Replay 1 Ankadine
Motivational Interview with Mary
Discuss how you might use the principles of motivational interviewing with Mary.
Motivational interviewing (MI) is a patient-centered counseling style that enhances an individual’s motivation to change by exploring and resolving ambivalence. It is particularly effective in addressing substance use disorders, such as Mary’s alcohol dependence (Bischof et al., 2021). The principles of MI can be applied in this case. The first principle entails expressing empathy. I might start by creating a safe and non-judgmental space for Mary to share her story, listen actively to understand her feelings, concerns, and experiences, and reflect on her statements to show that I know her struggles. I might develop discrepancy by helping Mary see the gap between her current behavior of alcohol dependence and her goals or values by gently exploring how her alcohol use affects her and Kylie and how it contrasts with her hopes for their future. If Mary shows resistance to discussing her alcohol use or making changes, I might avoid confrontation to roll with resistance. Instead, I might acknowledge her feelings and explore them further to understand her perspective. The final principle is that of supporting self-efficacy and I might achieve this by reinforcing Mary’s strengths and past successes to help her believe in her ability to change.
Provide a detailed overview of how the interview may progress. Include each step of motivational interviewing in your discussion.
The interview may progress systematically, following the four steps of engaging, focusing, evoking, and planning. The initial step in MI is to engage Mary in a collaborative and empathetic conversation. This involves establishing trust and rapport (Bischof et al., 2021). I might use open-ended questions, reflective listening, and affirmations to create a supportive environment. For instance, I might start by saying, “Mary, I understand that it has been challenging for you, and I appreciate you coming here today. Can you tell me more about what brought you to counseling?”. Once engagement is established, the next step is to focus the conversation on specific goals. This involves identifying and clarifying Mary’s goals regarding her alcohol use and her relationship with Kylie. I might say, “Let’s talk about what you would like to achieve through counseling. What are your thoughts on how your drinking affects your life and Kylie’s?”
In the evoking phase, I might work to elicit Mary’s motivations for change. This involves exploring her ambivalence towards alcohol use (Bischof et al., 2021). Reflective listening and strategic questions are key here. I might ask, “What are some of the good things about drinking for you? And what are some of the less good things?”. This helps Mary articulate both the benefits and drawbacks of her alcohol use. When Mary expresses a readiness to change, the conversation moves to planning. This involves helping Mary develop a concrete plan for change. I might collaboratively set goals and discuss specific steps Mary can take to reduce or stop drinking. I might say, “It seems like you are ready to make some changes. What steps do you think you can start with to reduce your drinking? How can we make sure these steps are manageable for you?”. This will support the development of a plan that Mary is confident about.
Describe how a provider would recognize this patient is ready to change. Use principles of motivational interviewing to support your answer.
A provider can recognize that Mary is ready to change when she expresses specific indicators in her communication. These include increased change talk rather than arguments for maintaining the status quo (Bischof et al., 2021). Indicators of change talk may include statements like, “I need to stop drinking for Kylie’s sake.” Another indicator would be Mary’s evoking hope and optimism through statements like “I think I can cut down if I have some support.” Commitment language, for example, Mary expressing the desire to join a support group, could also indicate her readiness to change (Jake-Schoffman et al., 2021). When Mary displays these signs, the provider uses MI principles to support her progress by affirming Mary’s commitment, exploring specific change strategies, and working collaboratively to create achievable change goals.
References
Bischof, G., Bischof, A., & Rumpf, H. J. (2021). Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice. Deutsches Arzteblatt international, 118(7), 109–115. https://doi.org/10.3238/arztebl.m2021.0014Links to an external site.
Jake-Schoffman, D. E., Brown, S. D., Baiocchi, M., Bibeau, J. L., Daubenmier, J., Ferrara, A., … & Kiernan, M. (2021). Methods-motivational interviewing approach for enhanced retention and attendance. American journal of preventive medicine, 61(4), 606-617. https://doi.org/10.1016/j.amepre.2021.04.005Links to an external site.
