ When they are ready for change, I work collaboratively with them to help them create a plan for themselves (their own plan!) and how they can best maintain and support the change that they wish to elicit. Part of change planning means that I would check in regularly with my clients to explore what has been working, and what has not been working, and make adjustments with them as needed. I always try and offer information to them if it is something that they desire and something that is relevant to their presenting issues or concerns. MI is collaborative, and that is what I strive to be with the people that I serve!