Motivational Inerviewing 2 - Extra Credit Opportunity

Good evening everyone, happy July!! I hope that you have all already begun enjoying your vacation from school- I know I have!

Monica and I decided to tackle this second motivational interview together again for the purpose of further practice, and some extra credit! This was a great opportunity for the two of us to continue putting our motivational interviewing reading to practice, and gaining further exposure on what motivational interviewing looks like. This week we decided we wanted to both focus on resistance (Rosengren ch. 6). 

Disclaimer: we decided to make role play for the purpose of this assignment. All issues presented by Monica in this interview were made up in order to demonstrate what resistance can look like in a client. Monica is playing a client who I have (hypothetically) been seeing for a while. Lately she has been having issues with texting while driving. While this is something she "has always done safely", she recently almost got into a really bad accident because of it. Her parents are so frustrated with her bad habit that they have taken away her car and refuse to let her have it back until she changes her phone usage while operating a motor vehicle. 

While working with Monica, I was continuing to use some of those microskills that I wrote about in my first motivational interviewing blog post such as: open ended questions, affirmations, reflective listening, and summaries (OARS). Monica was showing great resistance stating that she should be able to have her car back because texting while driving is okay if you are safe about it. She stated that "accidents happen" and yes she knows she messed up this time, but "it will not happen again, it only happened one time". To Monica, her parents are "overreacting" and she thinks all of this is unnecessary. While asking her open ended questions, she was able to open up and state that she always wants to stay in the loop, respond to people right away, and stay up to date on social media even when she is occupied driving. She has no interest in stopping and resisted against any possible change. 

Keeping in mind that most resistance stems from a fear of change, I was very conscious about the way in which I responded to Monica. She oftentimes was presenting me with reasons upon reasons of why her behavior is not wrong. As her "therapist" this was completely frustrating (one of my setbacks to be discussed down below on areas for improvement). With my client presenting so much resistance, I found myself just resulting to reflections out of fear for saying the wrong thing. Reflecting her statements in her language was helpful, and while doing so, I also tried to remain neutral and non judgmental. 

I think for the most part, while I thought nothing was being done, Monica still received the information well. I think in her role as the client, she was appreciative of my non judgmental responses, and my reflections which demonstrated empathy and understanding. For my personal assessment, I believe I reflected well and made great use of OARS but struggled with feelings of being stuck. As previously stated, I was getting frustrated with the excuses Monica was presenting and found myself showing that outwardly. Since this was role play, I of course was able to express that to Monica as a peer and we worked through it together. I suppose this leads into my question for further consideration. My question is, when working with clients who present many excuses, do we challenge them or roll with them...or? I guess I just found myself getting really stuck at points and would love to see how others who may have felt similar navigated around this. 

Thank you!