Good afternoon, everyone! For this third motivational interview practice, Monica and I decided we wanted to take a closer look at ambivalence, which is the focus of chapter eight in Rosengren. For the purpose of my own practice, we decided that Monica would continue to role play her character from our second motivational interviewing practice. To refresh, this “client” Monica presented was showing great distress following a serious incident. This incident was in relation to her habit of texting while driving, and resulted in her parents taking her car away until she commits to changing her bad habit of excessive phone usage while operating a motor vehicle.
In our second session, Monica stated that she did not think her phone usage was a problem and she is normally quite careful- with the exception of this incident that almost resulted in a serious accident. She was presenting a great amount of resistance when it came to talk about potential change.
As the counselor, I took this opportunity to practice “picking the flowers” with Monica. This was a hard task to take on and one I was fairly confused about while reading. I chose to focus on this aspect alone in order to gain a better understanding of it. While Monica was talking about all the reasons she should get her car back, and why texting while driving is “not that big of a deal”, I was listening and selecting elements that focus on change in order to further reinforce it. The above statement Monica made was a great example. She stated that she knew texting while driving “can be dangerous”. I took this statement as an element of possible change due to her knowledge of the dangers. Statements along those lines were made frequently by Monica and I chose to focus further on those specific elements.
I was listening intently to what my client was presenting and from what she was stating, I figured I would target reflective listening and provide Monica with some double-sided reflections. An example of a double sided reflection I used was: “I hear you say that you value staying connected with people, and being accessible to them is important for you, yet you know that texting while driving is dangerous and in order to get your car back, that habit needs to change.”
I believe that this information was received well by Monica. She seemed to really think long and hard when she was presented with a double-sided reflection. Hearing what she was saying to me repeated back to her in my own words was helpful for her. Monica stated that she was better able to see her contradiction when she heard me say it, and was able to name her ambivalence without me actually saying it out right.
No questions for further consideration.
In our second session, Monica stated that she did not think her phone usage was a problem and she is normally quite careful- with the exception of this incident that almost resulted in a serious accident. She was presenting a great amount of resistance when it came to talk about potential change.
In this third session, Monica was presenting a high level of ambivalence and went back in forth in her statements. “I know texting while driving can be dangerous .. but sometimes you still have to communicate with people, you know? Staying connected is SO important to me.” This is only one of many statements Monica expressed during our session together. One thing I observed was that Monica demonstrated knowledge of the dangers of texting while driving, but also truly believes it is okay if it is done carefully. At the end of the day she was aware this habit needs to change if she wants her car back.
As the counselor, I took this opportunity to practice “picking the flowers” with Monica. This was a hard task to take on and one I was fairly confused about while reading. I chose to focus on this aspect alone in order to gain a better understanding of it. While Monica was talking about all the reasons she should get her car back, and why texting while driving is “not that big of a deal”, I was listening and selecting elements that focus on change in order to further reinforce it. The above statement Monica made was a great example. She stated that she knew texting while driving “can be dangerous”. I took this statement as an element of possible change due to her knowledge of the dangers. Statements along those lines were made frequently by Monica and I chose to focus further on those specific elements.
I was listening intently to what my client was presenting and from what she was stating, I figured I would target reflective listening and provide Monica with some double-sided reflections. An example of a double sided reflection I used was: “I hear you say that you value staying connected with people, and being accessible to them is important for you, yet you know that texting while driving is dangerous and in order to get your car back, that habit needs to change.”
I believe that this information was received well by Monica. She seemed to really think long and hard when she was presented with a double-sided reflection. Hearing what she was saying to me repeated back to her in my own words was helpful for her. Monica stated that she was better able to see her contradiction when she heard me say it, and was able to name her ambivalence without me actually saying it out right.
Again, I think I did a great job with reflective listening, and being genuine with her, but I feel I struggled with this particular task I chose. Going into our meeting, I knew I was not confident in this practice, which is why I chose to focus on it (scary, but that’s what these practice sessions are for right?). I wanted to struggle through this, in order to better learn it :). Monica was so helpful in this session with me and I expressed to her my lack of understanding of “picking flowers” and together we navigated around what this looks like. Overall it was a great session and the fact that we focused on different areas of working with ambivalence was helpful in greater review of the chapter!
No questions for further consideration.
Jocelyn,
ReplyDeleteThanks for working on that particular way to address ambivalence. I agree that double-sided reflection worked well and I think I will atttempt some of that with my difficult clients. I wonder if adolescents will be as insightful regarding it as Monica was as I am finding ambivalence to be a consistent trait among many of my adolescent clients. I have to ask only because during a session I have had this thought run through my head but when you first hear the ambivalence is it hard to refrain from saying... “There has to be SOMETHING that is meaningful enough to you that it can motivate you?” I never say it as I know it is my job to help the figure these things out but after hearing I don’t care and it does not matter a half dozen times in one session you really start to wonder if you will ever get through.
Lisa
Hi Lisa!
DeleteYes, hearing "I don't know" a million times is frustrating I am sure! As you know I am not yet working with clients but will be soon and I appreciate your connection to the practice we are doing here in class and to your work with your clients. I think that double sided reflection would be a great thing to start implementing with your "difficult" clients as it presents them with an opportunity to agree or disagree opposed to simply saying they do not know. Perhaps it would be especially helpful with adolescents if you are using their terminology! There is something powerful about hearing what we say reflected back to us- it gives us an opportunity to hear it as a listener instead of hearing it as the talker.. if that makes sense lol. It is truly a different experience, and I would love to hear more about the work that you are doing with your clients!
Thanks for reading and reaching out!
Jocelyn