[Dorothy Muncey]

Question 1
I thought the Dr. used the spirit of MI by using open ended questions, listening and asking her what she enjoyed and then what her goal was. She shared openly because he was nonjudgmental and caring. I feel like using MI in sessions allow clients to make their own choices in recovery.
Question 2
He used MI skillfully. He was encouraging at her progress, and he allowed her to decide how fast to go and when she wanted to start. He introduced helpful medications after asking if she would be interested and allowed her to choose. He used importance and confidence rulers, decisional balance, evoking change talk.
Question 3
The patient responded well to the use of MI. She felt supported and came back into the next session, continued to improve and continued to develop a plan and increase her confidence and her commitment.
Question 4
This was a great refresher to MI and the Spirit of MI. The new skill I have learned and to hope to continue to develop is the rediness ruler/confidence ruler. I think focusing on the positive is helpful for the client to make changes and address ambivalence. Thank you for your time and the great information. It is easy sometimes to think you are using MI, but fall into the traps of using closed ended questions and not asking if you can share information.

[Dorothy Muncey]

Question 1
My general reaction to the video’s on MI strategies was he was he did a good job getting the client to assess his need, his desire by using simple reflections and getting to his goal by using complex reflections. He did a good job getting him to commit to change. The client decided what was important to him. His use of MI was very effective in getting client to make a commitment to change and begin to plan his strategies.

Question 2
What I would have done differently is not focus so much on his commitment level. I felt that was a little awkward and seemed like he was asking several times “When are you going to do it?” I would focus on the positives to help client create a plan and list the options. Client did recognize his obstacles and he did a good job not telling him what to do and ask him if he could share some information with him. I would focus on change planning. He seemed to become a little resistant when counselor shared the possibility of residential treatment after he said he would make a referral to another counselor.
Question 3
I try to use MI in my counseling. I feel it allows the client to be heard and to make decisions without feeling like someone is telling them what to do. It takes practice, but when it works, it works well.

[Dorothy Muncey]

My general impression of the interview is the interviewer did a great job staying on topic and not challenging him with his ambivalence. She guided him to make change talk skillfully.
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 sustained talk,, ,”It’s not because I want to do any of this crap.” “Yeah, the court sent me here.”
Examples of change talk…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. Reason . As long as I’m putting all this money into it, I’d like to come out with something. Need
Complex reflective listening…So the fact that your daughter won’t even take your word for the fact that you won’t drink kind of bites at you a little bit. This puts her on his side. It allows his to share more with her. Another example Kind of a mystery to you why she’d even be worried about that. He begins to share more and feels more comfortable.
Examples of signs of readiness…”This treatment center thing-is that here at this facility?” and “I wouldn’t mind coming here to live” I would allow client to decide what kind of treatment he wanted and listen to what he wanted to get out of treatment. I would continue to engage him in the process to help him get his needs met.

[Dorothy Muncey]

Question 1

My reaction to the confrontational style was “Please make it stop, It was so uncomfortable and she did not give him a chance to say how he felt about anything. She put all her effort into telling him what to do and not listening to him. The MI approach was much more focused on his needs and how he was feeling. He knew what the problems were, but it allowed him to make choices without being told what to do. He became more thoughtful and more relaxed and more open to make changes.
Question 2

A behavior I feel two ways about is exercise in exercise. 1) I don’t have time for it. 2) Does it really help, I am pretty active during the day. 3) I have never really had a problem with my weight before, I’m not sure it will help. Double sided reflection, “I know I need to do it because when I do make time for it I feel better.” “My clothes do fit a little better when I exercise even though I don’t lose any weight, I must be getting healthier.” Maybe I shouldn’t’ wait till I have a health problem to start exercising.” MI allows someone to make their own decisions and decide for themselves the change they need and being told what to do creates defenses. (and then we do nothing)
Question 3
.Target behaviors are usually 1) giving up alcohol 2) changing friends 3) relationship issues I fight the righting reflex when a client asked me “what should I do” and they seem to really want answers. They become a little uncomfortable at first and then settle in to reflect on their own questions. Sometimes it feels just easier to give the answers because we might, as clinicians, “know best” and Thinking they are coming to us for help, but resist. I love that you are calling it the “SPIRIT OF MI” I think that feels more relaxed and thoughtful. Listening gives the client time to reflect. Alot of people I talk to are always being told what to do and at first this approach seems foreign to them and a little uncomfortable, but quickly settle in to be allowed to make their own choices and decisions.

