1. I did enjoy listening to this conversation and appreciate the practical application of the material. It is, of course, always different to hear a conversation between a client and provider, rather than reading examples. This helps to tie it in and provide insight into when to use reflections and how to embody the goals of MI in work. Jim came in with a lot of sustain talk, and the provider was really understanding of that. When Jim challenged her about giving up her job, she replied that she understood how hard that would be for her, and therefore for him to give up drinking as well.
Sustain Talk: ”
Yeah I’ll be honest with you. There’s no need in me lying to you because you know unless you go down and tell the court that you know I’m not motivated to be here or anything, but I don’t like any of this I’ll be honest with you.”
“Yeah. And I’m about up to here with this kind of stuff. I hope you know that.
It probably isn’t your fault but that’s just kind of the way things have been going, you know.”
” wouldn’t mind coming here to live, but I wouldn’t want to be in one of them places where you sit around in pajamas a bunch of longhaired hippie types crying and bitching and stuff like that. That ain’t my style you know.” This almost seems like a commitment, but it may be desire.
“As long as I’m putting all this money into it I’d like to come out with something.” (Reason)
3. The interviewer uses complex reflections quite a bit based off of the statements Jim is saying. My favorite example is at the end, when Jim is starting to say that he feels torn about wanting to change, but not wanting to give up friendships and his way of life. The interviewer restates this to him, and it seems that this is a turning point for Jim. It is here that he admits he feels two ways about it, which the interviewer also states back to him.
“Well let me ask you this. Since you’ve been forced to come here and since you’re feeling like everyone’s kind of pecking on you like a crow, there’s a bunch of crows flying around pecking on you about this thing about your drinking…What would you like to do with the time that you spend with me here? What would be helpful for you?”
In this quote, I really liked how the interviewer used Jim’s own language to restate it back to him, while also stating out loud some of the undertones of Jim’s language. This allowed for honesty and openness, and shows Jim that he is not being judged in this space.
4.The first sign of change that I saw was when Terri asked him if he even could give up drinking. This led Jim to talk about his strengths and he seemed to gain a sense of accomplishment there. He has done hard things in the past and been successful, such as giving up fighting with others. He is reminded of how capable he is and there is a sense of pride restored to him. From here, I would continue with complex reflections, and possibly even add a twist if we hit more sustain talk. The next example of change talk that I saw was when Jim discussed court. Jim has a need to keep his license and job, which helps his desire to talk with Terri. This is an initial area that allows Jim to think about treatment.