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MIE8299 - SECTION IX- PRACTICE EXERCISE KEY

PRACTICE EXERCISE # 1 (KEY)

 

Recognizing Change Talk

 

Instructions: Read the following client utterance and identify statements and/or inferences of change talk.  After you have identified that change talk exists, identify it as preparatory or commitment language.  Finally, create a list of three responses the Clinician might use to evoke additional change talk.

 

  1. “I have never had a drinking problem, I have always been able to go to work and provide for my family. If it wasn’t for my wife nagging me, I wouldn’t have come here today.”

Change Talk

 

Reason- The client came in today because of his wife.

 

Circle One:

Mobilizing

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “Your relationship with your wife is really important to you.” (Reflecting Values)
  2. “There are absolutely no problems that have resulted from your drinking.” (Amplified Reflection)
  3. “On one hand you don’t see your drinking as a problem and on the other hand your wife seems to see it differently.” (Double-sided reflection)

 

  1. “I tried the stuff we talked about last week to calm down. My anger just consumes me and there is nothing that will help.”

Change Talk

 

“I tried the stuff…”- commitment, taking steps

**The client’s presence at today’s interaction, despite poor results the previous week might be evidence that there is a desire to make change. **

 

Circle One:

Activating/Mobilizing

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “You are not going to take no for an answer. When you put your mind to something, you see it through no matter how difficult it is.” (Affirmation)
  2. “Even though you did not have the success you hoped for last week, you are back here today looking to try something new.” (Finishing the paragraph)
  3. “On one hand you are feeling discouraged, as though nothing will work and on the other hand you recognize that something has to change and you are ready to keep working.” (Double-sided reflection)

 

  1. “I know that I have to do something different and that eventually something has to give. I just don’t think this is the right time.”

Change Talk

“I know I have to do something different.”  (Need)

 

Circle One:

Mobilizing

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “Something has to change.” (Simple Reflection)
  2. “Imagine that you and I were meeting again in twelve months. Imagine that at that time you have not yet made any changes. Tell me what things would look like.” (Projective Question)
  3. “This does not feel like the right time and yet you know something has to change.” (Double-sided reflection)

 

  1. “I want to be able to just go to bed at night and wake up the next day fully rested. These nightmares have become a real problem for me and it doesn’t seem like anything is helping to reduce them.”

Change Talk

“I want to be able to just go to bed at night and wake up…” (Desire)

**It can be assumed that the client has taken steps based on the statement that “it doesn’t seem like anything is helping to reduce them.” **

 

Circle One:

Activating/Mobilizing

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “It is extremely frustrating to go through the day without a full night’s rest.” (Reflecting Affect)
  2. “Getting a good night’s sleep is necessary as being able to perform well at all your daily tasks is important to you. “(Reflecting Values)
  3. “You haven’t found the right solution yet, but you are back here today looking for some new options.” (Finishing the paragraph)

 

 

  1. “I know I can do this if I tried, I have kept my cholesterol low in the past.”

Change Talk

**The whole statement has change talk**

 

Circle One:

Activating

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “You have done this before and you are thinking that there is nothing to stop me from doing this again.” (Finishing the paragraph)
  2. “Based on your past success with lowering cholesterol, there is no reason to think you cannot do it again.” (Affirmation)
  3. “Tell me about how you were able to keep your cholesterol low in the past.” (Open-Ended Question

 

  1. “I do not want this marriage to end like the last one and I know if I don’t do something different about my drinking, it will.”

Change Talk

“I do not want this marriage to end.” (Reason, Need)

 

Circle One:

Activating

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “Your marriage is very important to you.” (Reflecting Values)
  2. “You are terrified that this marriage will end up like that last one if you do not do something different about your drinking.” (Reflecting Affect)
  3. “Something really has to change.” (Simple Reflection)

 

  1. “I hate taking all of these medications. Yes, some of them help with my mood but they also have such awful side effects. If there was something that helped with my mood but didn’t make me gain weight, feel apathetic, or feel nauseous of course I would be open to it.”

Change Talk

“Some of them help with my mood” (Reason)

 

Circle One:

Activating

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “On one hand you really do not like what these medications can cause in terms of side effects and on the other hand you know they are really beneficial to you.” (Double-sided reflection)
  2. “You are not saying that you won’t take medications, you just want to find one that causes the least significant side effects.” (Finishing the paragraph)
  3. “You feel stuck between a rock and a hard place.” (Metaphor)

 

  1. “I stayed up late last week watching an infomercial about an exercise program that only takes thirty minutes.  If I were to do something like that, I think I could actually stick with it.”

Change Talk

“I stayed up late last week” (Taking steps)

“I think I could actually stick with it” (Activation)

 

Circle One:

Activating

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “Taking good care of your health is very important to you.” (Reflecting Values)
  2. “This seems like the right program and you are ready to give it a try.” (Finishing the paragraph)
  3. “Knowing that your health is really important for you, and getting back into the gym has been a major focus of our discussions in recent weeks. What do you think your next steps will be?” (Key Question)

 

  1. “I mean I am ready to do things different, I am just scared. I have been doing it this way for so long.”

Change Talk

“I am ready to do things different” (Commitment)

 

Circle One:

Activating

 

Three responses that the Clinician might use to evoke additional change talk.

  1. “Despite feeling apprehensive, you know that this is right time to make this change.” (Finishing the paragraph)
  2. “On one hand you are feeling scared and on the other hand you know that this is the right time to take action.” (Double-side reflection)
  3. “You have been doing it this way for a very long time.” (Simple Reflection)

 

 

 

 

 

 

PRACTICE EXERCISE # 2 (KEY)

 

            Recognizing Change Talk

 

Below is a list of client statements.  Please read each statement and identify a) whether or not there is change talk and b) what type of change talk do you see. Mobilizing or activating?

 

 

  1. I think I’m doing about as well as I can.
  2. I certainly don’t want to get cancer. (yes, mobilizing)
  3. I’ve just always disliked the taste of healthy food.
  4. I really hate how sore I feel after exercising.
  5. Well, I wouldn’t mind cutting down on stress in my life. (yes, mobilizing)
  6. I probably could eat less fried food. (yes, mobilizing)
  7. Yes, I’m going to take my medication every day. (yes, activating)
  8. It’s really hard to stay on these medications.
  9. But I love beer!
  10. I used to take my medications regularly. (yes, mobilizing)
  11. I’ve got to get my cholesterol under control. (yes, mobilizing)
  12. I’m going to get my cholesterol under control. (yes, activating)
  13. I’m willing to take oral medication, but I don’t want to take shots.
  14. There’s no way I want to take those medications.
  15. I would like to feel less angry all the time. (yes, mobilizing)
  16. I don’t think I really have COPD.
  17. I wouldn’t mind taking a once-a-day medication. (yes, mobilizing)
  18. I don’t like watching what I eat. I mean I guess I have to, but I don’t like being limited. (yes, mobilizing)
  19. I wish I could have less stress in my life. (yes, mobilizing)
  20. I might be able to cut down on liquor. (yes, activating)
  21. I’m not much on exercising. I guess I’ll do it if I have to but I don’t enjoy it. (yes, activating)
  22. It’s pretty scary thinking about not being able to smoke.
  23. I’ll think about eating more fruit. (yes, activating)
  24. I heard that taking fish-oil pills will help with my cholesterol. (yes, activating)
  25. I hope to eat at least twice as much fruits and vegetables. (yes, mobilizing)

 

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