Replay 2 Eleanis
Module 2 Discussion- Motivational Interview with Mary
By applying motivational technique in interaction with Mary, it would be important to initiate a good relationship with her and show much concern about her. The first of these processes, called engrossing, means that Mary’s tale and her issues are made safe from any sort of criticism and judgment. First of all, I would turn to selective listening and engage in parroting, affirming the speaker, and gaining his or her trust. For instance, I might say, “Mary, it seems to me that you are worried a lot about how your drinking has impacted your relationship with Kylie and your capability to be the mother you wish to be “this is some form of reflective listening that makes her feel heard and understood by the practitioner. Thus, during this stage, my main objective would be to help Mary receive and understand her and most importantly, follow the general rule that to support her, I should support myself first.
After developing rapport, I would transition to the next phase of Change taking focus, which is where the intervention narrows the discussion hitting directly on the alcohol use and its effects on her life as well as on her daughter. Instead, I would endeavor to subtly point out the conflict in Mary’s current behaviors with her overall life purpose, that is, to be a good mother to Kylie. I might also say, “In what ways do you think your drinking has impacted Kylie and your capacity to take care of her?” This question helps to raise Mary’s awareness of the negative effects of drinking and how they are incompatible with her goals and values (Colvara et al., 2021). I would let her do most of the talking and when she was through, I would paraphrase what she said to draw out any concern she might have with regard to her drinking. Thus, I will be able to assist Mary in acknowledging the practical effects of alcohol in her life, which can improve her readiness to alter.
The third part of the intervention method, which is called evoking, entails helping the client identify their reasons for change by inviting them to discuss their reasons to change, their desires, and their capacity to change, in this case, Mary’s propensity to change her drinking behavior. I would ask Mary general questions in a bid to make her think about the positives of moderating or stopping the use of alcohol. For instance, I may say, “How do you think things may change for good in your life and Kylie’s life if you were able to cut down or stop drinking?” Self-affirmation follows this, where I may say, “You have been strong by seeking help and desiring to change for Kylie.” I would also engage in reflective listening skills to restate positive change talk statements such as, “It appears that being present and taking responsibility for Kylie means a lot to you.” Using the client’s words and interests, I can assist Mary in getting the internal desire for change.
The last task, which is planning, involves the identification and formulation of an actualization plan to assist Mary. Luther: This would include determining certain things that she could do to cut down on her drinking; things like going to counseling, going to AA or other organizations like Women for Sobriety, or establishing an environment that has been arranged in such a way that it does not prompt drinking. I would help Mary to establish specific short-term objectives what Mary may encounter as challenges and how these could be addressed (Bischof et al., 2021). For instance, we might arrange for her to have weekly counseling and have friends and or relatives who could help her in case she relapses to the behavior. To deal with this issue, I would make sure that Mary receives positive support during the whole process of the plan’s implementation, including constant motivation on my part and willingness to accommodate changes. Thus, the creation of a detailed plan with Mary can make her regain control over the situation and also help her to be more positive about the changes as they start to be made.
I would know this when Mary utters change talk regularly and concretely, which shows the ABCs of change, namely, awareness, belief, and intention. This might entail Mary describing concrete actions or measures she is willing to take, perhaps with regard to counseling or self-help groups, and assertiveness or an eagerness to modify her behavior. She might use statements like, “I have to quit drinking because I want to be a better parent for Kylie.” or, “I think it is time to attempt counseling and perhaps it will help.” Furthermore, I would assess if she has discussed prior change accomplishments or has started to have higher self-efficacy in her ability to change. In this readiness category using the MI techniques, I would summarize the motivations she has stated, reassurance of her strengths, and agreement on a concrete plan. This assists in building her commitment and guarantees that she is gotten with the assurance that she can embrace change as a way of enhancing her life and that of Kylie.
References
Bischof, G., Bischof, A., & Rumpf, H. J. (2021). Motivational interviewing: an evidence-based approach for use in medical practice. Deutsches Ärzteblatt International, 118(7), 109.
Colvara, B. C., Faustino‐Silva, D. D., Meyer, E., Hugo, F. N., Celeste, R. K., & Hilgert, J. B. (2021). Motivational interviewing for preventing early childhood caries: A systematic review and meta‐analysis. Community Dentistry and Oral Epidemiology, 49(1), 10-16.
