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

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thomas barrett

Question #1

My reaction was the counselor did not seem genuine . His laugh seemed artificial and extended.
The therapist either interrupted or cut off the patient several times especially when the client was obviously going to expand on what he was saying. The therapist never apologized or offered the client to continue.
The therapist offered expert advice and or education without seeking or inquiring into the clients ideas.
The clinician offered expert advice on the response of the friend the client had in AA when he had no idea what would happen or any information on the individual the patient was thinking about.
The therapist kept asking questions when the client was talking especially in the sequence about the game planning.
The counselor was effective in helping change planning ideas but was too quick to jump in with his own ideas.
The counselor kept the change talk going forward effectively and kept the patient on task with change talk but did not be as specific as I thought he should be.

Question # 2

I would use reflection on what the client was speaking as a way to encourage ideas the client was thinking making it more of a collaboration and further engaging the client.
I would avoid interrupting the client and allow for more time for the client to finish his thoughts thus opening up the way for further exploration of his ideas.
I would use reflection and open ended questions to further explore the AA talk which may have allowed for further discussion on the religious aspect of AA to come from the client and not the therapist.
I would explore his readiness to change and have been more specific and explore specifically how that would look, his motivation and more of a timetable of when this would begin.
In summary I would have used much more collaboration with the client instead of sounding like the expert although he did kkep things on task.

Question #3

I have begun using this work in my practice. We began by exploring the readiness to change and rating their desire on a 1-10 scale. I followed up with open ended questions as to why it was not a 5 and why it was not a 10 . It was effective and opened the door to much more information useful in the change planning.
Through open ended questions and reflection we reviewed past efforts to stop drinking and discussed the stage of change of relapse . It was especially helpful reframing her idea of failure and relapse and again open the door to more information from the client feeling like a collaboration. It also was effective.
Through collaboration and with the information provided we worked on the idea of change planning and structure of what that change would look like through the clients eyes.
This allowed a natural sequence to begin being specific as to timing the client had in mind again through collaboration and reflection.
I was very aware of allowing the client time to process the open ended questions and was really surprised at the amount of time she took before answering often thinking she was not going to answer which she always did.
Double sided reflection, understanding the process of change ,setting some specific time goals by the client and being mindful of a collaboration was very effective.
I was really surprised in the response and engagement of the client when through collaboration and reflection allowing her to develop her ideas.