Possum, koala

https://psychwire.com/motivational-interviewing/resources

Motivational Interviewing - Good Example - Alan Lyme

http://www.youtube.com/watch?v=67I6g1I7Zao

0:03

a social worker at the Family Health

0:04

Center dr. Sheila asked me if I would

0:07

spend some time with you today

0:08

I'm really glad that you here I'm just

0:09

curious as to why he would send you to

0:11

me well I came to see dr. Steele last

0:14

week because of increasing stress and

0:16

anxiety that's kind of getting the best

0:17

of me and in the course of my

0:20

appointment with him he was asking how I

0:22

was dealing with that stress and I

0:24

mentioned that my one or two glasses of

0:27

wine a few nights a week is turning into

0:29

more frequent in maybe three or four on

0:32

some nights and he had some concerns

0:36

about that and and felt like maybe you

0:40

could help me with stress or something

0:43

yeah so he he actually see me because he

0:47

went to him for increased stress and

0:49

he's concerned that your alcohol

0:50

consumption may be a part of that

0:53

increase and prior to prescribing you

0:55

anything you want to make sure that you

0:57

had someone to talk to about that I

0:58

suppose okay I saw you filled in one of

1:01

the pink sheets might take a little bit

1:02

he told me to fill that out and bring it

1:03

with me okay thank you so you say here

1:08

that you have four or more drinks in one

1:10

week you mentioned that you may be

1:13

increasing that a little bit as well um

1:15

and that you have one or two drinks in

1:17

one setting typically yeah and maybe

1:20

monthly you have more than that what

1:24

what's what kind of drinks do you have

1:26

what do you drink we need to drive wine

1:28

with my meals

1:29

um you know again one or two typically

1:33

and more frequently three or four so my

1:41

stress is increased so starting to

1:42

increase this times drink a little more

1:44

okay well based on what you put here you

1:46

give it gives you six points on this

1:48

scale scale ranges from zero to forty so

1:51

six points will put you in what we

1:53

consider an at-risk zone so if it's okay

1:57

with you lots to talk a bit about that

1:58

okay

1:59

okay so that was sunset run zero to

2:02

forty it's not it's not a super high

2:04

risk but it certainly could be a risk

2:06

for maybe increasing stress maybe some

2:08

physical Emmas related to alcohol

2:11

well could start to show up if you were

2:13

to increase your drinking from there or

2:15

you can stay there this is a typical

2:18

standard drink size over here I'm not

2:19

sure whether that fits your description

2:21

of a glass of wine a lot I fill the

2:24

glass up so maybe a little more than

2:26

yeah maybe the little space that it's

2:27

upside to drink drink and a half each

2:29

one so that also increased a little bit

2:31

more so perhaps maybe drinking more than

2:33

you indicated on here and for women you

2:35

healthy woman your age no more than

2:38

three drinks in one setting is

2:39

considered to be lower or no-risk and

2:42

1/7 in one week so in total how much

2:45

total in the week and what you say here

2:46

is that even on this sheet you're

2:48

perhaps already drinking more than that

2:50

mmm

2:51

so what do you make of all that well

2:53

that news to me you know I thought red

2:57

wine with your meals is supposed to be

2:59

healthy and you know no more than seven

3:02

in a week that seems kind of prohibitive

3:04

yeah it seems it seems a little less

3:06

than perhaps you've been drinking with

3:07

what you consider to be healthy drinking

3:09

and certainly there's this conflicting

3:11

information out there about what's

3:13

healthy what's not healthy imagine the

3:16

increased stresses what because we're

3:18

concerned or to seal as your stresses

3:20

increases and if you were to prescribe

3:22

you anything maybe some interaction

3:24

between the two but also build and serve

3:27

them I would think so if you would what

3:30

is it that you like about alcohol well

3:32

you know it does at least in the moment

3:35

temporarily reduce my stress and I you

3:39

know like a good glass of wine I don't

3:41

don't drink the cheap stuff I like the

3:43

expensive what so you like the taste of

3:45

it mm-hmm and it does help to lower the

3:47

stress signal which is for that time

3:48

you're drinking one of those so good

3:50

things about alcohol for you um well you

3:54

know the nights that maybe I have a

3:56

couple more glasses than I should I wake

3:59

up feeling kind of yuck and of course

4:03

part of my stress is finances and I

4:05

mentioned I like the good stuff and so

4:07

if I'm drinking more than I'm increasing

4:09

my financial burden yeah so your

4:12

financial stress may be increased by the

4:15

fact that you're drinking yeah kind of

4:18

defeating the purpose there 22 the

4:20

drinking to do stress and increasing

4:22

stresses

4:23

so the one hand it lowers it on the

4:25

other hand it's increasing kind of a

4:27

seesaw teeter-totter effect then what do

4:31

you make of that give them that on one

4:33

hand it lowers and the other had it

4:34

increases and now it's increasing even

4:36

more maybe I need to find some other way

4:39

to deal with my stress yeah imagine

4:43

you've had some thoughts of that what

4:44

have you thought of trying well I've

4:46

exercised in the past and that helps

4:49

right now my schedule is kind of out of

4:51

whack and I just really don't know what

4:55

to do that's why I came to see dr.

