Motivational Interviewing
Motivational interviewing (MI) was developed in 1983 from a personal experience of one of the therapist, and it has been used since then. The definition of MI changed over the years. Currently, it is an evidence-based practice in the treatment of substance abuse users. This method focuses on establishing a collaborative guideline, based on patient’s values, to motivate the person for internal exploring of the issue and resolving it (MI, n.d)
Besides substance abuse, MI is a good method to include in the plan of care for patients with chronic health issues. Many of these chronic diseases such as diabetes can lead to mortality and can increase the cost of the health care as a whole. At the same time, many of these diseases
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can be prevented or managed easily through behavior and life style modification. The study that was done by Linden, Butterworth, and Prochaska in 2009 is a proof to this statement. Description of the Participants in the Study This study was done at Oregon Health and Science University (OHSU) as part of employees’ health insurance benefit which called employee wellness programme (EWP) with the focus on evidence-based prevention methods. The employees were asked to participate in a health risk assessment (HRA) survey which had additional focus on the chronic diseases. From 1017 participants who took the survey twice, 106 individuals with a chronic illness were chosen to participate in the health coaching program. Then their outcomes were compared with the 230 individuals with a chronic illness who chose not to participate in the program but also took the survey twice (Linden, Butterworth, & Prochaska, 2010, pp. 167-168). Description of How MI Was Used The participants were divided to four groups based on gathered data on variables such as clinical data outside recommended range or indicating metabolic syndrome, health status, smoking, and chronic illness paired with either low self-efficacy or patient activation.
Then professional coaches who were trained for MI programs started to coach participants mostly via telephone communication with the option of face to face interactions upon participants’ requests. The initial session was 30–40 minutes with follow-up sections lasting about 10–20 minutes. The number of follow-up sections was not limited and was based on participant’s risk profile, requirements and interests. The topic of discussion on each section was chosen by the participant from the menu that was created by the therapist based on participant’s risk profile. There was also a category named “other” on the menu which would give the participant the autonomy to choose a topic that was not on the menu but would be helpful increasing intrinsic motivation, self-efficacy, and patient activation and readiness to change (Linden, Butterworth, & Prochaska, 2010, p. 167).
Description of How Were the Participants Tested
The study tested several outcomes including self-efficacy for managing chronic illness, the patient activation measure (PAM), perceived global health status score, self-assessment of most important behavior change for participant’s health or quality of life, and risk status in this identified area based on readiness to change. Each participant took a survey twice before and after the program, and the scores were subtracted from each other. Then the net result was used for comparison between the participants and non-participant (Linden, Butterworth, & Prochaska, 2010, p. 168).
Description of the
Outcome The outcomes of this study can be summarized as followings 1. Scored from 0 to 100, the non-participant group improved their PAM scores by1.17 points while the participant group improved by 4.57 points. 2. scored from 0 to 10, the non-participant group had 0.21point decrease in their self-efficacy score while the participant group had 0.65 points increase. 3. Scored from 0 to 100, the non-participant group did not improve their health status significantly while the participant group improved by 3.6 points. 4. Scored from 0 to 10, the non-participant group improved their self-assessment score by 0.66 while the participant group improved by 1.4 points. 5. The behavioral risks were reduced in the participant group compare to the non-participant group (Linden, Butterworth, & Prochaska, 2010, p. 169). How could MI be Used in Family Practice Using this model helps the practitioner in the family practice settings to create positive rapport with patients. When patients feel that they have autonomy and they are able to participate in decision making process, they will probably be more complaint with the plan of care. MI has all six domains of health care quality in it by being safe, effective, patient-centered, timely, efficient, and equitable (USDS, 2015). In my opinion, MI can be effective for patients in primary care if it accompanies by active listening from practitioner and not rushing through the process. Unfortunately, this cannot be easily done while practitioners have a limited time frame to visit each patient, to do their assessment, to evaluate the outcome of previous interventions, and to come up with new interventions while including the patient’s opinion and desire in all of these which should be done in 20 minutes. At the end, I believe this is a hard process, but it can be done with patience and it gets easier with experience.
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Steinglass, P. (2008). Family Systems and Motivational Interviewing: A Systemic-Motivational Model for Treatment of Alcohol and Other Drug Problems. Alcoholism Treatment Quarterly, 26(1/2), 9-29. doi:10.1300/J020v26n01_02
The definition of motivational interviewing (MI) has evolved and been refined since the first publications on its use as a way to deal with behaviour change. The technical therapeutic definition of motivational interviewing is a collaborative, and goal oriented method of communication with giving specific observation to the language of change. It is intended to reinforce an individual’s motivation for and development towards a particular objective by evoking and investigating the individual's own arguments for change (Miller & Rollnick, 2012). Motivational interviewing was created to enable clients to prepare for changing addictive behaviours like drug and alcohol abuse (Miller & Rollnick, 1991, 2002) and has been viable to lessen other harmful behaviours including tobacco, drugs, alcohol, gambling, treatment
I met with Christine, an acquaintance I know through members of a twelve step program. We met for about 20 minutes over coffee. As we spoke, I asked the questions that I prepared, omitting some and adding others based on the responses given. The list of questions in reproduced in the last section of this work. Christine works at an inpatient drug and alcohol rehabilitation center in New Jersey, the specifics of which have been intentionally omitted. Her interest in the field is identical to mine; she has a personal history of substance abuse. After obtaining sobriety, she wished to help others with her experience. This similarity is the primary reason I wanted to discuss this topic with her.
