Reply To: Week 4 Homework Assignment (Applications of MI)

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Liz Riddell

1). The doctor was really listening intently, interjecting at appropriate times with reflections and summarizing of what the client was saying. It felt, at times that she was really driving the session and coming to her own decisions quickly. I wouldn’t change anything other than I might use a visual for the scales so that when she identifies where she is on the scale she can actually see it.

2) He used alot of open ended questions (which I liked), often reflecting and summarizing (to be sure he was clear on what she was saying) what she was saying back to her, showing that he was indeed listening to all of what she was saying. By asking her what her thoughts were on the “good” reasons for smoking and the “not so good” reasons, she was really able to come to breaking down her ambivalence and gain more confidence in her ability to identify what she felt confident she would work on and put things in motion for herself. He always kept the conversation focused on her and did not act like he was the “expert” and tell her what she needed to do.

3) He revisited her confidence level asking her where she thought she was now vs. where she was when she first identified her confidence level. By reviewing all the of the steps she has already taken and continue to use, he is listening to what she is saying and can then offer her more options, when the topic of medications comes up he is able to provide her with thorough information about what the options entail so that she comes to the the determination which option she feels is best for her and is willing to try. The “patient” is very responsive and seemed more ready at each session, coming into the last session (video) already having her goal in mind and how she was going to work toward that.

4) I am not a therapist, and since my job is Intake and gathering information I unfortunately don’t get to spend much time with the people I get to meet with. I would take more time in my initial (and only) meeting with people to support them in identifying the goals they want to work on and why they want to work on them by listening a bit longer, using more reflection and summarizing (which is something I don’t do enough of) and asking more clarifying questions when needed. Since I do like the use of scaling, I can use that more in my intake with people.

I do feel like alot of what is used in MI coincides with the psychosocial model of working with people, keeping it client centered at all times is very important so that the client does not feel like it’s the goal of the provider and not their own goal. I also feel that revisiting the positive changes (no matter how small) is also good to review with the client to keep the momentum of change going.