Transtheoretical Model Of Motivation

1. Three key things that the authors of the readings came that social workers need to know to be able to be facilitators of change.
Kennedy and Gregoire brought three key points to light.
• Transtheoretical model (TTM), which “emphasizes the importance of attempting and then maintaining new behaviour in understanding motivation for change” (p.165).
• self-determination theory (SDT) “addresses the source of motivation specifically by outlining a framework for understanding internal and external sources of motivation and the impact of each on treatment outcomes.” (p.166)
• Motivational interviewing “recognizes that human behaviour, however irrational it might sometimes seem, has a function and recognizes that change is a difficult process

and one that often involves considerable discomfort and anxiety” (Watson, J. 2014 p. 467)
It should be noted that both TTM and SDT are motivational theories.
2. What questions do you have about the utility or potential of Motivational Interviewing in social work practice?
• I don’t have any questions at this time about Motivational Interviewing.

Honestly, as an xsmoker, from an alcoholic family, I support this approach in treatment. Being on the receiveing end of a motivational program, I found it empowered me as an individual. Now on the opposing side, I can see only benefits from using this process. That being said, I don’t feel it should be used alone. Combinging with Cognitive Behaviour Theory (CBT), TTM and SDT will truly create an environment for change and sustainability for the client.

3. How would you take up the skills of Motivational Interviewing? Give examples.
• I knew a girl who had an eating disorder who liked to walk. When she decided to talk, she asked people to walk with her. I was the only one who would I call it, “walk talk therapy” (I asked her to walk slower, on purpose – changing her pattern of behaviour. She wanted to talk, therefore she altered the behaviour – showing interest in change).
• We walked and talked about silly things for the first 4 sessions. I then asked her what she really wanted to talk about. It was the food issue she had, in connection to exercise (Ok, she has opened the door to discuss the

issue).
• I told her that I supported her in all her decisions and asked her what she wanted.

Her response was to break the cycle of walking, as it was driving her crazy. She was very shocked that I didn’t even attempt to talk about the eating issue, (supporting the clients choice of direction)
• We discussed ways of breaking the walking cycle (CBT - every minute, stop for 5 sec, then walk again, or when you have the urge to walk, hold off for 30 second, or until it begins to feels a little unbearable, breathing techniques and trying to find the cause of the need to walk – she already had the answer, the eating disorder)
• I didn’t want the not walking to create a panic attack or an anxious episode. Following this process, she began to regain power in her situation where she felt she had no power over the addiction.
• As time went on, I would ask if she wanted to talk about the eating disorder. If she shunned away, I would tell her she didn’t have to talk about it, if SHE didn’t want to. I found this approach, created a bond, a safe place where she was more drawn to learning and understanding, and trying to change the thought process around the eating disorder and the addiction to

walking.

4. What critiques do you have about Motivational Interviewing and/or stages of change theory?
• I don’t believe that only one type of theory can be used. There is not one simple process that is best. You have to look at each individual and use the theory that is most appropriate for them at that point in time for that place. The theory should be ever changing.

Reference:

Kerry Kennedy PhD & Thomas K. Gregoire PhD (2009) Theories of Motivation
in Addiction Treatment: Testing the Relationship of the Transtheoretical Model of Change and
Self-Determination Theory, Journal of Social Work Practice in the Addictions, 9:2, 163-183, DOI:
10.1080/15332560902852052
To link to this article: https://doi.org/10.1080/15332560902852052
John Watson (2011) Resistance is futile? Exploring the potential of motivational
interviewing, Journal of Social Work Practice: Psychotherapeutic Approaches in Health, Welfare and
the Community, 25:4, 465-479, DOI: 10.1080/02650533.2011.626653
To link to this article: http://dx.doi.org/10.1080/02650533.2011.626653