Structure of Motivational Interviewing - Term Paper Example

Introduction Motivational interviewing is a kind of interview which consists of mutual discussion in order to bolster a persons own motivation, encouragement and pledge to change. Motivational interviewing is goal oriented and enthusiastic for evoking behavior change by helping patrons to discover and resolve the uncertainty and hesitancy. In 1983, the notion of motivational interviewing emerged from the experience and knowledge of treating alcoholism, and it was first characterized by Miller (Behavioral Psychotherapy 1983:147–172). Objectives The objectives of this paper encompass the use of respective research and performance that will widen a greater understanding of person-centered approach like motivational interview. Intentions also cover the working of members in a group to generate more specific and detailed results. The role play will grant the decisive and vital concepts of compassionate and concerned listening, self individuality, freedom, self-determination and consent. Literature Review The review of the literature epitomizes the most up-to-date motivational interviewing (MI) interventions with juveniles, looks at differences between intervention format and design, and discusses possible theory-based mechanisms and systems of change. Literature explorations were supervised to recognize and classify studies delivering Motivational Interviewing in an individual format for the treatment and handling of material use disorders (Tevyaw & Mont 2004).  Occasionally, pithy and concise mediations ratify the skills of intellectual approaches to counseling often referred as motivational ones. Warmth, genuine empathy, and acceptance are necessary to foster therapeutic gain within motivational interviewing (Rogers 1961). Another central concept is that ambivalence about decisions is resolved by conscious or unconscious weighing of pros and cons of change vs. not changing (Ajzen 1980). Amabile, DeJong & Lepper (1976) demonstrates the fact that the professional is unable to detect the client’s problems from the failure to gain trust, which leverages the client’s aversion to divulge their problem such as in this case study interviewer is taking the interview. The basic idea of the case study sounds to encourage the fact and verity that the sense of duty lies within the hands of the complexity and difficulties that are completely whirled around the entire life of the poor little girl. This criticizes the mark as they should be ready to discuss emotional problems in order to amplify recognition as well as an acknowledgement (Amabile, DeJong & Lepper 1976). The literature validates the significance and consequences of valuing the marks and allowing them to gain empowerment through trusting their own decisions rather than following instructions. (Lussier & Richard 2007). Grow writing up Interview 1: Neena is interviewer, Gabriel is Chelsea, Fay and Serge are observers. Interview 2: Gabriel is interviewer, I am Chelsea, Fay and Serge are observers. Interview 3: Fay is interviewer; Serge is Chelsea, I and Gabriel are observers. Interview 4: Serge is interviewer, Fay is Chelsea, I and Gabriel are observers. Discussions Interview 1 In the first session the areas of discussion were focused on Chealseas opinion on living a life full of freedom. She did not believe that her indiscipline was an issue, however, expressed her concern about her uncontrolled violent behavior. The session progressed to Chealseas vicious and rebellious attitude as a cause of boredom and loneliness. She discussed her feeling of isolation due to lack of attention, her mother being frequently at work and a sense of insecurity from her stepfather. Interview 2 In the session the areas of discussion were focused on the clients ambivalences for the reason why she was attending sessions, her torn family and her mother being remarried causing a feeling of isolation. The client discussed how the vacant place of the father in her family distorted her personality, thus engaging her in complexes. Within the second session the center of attention is on what the client would like to discuss within his understanding of interviews, and developing some activities like swimming and dancing in order to alleviate her boredom. Interview 3 In the third interview, it was discussed if any of her issues had improved since the previous session and whether if he she had joined swimming or dancing classes. The client showed no interest in any of those activities. The client also discussed about her school habits and friends. It was now evident from the discussions that she lacked a good friend to whom she may have talked about her problems. The interviewer came up with the idea of her joining a youth club. The client showed enthusiastic response as she could make some good friends from a youth club. Interview 4 In the fourth session, it was discussed how she felt attending a youth club and the benefits of it. She told how joining the club has helped her get rid of her complexes and also, how the relation with her step-father had changed, and the small changes she had made to control her temper. She discussed how she had better learnt to effectively communicate and socialize with unknown people. The interviewer asked her again to join a dance club, but it seemed that she had been more at home with a youth club. It seemed that she wanted to explore more of her personality and wanted some more control over her offensive behavior. Stages of Change Interview 1 At first the client shows irresoluteness as she shows no concerns for change. She does not believe that her vicious behavior is a cause of her disorderliness and mutinous approach. She progresses and starts confessing her hardships and problems. Interview 2 The client seems to be satisfied with the sessions. She is more comfortable with the interviewer. She shows many signs of pre-contemplation as she is denial, blames others for her problem, and makes excuses. However, she shows some elements of moving on, as she starts thinking about her vacillations, but is still unable to improve as she does not provide explanations for her ambivalence. The client moves on to the second degree of contemplation, as she thinks about some healthy activities to get rid of her boredom. She realizes the importance of change, however, seems like she cannot establish how to do so. She proceeded with contemplation; "I could look on the internet to see if there are any swimming clubs" showing a point of change. She enters the contemplation stage again and continues to hesitate as she says;"I guess it isnt really good for me, but I may do it as it looks a bit easier." The client weighs up the pros and cons (Prochaska et al 1985). Therefore enters the stage of contemplation and further talks about her desire to change. Interview 3 It was expected from the last session that the client might join a dancing or a swimming club, as advised from the interviewer. As it is suggested that patients easily understand the behavior change that are needed, however sustaining the changed