Thank you for doing a video on MI! I’m so grateful of this video!! My first day as a counselor is Monday!! I’m so excited!... and a little 😬 nervous.

This was helpful, as many clients don't have any interest in changing. I like that Dr. Grande didn't show judgement or berate the patient for her lack of insight into her substance abuse issue or desire to make any real change. I wish he had pushed her more into picturing what her life would like in 5, 10, 20 years if she continued to use as she had been using. She may have resisted, but it's an important seed to plant in my view. Thank you for posting this.

This client was really stuck. She initially was thinking the drinking and smoking isn't the problem, the DUI was the problem. She was determined to figure out how to continue to do what she wanted (using) and not have any consequences. She was not ready to face reality at all. I noticed that her thinking began to shift, or at least became opened in the end to figuring out how to get to a point of seeing the using as a problem. That would be a good place to start. Thank you Dr. Grande for the video.

I believe that motivational interviewing is a great approach when working with substance abuse clients, to help allow the clients to get past their denial and move into a direction of change. This video demonstrated a great role play of how to utilize motivational interviewing.

Dr. Grande did a great job helping the client assess her situation and the inconsistencies of her thoughts and behaviors. Ambivalence does not appear easy to work through, though it is necessary to become successful in motivating change.

Dr. Grande confronted the client with the question of if she is willing to deal with the consequences of her substance abuse since she stated that she couldn't imagine not using. This was a great way to address her ambivalence with her current issue. he continuously did this technique throughout the session which encouraged the client to think through her irrational thoughts. He also continued to summarize during the session and weigh the option of continuing her maladaptive behaviors. Ultimately, the choice was the client's and Dr. Grande was there to assist her in seeing the pros and cons of her decisions or lack thereof. There were goals set to at least the client on track toward making a change. There was no immediacy to get the client to stop using altogether but to at least consider it as an option and make small adjustments in the frequency of her usage.

During this interview, it was evident that the client was very ambivalent about wanting to change and get help, but she wasn't quite willing to give up the two things that she feels comfortable doing. It is almost as if drinking and using marijuana was her "safe haven" for her. Dr. Grande did a great idea of asking appropriate questions, more specifically "what do you lose?" speaking about why she continues to drink and use marijuana. This was to get the client to think deeper about her reasons behind her actions. This session was very beneficial for me to see how to bring to the clients awareness some of the challenges that she is struggling with. Overall, this role play was very informative to watch!

I thought that Dr. Grande did a great job exploring the client's ambivalence about her alcohol and marijuana use. I like how he made a plan with the client that met her where she was at in the process of change. I could see how motivational interviewing could be effective when working with clients who use substances.

It was evident from the beginning of the session that the client was fairly resistant to recognizing whether or not she wanted to change her behaviors with her pending D.U.I. court date. It was interesting to watch how Dr. Grande skillfully used questioning and confrontation in a nonjudgemental manner to support the client in developing goals. Dr. Grande was honest with the client when she posed her options as being quite "grim" and helped her to identify goals which were more in line with where she is currently at on the change scale; gaining motivation to change her substance use.

Thank you for posting all of these great resources!

I liked how Dr. Grande used a very non-directive approach, but was still able to implement some confrontation within the session. Dr. Grande assisted the client in exploring several different treatment options/goals due to the client's ambivalence. Dr. Grande never pushed the client to do something she was uncomfortable with; however, he did make certain to analyze the potential consequences of each of the client's potential plans of action.

To be honest, this approach seems challenging for a therapist with a client who doesn't know what she wants to change or if she wants to change.Yet, another excellent demonstration from Dr. Grande. I noticed a lot of challenging and confronting the client in this approach. A lot of questions used also. The conclusion of the session bothered me in a way because there barely seemed to be any growth.

Dr. Grande, thank you for sharing this video. I appreciate your use of the word "ambivalence" the word itself can be viewed different through different theoretical framework. Ambivalence can be viewed as a middle ground with wanting to change and not wanting to change. In this case, the client recognizes that she does not want another DUI and with Dr. Grande's help, she was able to see areas of potential change. On the other hand, the client expressed the pros of her substance use. Dr. Grande was attempting to bring awareness to the client's ambivalence and incongruent thoughts. Although change can take several sessions over a period of time, this initial session was done well in helping bring awareness to potential change.

personally, i feel that it would be challenging to use ANY form of therapy for a person who doesnt want it or want to make any change. although this was a good demonstration in the techniques of motivational interviewing, i feel it would be so much more effective with a client who wants the treatment and thinks they need it.

Working with a contemplative alcohol/substance user is clearly frustrating. Sometimes the only thing you can do is to start planting seeds. There is no point in a power struggle or pointing out the obvious, like saying, "Alcohol is making your life unmanageable don't you think?". This will only shut them down. The MI approach that Dr. Grande used seemed appropriate as it got the client at least thinking about her predicament. As she thinks about it more which with the pending court date, she will, hopefully she can come to her own conclusions that maybe she should stop at least for a little while.

Dr. Grande gave a great demonstration of helping the client through the contemplation stage of change regarding her substance use. I particularly liked when he had the client identify the pros and cons of her alcohol and cannabis use. Working through the consequences and alternative solutions for drinking and smoking appeared to really assist the client in working towards a reasonable solution to her concerns for the time being. I think teaching the client the stages of change early on allows the counselor to understand exactly where the client is on their willingness to change as this may impact the type of interventions used. Overall, MI is a great tool when working with any behavior a client wants to change whether it be substance use, weight loss, etc.

