[Jennifer Mrozowski]

Question 1)
My general reaction to the way the physician used Mi to guide these brief conversations with the client he is serving was to implement OARS. He asked open-ended questions so he could elicit stories with meaning to better understand this individual and from that, he could identify her strengths and be able to convey empathy through his affirmations and reflective listening. Ultimately creating that Alliance. I really enjoyed how the physician started out by asking this individual to change nothing about their current behavior. Explaining that just the act of becoming more aware of when they smoke could be helpful and to write it down so it could be discussed at the next meeting. This seemed to empower this person by being given a goal that they themselves realize is a manageable task. Then the physician asked the client he was serving when they wanted to come back, giving them the option and not placing any sort of unintentional demand/expectation on them. I wouldn’t have changed anything in any of these videos.

Question 2)
The physician used open-ended questions to identify this person’s ambiance about quitting smoking as well as asked her to explain the good and the not-so-good things about smoking, gathering more of the feeling behind why they continue to smoke even though they understand and just provided reasons to quit. After The client that is being servedreturnsThey have increased their determination as well as increased their confidence because they were able to track the behavior of smoking and they saw their problem area and already had solutions for these barriers. All the time allowing the client being served to have control over their own life, raising their confidence. The physician guided this person to ensure the success of their plan by confirming the steps that will be taken and aligning with goals and a realistic time frame.

Question 3)
I really like the use of asking, listening, and informing in the third video where the physician explains how this individual has changed their behavior the setting and medication is also an option he then lists the different types of medication and asks The client for their preference and then provides the information on that item. I especially like that the physician goes into detail about all the pros and cons as well as the side effects and even more importantly ensures that this person does have support in place. Explaining that having friends and family that would be able to tell if this person was more irritable or not acting the way they normally would.

Question 4)
I plan on trying to be a better listener each day, reducing how much-unsolicited advice spews out of my mouth by remembering to ask before I offer any advice. Our company has a peer support group for the staff and we have different topics that we discuss. I feel that helps me just be able to talk with like-minded people which assists me with practicing MI just to listen and really hear their values and what’s important to them during those sessions helps me to be helpful to others and less oppressive

[Jennifer Mrozowski]

Question 1)
I thought both these videos displayed many MI skills -There were many open-ended questions affirmations summaries complex and simple reflections as well as setting specific meaningful accessible realistic timed goals with attention to potential setbacks with solutions
In the first video, the counselor displayed eliciting the consumer’s commitment 59:07-1:33:23-01:52:28
The counselor elicited activation of a plan 03:18:17-03:48:28-04:12:16
The counselor to elicit the client to formulate the steps he would take to achieve his desires-05:19:19
Video two
The counselor started offreflectingThe client’s strengths that he had mentioned prior of himself-23:07
SMART
The counselor continue to elicit talk around what steps the client would need to take in order to start the process of going to an alcoholics anonymous meeting. 01:04:15-the counselor seemed to elicit a SPECIFIC and MEANINGFUL goal. Followed by a discussion regarding How and when this next step could actually happen then a proposed actual time frame.
The counselor brought up the potential for setbacks and asked how the setbacks could be handled
03:29:27
Question 2)Changes
The part in the first video where the counselor Summaries the individual’s options leading into the discussion of alcoholics anonymous-04:47:21- I may have tried using more of an open-ended question around AA to get a better understanding of how to proceed by saying: You had mentioned earlier wanting to know what other options might be available to you, and one of those options would be Alcoholics Anonymous, I was hoping you would share any feelings/thoughts/questions you might have about this particular program. This might have been able to provide a guide on what the person values doesn’t know and want to know about this program. I also would have added some 1-10 scale questions to gauge what was more important or how committed he felt towards the options.

Question 3)
I envision using MI skills daily-I enjoy listening to others I’m not always great at it however each day is better. Really listening to someone, understanding and respecting fact that the people I serve know what’s best for them and my job is to provide support for the organization of their desires because they are worth the time.

[Jennifer Mrozowski]

Question 1)My general impression of this interview was her ability to remain neutral and guide the conversation in the direction of reasons why Jim could or should change in his own opinion and how well she was able to reflect and summarize back to him the information he provided.

