Motivational Interviewing

 I know I always start my journals like this but I really did enjoy the readings this week. I have read a little bit about MI and have heard it referred to many times. Like the articles pointed out, I feel into the norm of people that viewed MI as a therapeutic tool rather than a framework. After reading, I would agree that some of the foundational beliefs and perspectives can influence the whole course of treatment and not just be implemented during MI. However, I think MI would need to be expanded (both in research and in therapeutic tools) before I would consider it theoretic perspective that I base my work off of. William Miller points out in his article that MI often overlaps with additional frameworks. I have seen a lot of overlap with the Unified Protocol and MI and could see how they would align in conceptualization and treatment planning. Based on last week's readings as well, I think MI and emotion focused therapy would align well. 

Miller describes four assumptions that underline MI as a psychotherapy that I found interesting. I would agree that humans have the capacity to grow and change in a positive direction. I don't think I would be able to work in corrections if I didn't think that ALL people are capable of change and grow into a more positive version of themselves. I think this could be challenging to get some client's to agree with, but I think deep down we all know that we are capable of bettering ourselves. I also agree that we can make choices and decisions. I think we can use heredity and environmental components to explain behavior, but we ultimately have a responsibility to change them if they are dysfunctional. It is not necessary someone's fault for being criminally involved, depressed, or bipolar, but they do have the autonomy to change the direction that their life is moving. I think developing a strong sense of autonomy with justice-involved people can be very healing as many within this population feel powerless, ashamed, and as if they will amount to nothing. I am neutral about the third point of autonomy (ironic I know)- I would say that I agree but I don't have a strong connection or disconnection to this component. I do think that language (the fourth point) is very important and holds a lot of power. I think the words we speak have meaning and purpose. I would need to be cautious to not get so caught up in speech, but I do think it can shed light on the "internal process" as Miller puts it. 

I also liked the expressions of deep empathy that were discussed in Neukrug's article. Even though the six responses are simple reflections, I think they can be very powerful and help a client' work toward their goals. I commonly reflect deeper meanings and point out discrepancies and I think they help me better understand the client and client better understands themselves. I didn't know that visual imagery was a component of any therapy (therapy that is somewhat legit at least). I often find myself getting mental images while client's (and nonclients) speak, but I don't often express them. I would be interested to see how related the visuals I come up with are to the client's understanding of the situation. I do think analogies and metaphors are useful tools as well because they can apply to a wide array of situations and be carried throughout sessions. I don't know if I would use the self disclosure component very often. I could see clients hating it and feeling that they are responsible for making me feel bad/sad/ whatever it is. Additionally, in corrections, I think it is best to not let some of the client's know that they can make me feel a certain way.  When client's may be intentionally manipulating you, I think it is best to not give them much to work with. 

My last thoughts were more research oriented than clinically. The articles often refer to treatment studies and the effectiveness of treatment and MI. I have recently worked on a couple of projects that focus on treatment progression rather than treatment effectiveness alone. Rather than just saying that the treatment worked, we are able to know at what point people made the most progress, how males and females progress though treatment differently, and how severity of mental illness can impact at what points treatment is effective. I think some studies that were refereed to used similar designs, but I think designs like this can provide a lot of useful information that just looking at the effects don't. I also thought about the relationship between mindfulness and poverty. Miller discusses how a focus on living in the present and short term gain are components of mindfulness and substance use. People who live in poverty tend to think in the short term and focus on the immediate future whereas those in the middle class tend to be very future oriented and those in the upper class tend to be past oriented (e.g., family names).  I don't really have a specific question in mind, but I just wonder how mindfulness would interact with socioeconomic status, specifically poverty. Miller does make an important distinction thought between mindfulness and pathognomonic of substance use- values. 

Like I said at the beginning, I really enjoyed the readings and I can see myself implementing MI as a therapeutic tool and in my conceptualization of clients. 

25/25