behavior is difficult (Apodaca & Longabaugh 2009). She talks about her school life and discusses that despite the fact of having such a spontaneous and lively personality, she has not found a good friend. It is evident that she needs behavior change, but for this she clearly needs a good friend or some healthy activity. The interviewer gave her the idea of joining a youth club in which she immediately showed some good response. At the end of the third session she shows some evidence of preparation, collecting leaflets containing information about the club. The client has yet not progressed in any interventions that has helped her change her feeling of isolation. Behavior change is, however a gradual process (Apodaca & Longabaugh 2009). Interview 4 At the beginning, it was evident, the clients had no concerns for her disorderliness; here she is ambivalent (Moyers et al. 2005). At the end of session three, the client makes a visit to the youth club, thinking whether to return but soon realizes its benefits. She interacts with different people in the club and soon finds some good friends. She becomes more confident and comes out of her complexes. Obsevations While asking questions, the interviewer made eye contact with the client. She sometimes looked away while she was responding to make her feel comfortable. Chelsea often fiddled with her clothes, move her legs, drink water and did bite her nails while she was asking her questions, especially in the first two interviews. She often gently gave her suggestions so that she explores her uncertainties completely. She adopted the empathetic listening technique throughout the interview that would allow her to carry out the conversation without interruption effectively. She would focus on what Chelsea was saying, got interested in her questions and reflected her thoughts with appropriate questions, so that the conversation keeps going, thus keeping an environment of an informal yet meaningful conversation. She tries to keep a balanced view as far as possible to keep Chelsea engaged. The interviewer uses eye contact throughout the sessions to keep Chelsea engaged. She would often nod her head in her support. Resnicow et al. (2000) says that listening is an active process where the body language is appropriate for the client to see. She often replies "oh right", "oh yes" and focuses on smaller details. Resnicow et al. (2000) suggests the interviewer to take help from reflective comments to ensure clients answers are being interpreted correctly. She oftently repeats her questions so that Chelsea unintentionally divulges some details, which she does not want to disclose, for instance "is there anything else you want to say about?". The interviewer does not keep a table between herself and Chelsea so that there is a comfortable environment and the conversation is carried informally. Her voice tone is calm throughout, but she increases the pitch of her sound when there is something worth praising or encouraging such as "thats a good idea". The interviewer tends to agree with Chelsea by often saying "ok" and "sure". She tries her level best to sound unjudgemental and unbiased. Furthermore, she encourages her positively such as "I know what you are going through", to give a sense of empathetic listening and expressing sensitivity to understand the complexity of the situation. The room was much quiet and noise free which helped Chelsea to open up and share her problems with the interviewer. The informal nature of the interview ensured that both the interviewer and client are making eye contacts, showing that they are attentive towards each other. Reflective Commentary Ideas were indigenious as all group members were concurred. Abuse of materials and mental health problems affect between 30 and 70% of people. It is not always necessary that the character we choose possibly may not be superficial as an entity that can provide assistance from person-centred analysis.Some of the facts are present that reveals how juvenile and young girls like Chelsea, become more image conscious at a younger age with more than a third of 10-11 year olds increasing to two thirds among 14-15 year olds, stating that their weight affects their well-being. What seemed to be most enlightening in this case study is the substantial negative behaviour influence from parents, society and peers which are distorted with no trouble. This provided the preliminary idea of Chelsea. It also emphasized how momentous, noteworthy and successful person-centred social change crafts would be in the midst of this age group. Conclusion To conclude, this case study made my rational more compassionate and empathetic. It also initiated awareness for me as it is a social and somehow critical issue. Motivational interviewing is complicated and tricky to learn as it is based on concepts and theories. The role play exhibits the effects of stereotyping as well as pigeonhole in such a manner that it creates standard to some extent, bigotry, discrimination, ambivalence and empathetic listening. Confidence, expectation, capability and potential play vital roles in motivational interviewing. MI could be a long process as it provides long term answers through the interviewee consciousness and awareness, whereas medical treatments only conflict the short term, quick and easy cures. This approach solves the interviewee ambivalences so they are less likely to go back to old ways back to their original behavior, combating the wider issues, even as maintaining self-sufficiency, empowerment and eccentricity to express feelings. References Ajzen, I., & Fishbein, M., 1980. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, Prentice-Hall, NJ.  Amabile, T.M., DeJong, W., & Lepper, M., 1976. Effects of externally imposed deadlines on subsequent intrinsic motivation. Journal of personality and social psychology, vol. 34, 92-98. Apodaca, T.R., & Longabaugh, R., 2009. Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidence. Addiction, vol.104, no.7, pp.705-715. Lussier, M.T., & Richard, C., 2007. The motivational interview. Can Fam Physician, vol. 53, no. 12, pp. 2117-2118. Miller, W. R. (1983).  Motivational interviewing with problem drinkers.  Behavioural Psychotherapy, vol.11, pp.147-172. Moyers, T. B., Martin, T., Manuel, J. K., Hendrickson, S.M.L., & Miller, W. R., 2005.  Assessing competence in the use of motivational interviewing.  Journal of Substance Abuse Treatment, vol.28, 19-26. Prochaska, J.O., 1985. Predicting change in smoking status forself-changers. Addictive Behaviours, vol.10 , no.4, pp.395-406. Resnicow, K., Jackson, A., Wang, T., McCarty,F., Dudley, W.N., & Baranowski, T., 2000. A motivational interviewing intervention to increase fruit and vegetable intake through black churches. American Journal of Public Health, vol.91, 1686-1693. Rogers, C. R., 1961. On Becoming a Person, Houghton Mifflin, Boston. Tevyaw, T.O., & Mont, P.M., 2004. Motivational enhancement and other brief interventions for adolescent substance abuse: foundations, applications and evaluations. Addiction, vol.99, no.15, pp.63-75. Read More