Question 2)Example 1 sustained talk -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. 
Example 2 sustained talk that’s a funny thing to say. I can do just about anything but I can’t say yes to that, that I can stop drinking. I think you’re right on that one. There’s a lot of things I can do, but I’ve never tried to stop drinking, I get thinking about it, honestly.
Example 3 sustained talk-First thing they would say I probably couldn’t hold my liquor and that’s why I stopped and that ain’t true. I can out drink any of them
Example 1 change talk-I wouldn’t mind coming here to live, but I wouldn’t want to be in one of the 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.-DESIRE 
Example 2 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
Example 3 change talk-Well, I want something that will help me with the court. NEED

Question 3)The use of complex reflective listening and strategic responses allowed the interviewer to remain neutral and make sure she was understanding what Jim was saying.  Example 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.Example2 It almost sounds like you don’t even know whether you could stop even if you wanted to.

Question 4)readiness to change Example 1  Jim: Maybe not right away but somewhere down the road. Example 2 Jim: As long as I’m putting all this money into it I’d like to come out with something. The next step would be to ask the person what might be some ways they could achieve the goal of reducing/quitting drinking. Then Ask them on a scale of 1 to 10 how Sure they are that they could stop or reduce their drinking. The interviewer would ask why they chose the number they chose and not a lower number.

[Jennifer Mrozowski]

Question 1
My take on the confrontational style of interviewing was a basic power struggle between two individuals. Both individuals demonstrated that neither one of them felt heard/understood. Both of these individuals displayed agitation as their conversation progressed. The conversation appeared to be circular with no focal point or true direction, just two people trying to communicate their values/beliefs.

Sal responded with verbal assertiveness and mild agitation as the conversation progressed. Sal attempts to clarify his desire to keep his dog as well as acknowledging that the pet hair/dander may play a role in triggering his asthma.

Sal was more verbal during this encounter, his tone of voice remained calm through the session.

Sal provided more information to the provider as he told his story and he continued to stay engaged and focused. Sal took in a deep breath and exhaled when the provider reflected his emotional state of feeling like all the changes he has already accomplished wasn’t good enough,

Sal was able to move closer toward some kind of action to improve the management of his asthma when the spirit of MI was utilized. Sal felt heard, understood, and confident enough to verbalize his true desire of keeping his dog who has been a part of his life longer than his wife as well as his desire to provide his son with a best friend while acknowledging that his dog may be a contributing factor to his asthma. Since the provider displayed and verbalized to Sal that he is in control of his own life and ultimately these decisions are up to him Sal was able to verbalize how bad his asthma would have to be for him to consider getting rid of his dog.
Question 2

1). I remain pessimistic so I won’t be disappointed

2). Being pessimistic allows me to plan for the worst

3). Pessimism keeps me safe

On the other hand regarding being pessimistic:

1). I desire a more fulfilling life

2). I would like a reason to get out of bed

3). I desire friends, a better job, and a life partner

Double-sided reflections:
1). On one hand you don’t want to get your hopes up just to be let down again and another part of you dreams of a more rewarding life

2). There is a part of you that finds comfort in always having a backup plan just in case things don’t go as planned and then there is another part of you that desires forward movement with a deeper purpose

3). One part of you values the pessimistic view of the world because it allows you to remain self-reliant. While another part of you wishes to be able to connect with others and have meaningful relationships

My general reaction to this exercise is I hope I did it correctly. As I was doing the double-sided reflections I saw the core needs of wanting to be loved or love another, desiring purpose, as well as the desire to be a part of a group.

Question 3
Consumer-generated target behaviors
1) Attend school
2) Reduce alcohol consumption
3) Reduce substance use

Provider-generated target behaviors
1) Gain a greater sense of self-worth/self-respect
2) Attend school 3 days out of 5
3) Stop alcohol consumption
4) Reduce marijuana use by ¼ of current use and stop other substance use

The consumers’ target behaviors are broad while the providers are specific. MI can be used to achieve the Provider-generated target behavior 1) Gain a greater sense of self-worth/self-respect by utilizing Affirmations

MI Agenda Setting strategy can be used to gain a better understanding of what the person we are serving values. Using MI allows people to be in charge of their own life, which can provide feelings of self-worth and empowerment.

[Jennifer Mrozowski]

Happy Hi, My name is Jennifer Mrozowski and I am a children’s case manager and CIS provider. I desire to understand and utilize MI

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