Week 2 Homework Assignment (Applications of MI)

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  • #24416
    Nichole Proulx-King
    Participant

    Question 1
    What are your general impressions of and reactions to the MI interview of Terry Moyers and the “Rounder?
    In general, Terry does a great job assessing Rounder’s readiness for change as well as understanding what is maintaining his resistance to change. Rounder is ambivalent about changing and somewhat angry when he first arrives. Terry responds calmly and really meets Rounder where he is at. She effectively reflects what he is stating in a way that helps Rounder consider whether or not he even wants to change.

    Question 2
    Give two or three examples of Rounder’s sustain talk and two or three examples of Rounder’s change talk, and identify whether each is a Desire, Ability, Reason, Need, or Commitment, Activation, or Taking Steps type of change talk.
    Sustain Talk:
    Example 1: “People keep saying that you need to stop drinking and I ain’t never done that either. I think I could. I’ve tried a couple of times and I wasn’t very… I think one time I quit for a week or two just to show people I could stop drinking. I wasn’t too happy. Really I didn’t know why in the hell I stopped anyway.” This is an example of Ability.
    Example 2: “When I get really angry. I don’t have to go slap somebody around. I used to, now. When I was younger I’d go over to somebody that upset me or irritate me and I’d take it to ‘em but since I’ve gotten older I kinda have a couple or 3 or 4 beers, kinda cool down a little bit.” This is an example of Reason.
    Change Talk:
    Example 1: “I 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 is an example of Activation.
    Example 2: “Yeah. Cause, if I get out of this, if I can save my house and my job I’d better do something that’s gonna keep me from doing this again, don’t you think?” This is an example of Need.
    Example 3: “You know there was another thing I was thinking about. If I don’t stop drinking I’m probably going to be right back in this mess again.” This is an example of Reason.

    Question 3
    Give two or three examples of the interviewer’s use of complex reflective listening and strategic responses to Rounder’s sustain talk. What impact does the interviewer’s use of complex reflective listening and strategic responses have on Rounder’s sustain talk and change talk? Be specific and elaborate.
    Example 1: “This accident is what caused you to have to come in here and got you in all that trouble at work and now they’re thinking about taking your driver’s license away and that’s why you gotta come here.”
    Example 2: “ It sounds like if you look ahead take look at your drinking and see where you’re going to go with that, you’re kind of worried about that.”
    Each of these examples have a significant impact on Rounder’s sustain and change talk. The way she frames these make it sound like Rounder is the one suggesting he has the problem and that he is choosing do something about it. In the first example, Terri puts the blame on the accident causing him to have to come in and she never tells Rounder that the accident was his fault. She validates his statements about the accident and how he is feeling and this helps to move him further into change talk. In the second example, she inserts a feeling into her reflection to help him understand that his his response is worry about what may happen and that this is normal.

    Question 4
    Give two or three examples of Rounder’s signs of readiness to change. If you were interviewing Rounder and you noticed these signs of readiness to change, what would your next step be in this interview? Be specific and elaborate.
    Rounder begins to ask questions about what it would be like to live at the facility. He is showing signs of contemplation in asking these questions. Rounder also begins to identify that he does not want any further consequences from his drinking. Again he is starting to contemplate what it may be like to change these behaviors. The next step in this interview would be to continue to highlight Rounder’s ambivalence and then start asking questions that may move Rounder into the Preparation phase of change.

    #24417
    Betsey Davis
    Participant

    Question 1
    What are your general impressions of and reactions to the MI interview of Terry Moyers and the “Rounder?”
    I was impressed by how respectful this discussion went. He entered therapy highly distressed and resistant and they were able to join fairly quickly which deflated his negative emotions and moved the discussion into a more productive arena. She was respectful and able to empathize despite his sustaining talk. The counselor made it look so very easy. This is a good example of why it is so important to have these skills.
    Question 2
    Give two or three examples of Rounder’s sustain talk and two or three examples of Rounder’s change talk, and identify whether each is a Desire, Ability, Reason, Need, or Commitment, Activation, or Taking Steps type of change talk.
    Examples of sustain talk:
    1) ” . . . the only reason I’m coming here is so I can maybe save my driver’s license so I won’t lose my job and so I won’t lose my house. It’s not because I want to do any of this crap you know.” –Reason
    2) “It almost sounds like you don’t even know whether you could stop even if you wanted to”—Ability

    Examples of change talk:
    1) “People keep saying that you need to stop drinking and I ain’t never done that either. I think I could. I’ve tried a couple of times and I wasn’t very. . .”—Ability
    2) “My wife had to come bail me out several times. It got pretty costly doing that. Even though I enjoyed it, it was kinds. . . .it got a little bit costly, I got a bad name in town, things like that”-Reason
    3) “I want something that will help me with court. . . As long as I’m putting all this money into it I’d like to come out with something.”—Desire
    4) “Yeah. Cause if I get out of this, if I can save my house and my hob, I’d better do something that’s gonna keep me from doing this again, don’t you think?”—Need, Activation
    Question 3
    Give two or three examples of the interviewer’s use of complex reflective listening and strategic responses to Rounder’s sustain talk. What impact does the interviewer’s use of complex reflective listening and strategic responses have on Rounder’s sustain talk and change talk? Be specific and elaborate.
    Complex reflective listening/strategic examples–impact:
    1) “So it’s confusing to you why your drinking should cause a problem or everybody should be talking about that when you look around and you see that other people drink more than you do.”—This statement seemed to validate what client was saying, seemed to make him feel understood and helped deepen client’s thinking. It helped shift his thinking some, increasing discrepancy.

