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

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Kelly Colbath

1. As I have seen other members of the class state; I feel that these two videos were sort of hard t follow in some ways. My general reactions is that the basics of MI are present, but the clinician does not do enough eliciting as he could be to support the client with identifying and committing to a change plan. I think there were a lot of components of the clinician’s interviewing that were effective but also a lot of components that could use some improvement. For example, what the clinician does well that I observed was: introducing timelines to the conversation (i.e. asking the client for a deadline of when he plans to act on an action step he has identified in his change planning), recapping the conversation to steer the conversation in a direction towards commitment, and asking the client to identify the barriers to progress and how he plans to overcome these barriers. However, areas of improvement I observed were: the clinician did a lot of interrupting, not a lot of open ended questions (and the ones he did use were repeated throughout the entire interview), and providing education without asking if the client was interested in this perspective. Generally, I just think the clinician did a lot of the talking which put the client in a position to do a lot of agreeing and brainstorming but not a lot of committing or being specific about the change planning. Both interviews felt like a lot of brainstorming without the specifics on how the client would follow through.
2. If I was the counselor in the role play, I would utilize more of the SMART method outlined in this lesson. In order to do this, I would open up the conversation more to the client and spend more time asked him open ended questions about what HE thinks might work for him and less about what has worked for others in the past (as the clinician does by referencing AA multiple times). I would also encourage the client to identify specifics of what steps he wants to take and WHEN he is committing to take these steps as a way to increase the likelihood of the change he has identified wanting to make. Generally, the things I would have done differently to improve on what the counselor in the video did would be to: use more open ended questions, asking key questions towards commitment, less interrupting, more focusing on what the client has identified as effective and elaborating on HIS options, more specific planning, writing down the action steps of the change planning so that both myself and the client have a copy to refer to, I would ask for more permission from the client before offering up educational pieces or input, and lead the conversation in a direction that would allow/encourage the client to identify more specifics regarding the change plan.
3. I imagine myself using most, if not all, of the MI strategies from this lesson in my own work with my clients. A key component of my role working with clients and supporting them with identifying their overall goals, outlining the action steps towards achieving those goals, and connecting them with supports and resources within their community they can access to work towards these goals. However, as eager as many of my clients are to achieve their goals, I see a lot of ambivalence when it comes time to address the “change” that is needed in order to work towards their identified goals. The strategies discussed in this lesson such as the SMART method will be helpful to utilize with my clients as a way to get them motivated towards the change they have identified, put them in the “driver’s seat” of that change plan, and getting them to identify for themselves what they feel would be effective-rather than feeling like they are being forced into a lifestyle change. Many of my clients are so accustomed to being told what to do or being told by providers what they SHOULD be doing… my goal is to implement more MI strategies into my work with the youth to elicit excitement, motivation, and autonomy in their lives so that they can feel in control of what they want their life to look like. I also think that by doing this (implementing these strategies), the change planning will be a lot more effective in the long run and I will be able to see my clients continuously make more progress towards their goals.