Motivational Interviewing

Introduction
The following dialogue occurred during an interview between a parole officer and an offender. Your task is to review the dialogue, then answer the questions that follow. You may find you have to review the notes above, as well asMotivating Offenders to Change (http://nicic.org).
Background
Jerry Nash, a parole officer, is interviewing Rob Gregg, an offender. Gerald is an experienced officer who has had little exposure to MI, so he will need your help to apply the techniques. Robbie is in the institution for the 2nd time, for robbery. He is a decent fellow, it seems, but has not made the connection between his cocaine habit and the robbery offences.
Part A: The Dialogue
Jerry:  Hi, Rob…come on in, have a chair.
Rob:  OK, thanks. What’s up?
Jerry:  It’s been a couple of weeks since we last met. I thought we should get together and talk about how things are going. I appreciate you coming by.
Rob:  No problem…nothing better to do…
Jerry:  So…how are things going?
Rob:  OK, I guess
Jerry:  Tell me more…what does OK mean these days.
Rob:  Just OK…It seems like I’ve been in a long time, and it’s a long time until I see the light of day again.
Jerry:  You’re in too far to quit, and it seems like you’ll never get out?
Rob:  Yeah. Like that.
Jerry:  You miss all the things that are waiting for you on the outside.
Rob:  I do…though I’m not sure any more what’s going to be waiting for me.
Jerry:  You’ve been in here so long, you’re no longer sure about your life on the outside.
Rob:  Sometimes I can’t wait to get out, and at other times…I just don’t know if I care. And I worry about when I do get out, whether I will be able to stay on the street.
Jerry:  If you were to be released today, on a scale of 1 to 10, how sure are you that you could make it on the street?
Rob:  I don’t know…maybe about a 3, or a 4.
Jerry:  3 or 4…so at this point, not too confident.
Rob:  Yeah…but on another day, I might be much more confident. It’s just that…
Jerry:  Yes?
Rob:  Well…it’s just that there’s coke around the institution this week, and oh, man, it’s tempting. So far, I’ve stayed away, but…I’ve been close to it, you know.
Jerry:  Tell me about that feeling.
Rob:  Well…coke’s been my problem all along, right? Or one of them. When I’m using, it’s all I care about. Then I’m off it for a while, and I think I’m done with it, until it’s there, and it’s all I can think about.
Jerry:  Rob…you know your parole date is coming up next year…and this is a real concern…
Rob:  I know…
Jerry:  So…I think it’s something we need to spend some time on. Do you agree?
Rob:  Oh, yeah, definitely! But it’s…
Jerry:  Tell me about your drug use.
Rob:  (Goes on to talk at some length about smoking dope when he was 14, graduating to cocaine in his late teens, experimenting with heroin but backing off, and his increasing addiction to cocaine leading to a series of robberies.)
Jerry:  Let me see if I can put all this together. At the age of 28, you’ve been involved with drugs for almost 15 years, of varying kinds. Now you are in prison for a long sentence because of crimes which are related to drug use. You recognize the link between drug addiction and the crimes, and have taken some treatment, but are not feeling much confidence about your ability to stay away from drugs, cocaine in particular and therefore to stay out of gaol.
Rob:  I’d say that’s pretty close.
Jerry:  It’s progress that you are ready to acknowledge the link between drugs and being in prison.
Rob:  You think? Well you might be right…but I really don’t know how you can help me. You’re not much older than me, and you’ve never been into drugs, I can tell.
Jerry:  If that’s a barrier, we can certainly try to find someone to remove it.
Rob:  Maybe…we’ll see how it goes.
Jerry:  OK. Well…help me to understand. I’m thinking that in terms of using coke, there are some good things, and some not so good things. Am I right about that?
Rob:  Hmm…I guess so.
Jerry:  What are some of the good things?
Rob:  Well, the feeling, I guess, the euphoria. No worries about anything…
Jerry:  Anything else?
Rob:  Well…the company. The money, if I’m selling. The feeling is the real reason though.
Jerry:  How about some of the not-so-good things?
Rob:  Ha!…the downer when I’m not high. The feeling of needing to get high. My lady’s reaction, and my kids – I know I’m neglecting them.
Jerry:  You care about your lady – it’s Susan, right? – and your kids, and what they think.
Rob:  Susan, yes. Yeah, I do. They matter to me. She comes to visit every week…
Jerry:  Susan and the kids really matter to you…how do you reconcile that with your drug use?
Rob:  Well…in here, it doesn’t matter, does it, except I would feel that I was letting them down.
Jerry:  Does the fact that Susan visits have anything to do with your confidence level, or your ability to stay away from the drugs that are in here?
Rob:  Yeah…I am more confident and feel stronger when I know she’s coming, and right after she has been.
Jerry:  So…when you are ready to hit the street, will she be an important part of your plan?
Rob:  Yes…she’s the key, I think.
Jerry:  Between her visits, though, you find it hard.
Rob:  I do. It’s the hardest, man.
Jerry:  Susan is in your corner, loyal to you. You’re most confident in your ability to stay clean when you are expecting her, and after she has left, but in between times it can be more difficult. Is that a fair description?
Rob:  Yeah.
Jerry:  I wonder if you would be interested in working together to see if we can come up with a solution. I am thinking that if you maintain your confidence between Susan’s visits, it might be a big step.
Rob:  I might be…
Jerry:  Because you know, you have kept away from the drugs while you’ve been here, you’re making that choice every day.
Rob:  I guess so.
Jerry:  Now…what’s the next step, Rob?
Rob:  I guess I could…check in with the Addictions Counsellor.
Jerry:  OK…when do you plan to do that? And what will you talk about?
Rob:  I think he’s here tomorrow night. I’ll see if I can get an appointment. Maybe he can help me find ways to reduce my cravings.
Jerry:  I like the sound of that. And if Susan is coming on the weekends, what do you think of the idea of meeting midweek, say Tuesday or Wednesday, each week.
Rob:  I think that would be good.
Jerry:  Well…on a scale of 1 to 10, how is your confidence level now?
Rob:  Maybe a 5-6…up a bit, I think!
Jerry:  Well, I’m sure glad it didn’t go down! Take care and see you next week!
Rob:  Yep…thanks…see

Assignment 8.1: Motivational Interviewing Techniques and Skills

Value: 5%

Marks: 15

Part B: The Questions

A phrase or dialog can meet the criteria for more than one answer.

1.  Identify 3 open questions.

2.  Identify 2 affirmations.

3.  Identify 2 paraphrases.

4.  Identify 2 reflections.

5.  Identify a summary.

6.  Identify a statement which expresses empathy.

7.  Identify a place where Jerry rolls with resistance.

8.  Identify a place in the dialogue where Jerry helps Rob to see a discrepancy in his reasoning.

9.  Identify a place where Jerry supports Rob’s self-efficacy.

10.  Identify a good and not-so good question.

11.  Identify a forward-focused question.

12.  Identify a scaling question.

13.  Identify a place in the dialogue where Jerry gives advice without appearing to do so.

14.  Identify an action question.

15.  Identify a question which connects talk to action.

Submit this assignment to the assignment drop box.

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