    2) “It almost sounds like you don’t even know whether you could stop even if you wanted to.”—This strategic response of aligning with the client’s sustained talk which he began to explore more. He responded with, “I get thinking about it. Honestly”.

    3) “So you’re kind of wondering what it would even be like here.”—This strategic response helped address client’s feelings of uncertainty so that he could address them and talk about them, thereby making treatment more of a possibility—something he might be able to do.
    Question 4
    Give two or three examples of Rounder’s signs of readiness to change. If you were interviewing Rounder and you noticed these signs of readiness to change, what would your next step be in this interview? Be specific and elaborate.
    Examples of signs of readiness for change:
    1) Rounder said, “I don’t know that its true but you might say that.”—This seemed to be one of the first times in the interview that the client verbalized he may not be right about his interpretation of his situation, the first crack in the armor so to speak.

    I would ask him to elaborate on that, say more about this. I’d try to get him to be specific in how maybe his drinking wasn’t harmless. I’d ask him for times in his life where it was problematic or it didn’t help move him closer to his goals.

    2) Client stated: ”You couldn’t give me an answer and I can’t give you one, so that’s just kinda. . .That’s a hard thing. Maybe that’s something I need to think about before I even do any of this stuff that you’re or they’re talking about.”

    I’d want to explore with him what alternatives may look like to help him envision other possibilities for his friendships with his drinking buddies or if he knew of anyone who had stopped drinking and how his friends responded to it. How he may have responded if someone in his life made that change.

    3) “I wouldn’t mind coming her to live, but I wouldn’t want to be in one of them places where you sit around din pajamas a bunch of longhaired hippie types crying and bitching and stuff like that. That ain’t my style you know.” At this point in the interviewing, client was asking lots of questions with a lot of energy. He seemed to be moving closer to a resolution of what he wanted or think he may be able to do.

    Again, he is trying to envision what treatment could or would look like and how he could fit into it successfully. I would steer the conversation more toward what he could see himself doing, what he may find helpful, etc. I would then ask him what he wanted to see the next step be and what he felt he wanted to do.

    #25478
    April Sawyer
    Participant

    Question 1
    What are your general impressions of and reactions to the MI interview of Terry Moyers and the “Rounder?”
    Terri does a good job rolling with resistance and meeting the client where he is at. Jim moves from resistant to ambivalence and ultimately to change talk through Terri’s reflective listening and strategic responses. Terri was respectful to her client and did not demonstrate a stance on the subject at hand which allowed for Jim to be open to the conversation and not feel the need to be defensive.
    Question 2
    Give two or three examples of Rounder’s sustain talk and two or three examples of Rounder’s change talk, and identify whether each is a Desire, Ability, Reason, Need, or Commitment, Activation, or Taking Steps type of change talk.
    Sustain talk, Desire, “I’m not real happy about being here. I hope you understand that”
    Sustain talk, Need, “the only reason I’m coming here is so I can maybe save my driver’s license so I won’t lose my job and so I won’t lose my house. It’s not because I want to do any of this crap you know”.
    Sustain talk, reason, “I’m not motivated to be here or anything, but I don’t like any of this I’ll be honest with you. It’s taking a lot of time that I don’t have. Its taking of money I don’t have for the court and the fines and all this stuff.
    Change talk, ability, “I 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”.
    Change talk, reason, “You know there was another thing I was thinking about. If I don’t stop drinking I’m probably going to be right back in this mess again”.
    Change talk, activation, “As long as I’m putting all this money into it I’d like to come out with something.”
    Question 3
    Give two or three examples of the interviewer’s use of complex reflective listening and strategic responses to Rounder’s sustain talk. What impact does the interviewer’s use of complex reflective listening and strategic responses have on Rounder’s sustain talk and change talk? Be specific and elaborate.
    “So it seems to you like I might try to push you around and make you do a whole bunch of things you don’t want to do”.
    “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?”
    “It almost sounds like you don’t even know whether you could stop even if you wanted to”.
    Terri’s reflective listening and strategic responses allowed Jim to remain active in the conversation as he did not feel the need to defend himself or his thoughts. Jim was able to move from sustaining, to ambivalence to change talk by talking his way through the different questions that Terri posed on the subject at hand.
    Question 4
    Give two or three examples of Rounder’s signs of readiness to change. If you were interviewing Rounder and you noticed these signs of readiness to change, what would your next step be in this interview? Be specific and elaborate.
    A sign of Jim’s readiness for change is when Jim started asking questions about the treatment center and showed interest in the possibility Jim asking questions about the treatment center. Jim was no longer just checking the box for what he was court ordered to do he was looking at options.
    Another sign of Jim’s willingness to change was when he started to want to get something out of the experience. Jim expressed that he was spending time/money of the treatment he should get the benefit of what he is paying for.
    Another sign of Jim’s willingness to change is his thinking about the future and acknowledging that if he does not change his drinking he will be in a similar situation. Jim’s recognition that his drinking has caused this incident and will likely cause another is signs that he has accepted that his drinking is a behavior that he needed to change

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