4:56

Steele I thought maybe he can prescribe

4:58

me something that would help me you know

5:00

when I'm feeling overwhelmed and he may

5:02

be able to I'm not saying that he cannot

5:04

I'm just imagine that he's concerned

5:06

that if you continue to drink on the

5:08

level that you are drinking that

5:10

whatever he prescribes you there may be

5:12

an interaction with the to imagine that

5:14

she's concerned I'm not completely sure

5:17

so you've had some success in the past

5:19

with changing behaviors and if you were

5:21

to decide to make any changes here it

5:24

sounds like you could drop all that to

5:25

make those changes how important would

5:28

it be for you on a scale of 0 through 10

5:30

i below the visual here with that if

5:32

zero is not important tennis is very

5:34

important to do something about your

5:36

drinking way mm-hmm well I mean if if it

5:39

means that it's increasing my stress and

5:43

or he's not going to prescribe me

5:45

anything because of my drinking then

5:48

it's fairly important maybe about a 7

5:51

mm-hmm let's put it up there why do you

5:53

choose a 7 or a 504 well again I've got

5:58

to get things under control you know my

6:00

kids are depending on me and I've got to

6:03

go to work to help ease this financial

6:07

stress and so you know all those

6:10

responsibilities there's a lot riding on

6:13

your decision in what to do this what if

6:15

anything will bring up too late online

6:17

on that scale

6:18

um well the you know the risk that you

6:22

mentioned about the drug interaction I

6:27

certainly can't afford to you know have

6:30

any more stress

6:33

yeah so so you choose to lower your

6:36

stress rather than increase it and if lo

6:39

and your drinking would have that effect

6:41

that something be willing to do right

6:42

now how confident are you that you could

6:44

do something about your drinking I'm

6:47

pretty confident and you know probably

6:50

about a seven or eight okay so it's

6:52

pretty hot up there again and what if

6:54

what if anything would you choose to do

6:55

would be to cut down with a bit to quit

6:57

just in case but you know I like I said

6:59

like a good glass of wine I don't want

7:01

to quit altogether

7:03

I'd be willing to try cutting that but

7:05

you know if it's going to if doctor seal

7:07

would agree to prescribe me something

7:09

for the anxiety and it meant that I had

7:12

to not drink at all I'd be willing to do

7:14

that at least for a period of time so

7:16

you'd be willing to stop altogether

7:18

that's what was indicated by the

7:19

physician okay so so based on that how

7:23

ready are you to do anything right now

7:25

whether it's to cut back whether it is

7:27

to quit well again you know if I can get

7:31

something to help me manage if maybe I

7:33

can find some other way to deal with the

7:35

stress then then you know I be pretty

7:39

ready I again maybe about in on that

7:41

scale maybe an eighth okay so that's

7:43

that's pretty hot there as well it

7:46

sounds is that you'll be pretty

7:47

motivated to do something about this

7:48

right now given your responsibilities

7:51

given your children relying at this

7:52

point and just on on lowering anxiety in

7:56

general it sounds and that's one of your

7:57

goals as well well I'm pretty confident

8:00

that once you decide to do whatever it

8:02

is you decide to do you'll be able to

8:03

follow through that based on your

8:05

experience in the past of of making

8:06

behavior changes imagine some things

8:09

that you can draw upon what's one thing

8:11

that you could do imagine you thought of

8:14

some things might help to lower your

8:15

stress well I you know the the exercise

8:19

but again that's that's kind of

8:20

difficult to fit in right now hoping

8:24

that dr. seal will prescribe something

8:27

for me to take when I'm feeling

8:28

particularly overwhelmed and maybe just

8:32

having somebody to talk to to bounce

8:34

some things off of one of the things we

8:36

can't offer here is for you to come in

8:38

and talk to one of our behavioral health

8:39

specialists may be able to help you talk

8:42

talk through this there's a terrible

8:44

stress and sound like responsibility

8:46

there and we can make a point for you if

8:49

you like before you leave today dad talk

8:51

to someone that'd be nice right it also

8:53

has some information here if you're

8:54

interested some a pamphlet on alcohol

8:58

and and how what healthy limits are and

9:00

how it may be affected by medications

9:02

that you took as well and I wish you

9:05

lots of luck it sounds as though you

9:07

really committed to making this shift in

9:08

this change and imagined doctors still

9:11

wanna fight with you and see how you do

9:13

with your with your change within a few

9:16

weeks again I look forward to speaking

9:19

to in the future all right thank you

9:21

very much you're welcome