As the client came into the session, she most obviously was not interested in changing her ways. Instead, she only came to counseling in the hope that her charges would be dropped and she wouldn't have to go to rehab. During the session, I liked when Dr.Grande asked the client "How do you figure those two out" when she described the benefits and consequences to using drugs. By asking this question, he is trying to elicit ways in which the client can overcome her dilemma. What I like about this question is that the helper is using one of the core concepts of Motivational Interviewing, which is evoking change. When discussing strategies that the client could use to stop using, the helper took on a partnership role by helping the client choose what options are best for her. Also, even when the client confirmed that she was not excited about stopping her use of drugs, the counselor was extremely compassionate and accepting. Lastly, I appreciated that the counselor ended the session by asking "What can I do to help you" because it forced the client to generate her own motivations to her problems.

The client in this role play was very stuck in knowing what she should do versus what she wants to do. She made it clear that she did not want to change her ways in terms of using alcohol and marijuana, but she also does not want to get another DUI or jeopardize how she is viewed in her court hearing. The counselor was willing to have her explore how she would like to change her thinking so that she will be able to stop the use of alcohol and drugs on her own terms, rather than the counselor telling her what should do in terms of stopping the drug use.

Dr. Grande did a good job with showing unconditional positive regard towards the client even though she was difficult. He also helped the client dissect her issues with drinking and marijuana use. She did not appear to be ready to make a firm decision to quit just yet, but as counselors we will have to be willing to be of assistance through each step of a client’s process. For some, sessions like this one will be a good stepping stone for the future. Dr. Grande brought some things to her attention and she can go home and re-evaluate everything on her own time. He can’t force her to be ready anyway.

Dr. Grande- I enjoyed watching this role play as you were able to ask the client the appropriate questions using motivational interviewing. The client reported that she notes her behavior is not good but the substance use makes the client feel better. During the session, the client was not interested in changing her behavior. The client also reports that she uses marijuana and alcohol to cope with the brain injury and states that it is easier to use to not remember things. I find that the empathetic rapport between you and the client was able to help the client feel more comfortable but the client is not able to stop drinking or using marijuana.

Dr. Grande showed multiple techniques in this video that helped the client by guiding them during the clients thoughts of contemplation. I like how Dr. Grande guided the client but did not tell them what to do.

This was a video that interested me alot because I work with addiction. I liked how he tried to reflect and weigh the pro's and con's of the clients use. She was not interested in changing her habits and and use even with impending charges and consequences. When looking at options to consider the client was not interested in these so Dr. Grande asked what as the counselor, could he do to help the client and help her to identify her goals. HE also assessed clients ability to stop using and set up followup visits to discuss and work toward goals.

The client entered counseling with the idea that she could attend sessions in order to get out of any mandatory sentencing from the judge. The client expressed that she needed to make a change however, she did not want to discontinue using marijuana or alcohol because that is how she copes with her life stressors. The client was aware of the behaviors that she wanted to avoid however, she was not aware of the incongruence between the behaviors she wanted to avoid and not wanting to discontinue the use of illicit drugs. Throughout the session, Dr. Grande was able to present questions the client to determine how she was going to deal with her recent concerns. Together they were able to set goals to make changes.

The client in this video showed incongruities throughout the session of not wanting to have run-ins with law enforcement but also doesn't quit using alcohol and marijuana. She was not susceptible to change and showed no signs of wanting to until the end as Dr. Grande brought out awareness throughout the session for the client. Dr. Grande was understanding toward the client and never posed his own bias for the ambivalence the client showed for not having a desire to quit the drug use. They discussed consequences of continued use as well as goals to help the client improve her situation.

The client’s path encounters an obstacle. She must change but prefers inaction and resists examining inconvenient realities. Finding a way-in where there seem to be no doors or windows requires cat burglar-like therapeutic skill. Dr. Grande digs in to loosen the intransigence and shows purposive technique for the difficult work of persuading inertia into motion. Synopsis of this episode brought to you by...

First, I'd like to say thank you, Dr. Grande, for uploading this video. Secondly, the client really seemed resistant to changing her behaviors. It was almost as if she didn't know how to survive without using marijuana or drinking alcohol despite her DUI. Dr. Grande asked the client if she was told to completely stop using either substance as part of her treatment or she was going to receive a jail sentence, what would she do? She didn't give a clear answer. Personally, I would think that anyone would avoid jail at all costs, but I guess my theory was wrong. Overall, this technique can seem a bit challenging. Dr. Grande also confronted the client's incongruent statements appropriately.

While it seemed difficult working with this particular client due to her inconsistent thoughts or unwillingness to actually change her behavior, Dr. Grande did well to bring the clients inconsistencies into awareness, while allowing her to notice the consequences or potential outcomes of her actions such as being ordered to discontinue the use of alcohol and marijuana altogether. By providing such a reality, the client is able to truly consider how her behavior may affect her life and circumstances moving forward, therefore motivating her to make a change and limit her use to prevent further or more detrimental outcomes from occurring.

How do you prolong this for a 45min session though? Especially when they are so reluctant to change.