Motivational Interview Case Study

Motivational interviewing recognizes and accepts the fact that clients who need to make changes in their lives approach counseling at different levels of readiness to change their behavior. During counseling, some patient may have thought about it but not taken steps to change it while some especially those voluntarily seeking counseling, may be actively trying to change their behavior and may have been doing so unsuccessfully for years. In order

An interview utilizing motivational interviewing techniques was conducted by a nurse practitioner student and a consenting patient. The patient is a 55-year-old, male, with occupation as a heating, ventilation, and air conditioner technician that the nurse practitioner student identified on physical examination to have mild hearing loss. Hearing protection is admittedly not worn consistently at the jobsite during the history taking portion of the exam. This paper will discuss the behavioral health problem of noncompliance with hearing protection, the evidence supporting motivational interviewing strategies to support behavior change, and a discussion of the techniques used during the interview.

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

Changing is something that someone has to want to do, if there is no motivation things will stay the same. The first step to change is knowing and accepting the wrong that has been done and trying to figure out a way to change. There are numerous of practices that are used to help an offender bring their mistake to the light. These types of methods are called Evidence Based Practices and are used to help both the offender and probation officer learn to communicate on a different level. Evidence based practices are cognitive behavioral training, vocational education and training programs and treatment oriented intensive supervision program. They are used to reintegrate offender s back into the community successfully. The type of evidence based practice that I am going to talk about is motivational interviewing, the pro and cons and if it helps the offenders learn from their mistakes and if it is going to help in the future.

Combined Motivational Interviewing and Cognitive-Behavioral Therapy with Older Adult Drug and Alcohol Abusers is an article written by Lyle Cooper concerning the abuse or misuse of illicit drugs, prescription medications, and alcohol in older populations. Due to lack of knowledge or resources, elderly individuals are falling victim to substance use problems and the numbers are projected to rise. Therefore, an assistance program called HeLP was created to provide evidence-based treatment to the specific cohort of 50 and up age range. Motivational interviewing is used to eliminate internal uncertainties clients may have concerning their treatment; hence, opening themselves up to behavioral changes. Clients who decide to move on to the next stage and if HeLP workers deem it necessary, cognitive-behavioral therapy is implemented to promote changes in thoughts, behaviors, and prevention of future relapse.

The process of motivational interviewing is essentially about creating "intrinsic motivation to change" within the client (Moyers, 1998). The choice to change must originate with the client and the process for helping this occur begins with motivational interviewing. There are two phases within motivational interviewing, the first focuses on increasing the client’s motivation to change and the second phase is negotiating a plan and consolidating commitment. It is important to understand the traps that can be encountered within this process, such as the question/answer trap. In this trap the client is led by the counselor with little chance to have free speech to explain themselves because the counselor is just focused on the next question instead of focusing on where the client is leading them. This trap is very similar to the expert trap in the fact that the client is left to believe they cannot find answers for themselves; they instead must listen to the expert who is giving them the answers. This is most definitely not the way to motivate a client to make changes for themselves. Other traps include premature focus, denial, labeling, and blaming; all of which can prevent the client from opening up in the treatment process.

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

The spirit of motivational interviewing (MI), which entails collaboration, evocation and autonomy, is the fundamental approach to elicit intrinsic motivations (1, 2). Throughout the video, the therapist appears to have applied the MI spirit in accordance with Miller and Rollnick (2). The therapist firstly created an encouraging atmosphere for change by monitoring and accommodating the client’s aspirations (collaboration). The therapist then evoked the client’s motivation through their perceptions, goals and values (evocation) and also informed about the right for self-direction leading to commitment to change (Autonomy). However, to sustain the MI spirit, a breakdown of the requirements will be discussed below.

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.

Psychologists William Miller, PhD. and Stephen Rollnick, PhD. developed the counseling approach known as Motivational Interviewing (MI). Motivational Interviewing evolved out of experience in the treatment of persons who were problem drinkers, and was first described by Miller in 1983. In 1991 Miller and Rollnick provided these techniques as a method that promotes and engages intrinsic motivation within the client in order to change behavior. MI is a client-centered counseling style that is goal -directed and brings about behavior change by helping clients to explore and resolve ambivalence. Traditional Rogerian client-centered therapy does not guide or direct or focus in the way that MI therapists do to influence individuals to consider making changes, instead of non-directively explore themselves.

Afterwards, the essential concepts and methods were later particularized by Miller and Stephen Rollnick, Ph.D., in 1991. This involved a more comprehensive description of the clinical procedures of motivational interviewing. Motivational Interviewing is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence (Miller & Rollnick, 1991). Motivational Interviewing is goal directed and more focused when compared with nondirective therapies. The central purpose is to examine and resolve ambivalence, with an intentionally directive therapist to carry out this goal (Miller & Rollnick, 1991).

The idea of motivational interviewing builds on Rogers' theories about people having freedom of choice and changing through the process of self-actualisation (Davidson, 1994). Miller and Rollnik (1991) describe it as a technique in which the heath practitioner becomes a helper in the change process while expressing acceptance of their client. A central goal of motivational interviewing, says Geldard & Geldard (2012), is to help resolve the ambivalence which prevents clients from realising their personal goals and to facilitate positive change. Motivational interviewing is mostly utilised to counsel those troubled by addiction (not just substance, but also behaviours).

Solution-Focused Interviewing, The Transtheoretical Model, and Motivational Interviewing are three approaches used by practitioners to assist and guide people in changing their behavior. Each approach has its own format and process and this paper will compare and contrast some similarities and differences between these three approaches. This will be done by looking at five client scenarios and comparing and contrasting them with the approaches. The five client scenarios are; the client who wants something and sees themselves as part of the solution, the client who says someone else needs to change, the client who seems uninterested or resistant to changing, the client who wants what is not good for them and finally the client who does not seem to want anything.

McCabe C. (2004) Nurse-patient communication: an exploration of patients’ experiences. Journal of Clinical Nursing. 13, 41-49.

A thematic analysis of an interview was used to help students develop an understanding of the role of an RC. This role is dynamic and challenging; it offers great opportunities to grow and work in an academic team based environment that fosters constant learning. Often RCs play a significant role in the process of bringing a project from conception to completion which requires a variety of qualifications and leadership qualities. An inductive approach to this process, beginning with data collection and analysis, allowed me to consider specific aspects of the topic and progress on to more general concepts. Eventually, I was able to discover connections between existing knowledge and the data I analyzed. The finalized themes included Qualifications; Role of Team Leader; Rewards and Challenges.