Five Basic Principles Of Motivational Interviewing In The Nursing Process

Motivational interviewing is a way of conducting and occupy the essential motivation within the client in order to change behavior. It is “an efficient and collaborative style of clinical interaction that can boost the effectiveness of the therapeutic alliance” (Jellinek, Henderson, Dilallo, & Weiss, 2009, p.108). Motivational

According to the Transtheoretical model the client who wants something and sees themselves as part of the solution is in the preparation stage and "are ready to make a change in attitude and behavior and have already have begun to increase self regulation and to change" (Diclemente, & Velasquez, 2002). The practitioner at this stage helps the "client set goals and priorities to achieve change and to develop a change plan"(Diclemente, & Velasquez, 2002).

Motivational interviewing is a practice wherein conveying acceptance of your client, you become an aid in the process of change. Motivational interviewing fosters Carl Rogers ' optimistic and humanistic theories; around ones competences for employing free choice and shifting through a course of self-actualization. The therapeutic relationship for both Motivational Interviewers and Rogerians’ is a democratic partnership. The concept of Motivational Interviewing (MI) progressed from the experience of treating problem drinkers. Motivational Interviewing was first described by William R. Miller, Ph.D., in 1983.

The nurse understands she has the knowledge of the disease process, and the patient has the knowledge of how the disease affects himself. The second phase of the relationship is the working phase, where the patient identifies who can help them with their health care problem. The nurse looks at the health care problem from the patient perspective and begins educating the patient on their health care problem, therefore the educated patient is better able to collaborate with the nurse to determine what interventions are necessary and acceptable to the patient to achieve a patient centered health related goal. The termination phase is the final phase of the theory, the nurse and the patient determine how the patient will maintain their progress and continue to work on the health care goals independently without the assistance of nursing. (Deane, & Fain, 2016).

King’s Theory of Goal Attainment was proposed in the 1960s and published in 1981. It was derived from her conceptual system which presented in 1968, and incorporates the concept of self, perception, growth, development, time, interaction, communication, role, and coping. The Theory of Goal Attainment is a practice methodology based on the nurse and patient setting goals together, and the nurse assisting the patient to meet these goals they set for their health (Caceres, 2015). These interactions between the nurse and patient are the process in which the professional relationship develops, mutual goals are set, and actions are planned to achieve these goals. It is an interaction-transaction process and is based on the nursing

One of the expected outcomes by the application of this theory would be “linking client-nurse interactive phenomena with client outcomes” (Byrd, 2006, p. 271). During this research Dr

Motivational interviewing is a counseling approach that was studied and understood as an applicable theory of practice that would be beneficial in the environment where I currently work which is an alcohol treatment facility. Whereas, it is understood that clinical and applied aspects of Motivational Interviewing (MI) have shown effective as a relatively brief intervention (Levensky, Cavasos, & Brooks, 2008), especially those dealing with an alcohol dependency. According to Miller and Roderick, MI, has been defined mostly as a directive, client centered counseling approach for eliciting behavior change by helping clients to explore and resolve ambivalence. In addition, with its goal-orientated approach it can help break down resistance to change (Corey, 2013, pp. 191-194). This theoretical approach is the most favored for the environment in my profession of choice, in addition, integrating it with the practice of Cognitive Behavioral Therapy (CBT) which is already in use.

The client, Maria received a score of nineteen on her Alcohol Screening Questionnaire (AUDIT). Maria’s score can be interpreted as being in zone three which is considered harmful. The appropriate action for the aforementioned zone is a brief intervention or referral to specialized treatment. The intervention process is a procedure that is used to highlight how problematic alcohol use can be in one’s life. After the client and social worker’s realization of the frequency and seriousness of the patient’s alcohol use, it is advantageous to formulate a plan to lessen alcohol usage. Motivational Interviewing is a method that can be used in counseling sessions which encourages the client to become a motivated participator of change by identifying, exploring, and resolving he or she’s ambivalence towards their damaging behavior [PowerPoint Slides]. MI is collaborative and client-centered thus the patient can contribute to their planned change process. The process of MI involves appealing to, concentrating on, evoking, and lastly, planning with the patient. Subsequent steps of MI are reflection, summarization, and exploring inconsistencies [PowerPoint Slides]. Shifting gears,

I believe that heath is based on emotional, spiritual and physical well-being. I believe that it is the absence of illness and abnormal conditions. I believe health constantly changes across one’s life span. I believe that it is important for a nurse to ensure that the relationship is not only with the client but with their families, friends, other health care providers and caregivers. It is the nurse’s responsibility to provide individualized care for each client. A nurse should educate them and their family to ensure health promotion and health maintenance

The first stage of this framework is coming to know the client, which requires the nurse to understand that the personal meaning of health and healing is individualized and the context of this area is highly subjective. Gillespie and Paterson (2009) state that “clinical decision-making processes are triggered by recognition of a cue from a patient” (p. 167). In the case of this patient, the decision was based off a cue; a change

By creating a therapeutic environment in which the client feel safe to be entirely honest and open about their thoughts and feelings we can enable the client to be

Motivational Interviewing (MI) refers to a client centred counselling approach, which is directed to enhance motivation in an individual for behaviour change Miller & Rollnick (as cited in Christopher & Dougher, 2009). MI as a method understands and accepts that the clients are at different levels of readiness to change their behavior. It consistently focuses on goals to prepare the client for transformation by providing motivation for commitment to change (Bricker & Tollison, 2011) in the domains of substance abuse, addiction and risky health problems. It proceeds to make the client aware of the causes, consequences and risks that could be a result of the behavior. Through this, the client foresees the possibilities of enhancement and becomes motivated to achieve it (Jenson, Cushing, Aylward, Craig, Sorell & Steel, 2011). MI is coherent with the

Since behavior is regulated by its consequences (but only as those consequences are interpreted and understood by man) (Edleman & Mandle, 1998), it is nursing's practice to assist man by working with beliefs, attitudes, values and environment to help achieve positive outcomes and efficacy expectation. Nursing is also responsible to assist man to realize outcome expectations.

While Hevern focuses on the role and importance of narrative psychology in the development of nursing practice, Whitehead considers the application of social psychology to the discipline (822). As reported by this author, nurses are often charged with the responsibility of providing patients with the support that they need to engage in health promotion behaviors. This often includes changes in behaviors such that the patient can improve health and quality of life (822). Social psychology when incorporated into nursing practice can facilitate the nurse’s understanding of health promotion behaviors that are used by the patient. Understanding of the social psychology of the patient provides the nurse with the ability to target specific beliefs and behaviors which may be detrimental to health promotion. By

Implementation is the “acting” towards behavior change. The nurse gives emphasis to self-responsibility for implementing the plan. Depending on the client’s needs, nursing interventions may consist of supporting, counseling, teaching, consulting, modeling, and enhancing the behavior change. The nurse has to offer ongoing and non-judgmental support that focuses on the desired behavior change. Moreover, the nurse will help the client identify his social support system, which is vital in the goal attainment process. Evaluation of the outcomes should not be sporadic, but rather done on a continual basis in shared collaboration of nurse and client. Evaluation is the time of celebrating successes, or a time when the client may choose to rearrange priorities, or adjust strategies.