[Dorothy Muncey]

Hi, My name is Dot Muncey and I am an LADC currently working in a 16 Bed Substance Use Rehab. I am new to Residential Treatment working my entire 22 year career as a counselor in Out Patient treatment. I am looking for a refresh in the art of MI. I look forward to this class.

[Dorothy Muncey]

Question 1
I noticed urge surfing was difficult. Focusing on an impulse was interesting because I wanted to move my head and neck like I usually do during meditation. I was uncomfortable at first, but then began to focus. I feel that learning this would take practice and clients would have to be highly motivated to see results.

Question 2
I chose Thought Diffusion because I am a visual person and found it relaxing to visualize something familiar. Leaves floating down the stream was relaxing and easy to visualize negative thoughts or emotions on the leaves and floating away. I believe this would be easy for clients to learn to relax and focus on self and positive thoughts. This allowed me to connect with nature while focusing on myself and feel it would also allow clients to relax and let go of negative feelings.

Question 3
The past four week have been insightful and enlightening. I enjoyed learning new and some review of mindfulness. Guided meditations are a great way to start your day or to take a break and focus on positive and let go of negative. Clients and everyone really could benefit from learning at least one of these meditations. Substance use clients would benefit when having cravings or a stressful situation. Learning to focus on something positive and not on the craving.

[Dorothy Muncey]

Question 1
Soft belly exercise was great because it allows you to focus on the beath.
The focus on the breath and the belly allows for a place to focus for beginners. Breathing in through the nose and out the mouth is not natural for most people unless they do yoga or palates. We do not breathe deeply enough, and the guided meditation focuses on the how and why. Easy to follow allowing you to relax and focus on self.

Question 2
This exercise also was very easy to follow, and the repeat of the phrase was helpful. I feel I forget to breathe if it is not repeated, and the phase repeated keeps focus. I also did like the guide that says, “this is an invitation” This is a choice for the participant and myself to open up to relax. This would be easy for beginners to focus on themselves be less judgmental and allow for change.

Question 3
In my work with Substance Use clients, we start every morning with a Mindfulness meditation. (I am thankful for this class as it has confirmed to me what I have been doing is what is being taught…a nice review) I feel it is a great way to start the day. I have noticed in the beginning all areas were difficult and breathing in through the nose and out through the mouth made new participants ‘dizzy’ but after a few days becomes normal and focus is extended. Having options to focus on is important to mix up the mindfulness exercise and participants can take turns leading and feel empowered.

[Dorothy Muncey]

Question 1
I have practiced yoga for years so noticing my breath is a natural experience. This allowed me to focus on each body part. This is effective to allow the mind to focus and the continued movement of the breath allows the mind to focus on movement and the breath.

Question 2
Focusing on one object was challenging in the beginning, it began to get easier with the touch. It became more real and easier to focus when touching it. I wondered if it was like having something in your pocket to remind you of something. My mind did wander with the visual part, but not when I had sense of touch.

Question 3
How would you envision adapting and integrating the Lying Down/Body Scan Meditation and/or the Focusing on a Single Object into your clinical work with people with substance use or mental disorders? Be specific. Both exercises appear to be beneficial to help clients focus but probably space would limit the ability to have clients lie down. Focusing on an object to describe it would work in almost any situation. This is a good tool for clients to master to allow the mind to focus. This would be invaluable in someone with a substance use disorder when faced with cravings or making a decision to use or not.

[Dorothy Muncey]

Question 1
Physically counting my breaths, I noticed I was more focused on counting than breathing. It did take my mind off my thoughts and allowed me to stay focused. I think this would be a good/valuable tool to introduce people to meditation and might remind some of the counting to 10 of calming down.

Question 2
Focusing on your breath did allow me to relax more and to guide my thoughts back to my breath. My mind does wander and breathing focus brings it back. I think this might be because I do practice yoga and was familiar with this technique. My yoga instructor says this is the easiest to do, but the hardest to master.

Question 3

Both were very similar with the sitting comfortably, finding a relaxed position with hands and body, but the difference was what to focus on. Introduction might be with the counting and then focus on guiding mind with the breath.

[Dorothy Muncey]

Hi, My name is Dot Muncey and I am a LADC currently working in an inpatient residential setting. I am looking forward to this class. I believe Mindfulness work is helpful in recovery.

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