The case scenario is of a homeless young guy named Jim who appears to have an intellectual disability. Jim is addicted to marijuana and abuses alcohol and has suicidal thoughts. He has anger control issues where he is known to verbally threaten others. He currently has a counsellor who he had established a therapeutic relationship. From these sessions, the counsellor has learned that Jim had been physically abused by his stepfather. From reading this case scenario about Jim, it is evident that he would benefit from several different approaches or interventions including motivational interviewing and cognitive behavioural therapy.
What is Motivational Interviewing? Motivational interviewing (MI) is a patient-centered method for enhancing intrinsic motivation to change health behavior by exploring and resolving ambivalence. What will be discussed is how can organizations help the patients change negative behavior to a positive behavioral change, diminishing the lack of motivational behavior. (Miller & Rollnick, 2002) states that we have to help clients overcome their ambivalence or lack of motivation toward changing their behavior in positive way. Also, figuring out a solution on how to overcome this negative behavioral challenge of lack of intrinsic motivation to change. How will we overcome it? by focusing on the MI (Motivational Interviewing) approach, and finding
The Motivational Interviewing film was very informative. I was able to get a clear understanding of what is to be expected by the therapist during a session. The film explained the therapist should engage in reflective listening, develop a growing discrepancy, avoid arguing with clients, roll with resistance and support self-advocacy. Miller believed that this approach was far more effective than traditional methods, where the therapist pushed for change. In contrast, Miller explained that motivational interviewing focused on empowerment and helping clients to become motivationally driven to change. Also, Miller stressed the importance of working alongside clients, a term he referred to as dancing. The process in which the client leads
Therefore, when I work with substance abusers I will show empathy, encourage and validate their successes and their feelings about any failures. In addiction, I will help the person learn from their failures and normalize the situation. Furthermore, I would attempt to ensure that the person had several coping strategies in place, to help when he or she finds themselves in a difficult situation. Moreover, I intend to ensure the client has all the tools he or she needs to succeed while getting to the root of their problem through counseling.
The key concept of the health belief model includes threat perception (perceived threat), behavioral evaluation, self-efficacy and other variables. The threat perception has very great relevance in health-related behaviors. This perception are measured by perceived susceptibility (the beliefs about the likelihood of contacting a disease) and perceived severity (the feeling about the seriousness of contacting an illness and leaving it untreated). The behavioral evaluation is assessed by the levels of perceived benefits (the positive effects to be expected), perceived barriers (potential negative aspects of a health behavior), and cues to action (the strategies to activated one’s readiness). The self-efficacy key concept was not originally included in of the health belief model, and it was just added in 1998 to look at a person’s belief in his/her ability to take action in order to make a health related change. The other variables that are also the key concepts of the model include diverse demography, sociopsychology, education, and structure. These factors are variable from one to another and indirectly influence an individual’s health-related behavior because the factors influence the perception...
People with addiction may seek counseling to help them recover from drug usage. Using motivational interviewing can help find out how motivated the client is to staying clean and what will encourage them to stay away from drugs. The clients also needs to see how the addiction is effecting their lives and the lives of their loved ones.
Capuzzi, D., & Stauffer, M. D. (2008). Foundations of addictions counseling. Boston, M.A: Pearson Education.
Motivational interviewing is based on a client centered approach to therapy that uses open-ended questions, affirmation, reflective listening and summaries to help the client recognize the pros and cons of change and their reasons for resisting change thereby eliminating their ambivalence about change. Once the client deals with their ambivalence the Miller and Rollick believe that the client will be able to make the necessary changes. In addition, motivational interviewing gets the client to argue for change not the counselor. Furthermore, the client not the counselor is responsible for their progress.
This paper discusses alcoholism, its behavior on individuals and its association with relevant health conditions. With the changing health care system, health care providers, nurses, and counselors have stepped into the arena of health promotion. A scenario case study was put together to depict the need for counseling individuals with risky behaviors and how it impacts their health. Recommendations and goals were incorporated into the clients counseling. Millers interviewing technique was used to guide the counseling session conducted with a person afflicted with alcoholism with the end resulting in behavior changes. Motivational interviewing is an approach based upon principles of experimental and social psychology, attribution, cognitive dissonance, and empathy placing emphasis on internal acceptance for change. Cognitive dissonance is created by contrasting the ongoing problem behavior with the behaviors negative effects. Empathy is incorporated to channel the conflict into a behavior change solution.
Richard A. Brown, David R. Strong, Ana M. Abrantes, Mark G. Myers, Susan E. Ramsey, Christopher W. Kahler, Effects on substance use outcomes in adolescents receiving motivational interviewing for smoking cessation during psychiatric hospitalization, Addictive Behaviors, Volume 34, Issue 10, Research Advances in Comorbidity of Substance Misuse and Mental Disorders, October 2009, Pages 887-891, ISSN 0306-4603, DOI: 10.1016/j.addbeh.2009.03.003.