Motivational Interviewing: Consulting

Narrator: A Head Start teacher Ms. Jefferson is meeting with a parent Mary at the Head Start Program where her four year old son Joe attends. Their previous conversations have included discussions about Joe's strengths as well as some concerns about his behavior in the classroom. Joe’s concerning behaviors include frequent hitting and biting other children yelling and screaming when he becomes angry and having trouble following his teacher’s directions. Ms. Jefferson has invited Mary to come to provide her perspective on how things are going for Joe in the program.

Ms. Jefferson: Mary, thank you so much for coming in today to talk about how things are going with Joe.

Mary: I had to rearrange my work schedule and my boss is giving me a hard time about it but you said it was important.

Ms. Jefferson: I know it can be hard to rearrange your work schedule and it sounds like it wasn’t easy with your boss. I know you are very committed to Joe. I know I called you for this meeting but before we get started I wanted to see if there were any topics or concerns that you wanted to address? What should we put on the agenda?

Mary: I’m here because you asked me to come in and because Joe is everything to me. I was concerned that you wanted to have a meeting about it and I want to hear what was so important that I had to take off work.

Ms. Jefferson: Sure. Well the main reason I called this meeting was to talk more about Joe’s behavior in class and see if we can put our heads together to come up with some solutions.

Mary: That is fine. But honestly I don’t think anything is wrong with Joe. I think the problem is the classroom. No offense but it seems out of control in there and Joe doesn’t have any of these behaviors at home. Maybe he acts up at school because the other kids are constantly bugging him and because it is so crazy.

Ms. Jefferson: So you’ve had more success at home than we have with his behavior in the classroom. As you've mentioned what we have been doing doesn’t seem to be working as well as we hoped. And it sounds like you have some concerns about the classroom environment. Tell me more about that. Mary Well I’ve seen other kids pushing Joe and I think that he should stand up for himself. I don’t want him to be a wimp and get picked on his whole life. Those kids don’t have any respect and they shouldn’t get away with calling Joe names and getting in his face all the time. It’s loud in the class and I don’t know if you or Ms. Rita sees the things that Joe tells me about.

Ms. Jefferson: You feel like you are hearing about and seeing a lot in the classroom that we might not be aware of. I really appreciate you sharing these concerns with me. Of course, you want Joe to be able to stand up for himself if other kids are bothering him. Tell me more about what's happening that we don’t see and how the other kids are treating Joe?

Mary: It’s mostly that kid Alex. All Joe talks about is how Alex is always pushing him and telling him what to do. I’ve seen that kid and he does not know how to behave. Maybe Joe is just defending himself? I don’t know I don't know if there is anything else that I can do. I think that the school has to figure this out.

Ms. Jefferson: It sounds like maybe we can look more closely at interactions between Alex and Joe. I also hear that you want us to figure out what we can do in the program to help the situation. Mary Exactly.

You guys need to figure something out.

Ms. Jefferson: Sounds good. Would it be okay if we talked about Joe’s progress and what we have been doing?

Mary: Sure.

Ms. Jefferson: First let me say Joe is a great kid. He has many strengths. He is always eager to help out; he is really learning his letters quickly. However we are concerned that the hitting and biting have not improved since our last meeting despite some of the things that we have tried already. Mary Does he mostly just hit Alex?

Ms. Jefferson That is certainly something we will take a look at. We will observe to see if there is a pattern with Alex. Would if be okay if I shared another idea that we’ve been thinking about?

Mary: Sure I guess.

Ms. Jefferson: We would like to have our mental health consultant Ms. Gibson come in and observe Joe in the class. She will observe how Joe and the other kids interact. We can even give her your suggestion of paying close attention to Joe’s interactions with Alex. Her job is to give us her perspective or ideas on what might be contributing to Joe’s behaviors.

Mary: I’m not sure about that. I don’t think so. That is not necessary. Like I said Joe doesn’t act this way at home. He is not mental or something. Doesn’t the mental health person see crazy kids?

Ms. Jefferson I hear your hesitation to have Ms. Gibson observe Joe. Let me assure you we do not think Joe is mental or something. It sounds like maybe her title mental health consultant might have put you off?

Mary: He isn’t crazy. I don’t want someone in our business, you know, judging me and my son. I’ve got enough of that. I think you're making it seem like this is his problem. We didn’t have any of these

behaviors before he came here and I don’t have any of this at home. You’ve always been straight with me, Ms. Jefferson, and I appreciate that and I like how you treat Joe, but I don’t like this. Maybe he should go to a different school or stay home with my mother if you can’t handle him.

Ms. Jefferson: You are right, Joe isn’t crazy. This is not just Joe’s problem. In fact really we need help trying to figure out what we can do to support Joe. I hear you that you are not comfortable at this point with Ms. Gibson coming in to focus on Joe right now. That's okay. I respect that. You are his parent and you know what is best for your family. These are hard conversation to have. You know I realize you haven’t met Ms. Gibson and this may be the first time you have heard about her role here. Would it just be okay if I told you a little bit about what she does here?

Mary: Go ahead.

Ms. Jefferson: This is a lot of information to take in. She is here at our center one day a week. You may have even met with her without realizing it. She is tall with sort of spiky gray hair. She is often in the classrooms playing with the kids talking to us and sometimes even doing some lessons with the kids about feelings and things like sharing.

Mary: I have seen that lady. I thought she was one of those grandparent volunteers.

Ms. Jefferson: It seems that you are still unsure. You are worried about being judged and us focused on something being wrong with Joe I can understand that. You know you may or may not be interested in just meeting with Ms. Gibson? You could get a sense of her for yourself. Not just taking my word for it.

Mary: I’m not sure. Maybe.

Ms. Jefferson: You are unsure. That makes sense. We’ve talked about a lot today. Maybe it would be helpful to let this all sink in? What if we talked on the phone tomorrow just to see how you are thinking about it?

Mary: You can call me tomorrow and I’ll think about it but I still don’t know. Maybe this lady should be looking at other kids.

Ms. Jefferson: Ms. Gibson does look at other children I promise you that Joe is not the only child we suggest Ms. Gibson help us with. She offers us a lot of help with many children so that we can teach them in different ways. Thanks for even considering a meeting with her and being open to us talking some more about this. I’ll call you tomorrow to see what your thoughts are after you’ve had more time to mull it over. What time is the best time to call you?

Mary: Noon is fine.

Ms. Jefferson: Sounds good. I want to thank you for coming in. And I really appreciate your willingness to listen to our thoughts and I’ll talk to you tomorrow.