Motivational Interviewing and Its Function in Person-Centred Social Change - Coursework Example

PERSON-CENTRED SOCIAL CHANGE Introduction The role-play exercise main goals were to look at ourselves, in addition to discovering myself as an individual as well as a community development worker practitioner, plus also as a therapeutic advocate. Moreover, it was also intended at stressing identity work in addition to the various masks that people wear while working with different communities together with the challenges posed to clients and practitioners by this. The exercise also stresses on the intolerances and power relations normally drawn in when working with individuals in the society. Objectives This paper will talk about motivational interviewing (MI) as well as its function in person-centred social change. In addition it will afterwards delve into reflective listening, being amongst the most significant skill in MI and lastly touch on sympathy. Making use of efficient dialogue in listening together with assisting people will be examined, and afterwards we will do an investigation on how all these are linked to the role-play activity undertaken by the group. The paper will also delve into social construction of identity as well as various masks that we put on a day to day basis so as to perform various tasks in society. Finally, it will conclude with a reflection on the full essay, the work done by the group as well as role-plays. Literature review The group activity referred to throughout this paper made use of MI to play the role of a person-centred social transformation. A female aged 30 and a victim of alcohol and domestic violence was the focus of the group. MI is a directive, client-focused, method utilised to bring forth behavioural transformations by helping clients to open and end uncertainty (Rollnick, 2010).Normally, there are 4 general ideologies related to the practice (convey sympathy, develop divergence ,roll with opposition together with support self-efficacy).Thus the involved practitioner ought to work with sympathetic techniques, usually, via insightful listening, in addition to showing a consideration of how the client feels without judgment or blame allocation(Miller & Rollnick,2002). The practitioner also assists the customers to discover their own solutions instead of imposing them. For instance, Egan claims, “Empathy as a form of human communication involves listening to clients, understanding them and their concerns to the degree that this is possible, and communicating this understanding to them, so that they might understand themselves more fully and act on their understanding” (Javis et al., 1995, p.4). Thus, MI as a style should exhibit itself in the practitioner’s approach in 3 possible elements; “evocation” recognizes that efficient behaviour transformation has to begin with the customer and not necessarily with the practitioner; and lifestyle alterations are most maintainable when clients voice them autonomously. “Autonomy support” implies that customers must make a choice on their own manner of transformation, since in that manner, they are more likely to continue in that transformation; excessively forceful or influential techniques are not entertained, hence reasons for making behavioural transformations have to be individually appropriate to the customer. ‘Collaboration’ stresses the power-sharing client-practitioner association by recognizing a dual proficiency, since clients are the specialists in their transformation (Rollnick et al., 2007).MI’s aim is to widen discrepancy. Practitioners must utilise whatever is given to them so as to expand their objectives. A client may choose not to talk about an issue and hence should be permitted to desist from discussion and argument must be shunned during the session. In case of an argument, the practitioner ought to resist or move with it (Ramseir & Suvan, 2010). A key point in MI is that nobody can effect alterations for the client. It is the client’s role to make alterations, which is self-efficacy; main component to encourage transformations (Hohman, 2012). There exist different phases that practitioners encounter with the client. At the pre-contemplation phase which actually is the start of counseling, the client does not acknowledge that she has an issue(s).This phase then moves from premature phase to contemplative phase. At this phase, the client admits there is an issue(s) and that she requires to transform, however she feels cornered (Tomlin & Richardson, 2004).The client may be uncertain on the course of action to take, hence, the practitioner ought to increase and exhibit absolute trust in the association. Trust, normally is regarded as essential in any intervention, since it is through this trust association that the client decides to transform (Higson-Smith, 2002) .This is the preparation phase and is the perfect time of helping the client in goal setting and introducing transformation plans(Jarvis et al.1995). Encouragement assists the client to participate in an active effort that reduces undesirable habits, making them employ an active strategy for transformation (action stage).The client may arrive at a phase where s/he requires to uphold a position to adhere to his/her plans for avoiding relapse (Tomlin & Richardson, 2004).Individuals who relapse tend to recover more and can achieve more in the following phase since relapse is like taking a step backward and 2 steps forward. Relapse is a new technique of helping clients in learning how to tackle old habits hence assists them accomplish their goals (Curtis, 2014).MI therefore entails client’s responsibility of pressing towards transformation. The key element of MI guiding technique is insightful listening, since understanding widens across it and acts to aid the client and steering their responsiveness towards the merits of habit transformation (Rose, 2008).Rosengren (2009) points out that a sizeable determinant of a client’s reaction to treatment is dependent on the practitioners understanding and that treatment effectiveness can be determined from the level of understanding exhibited by the practitioner while undergoing treatment. He adds that, in insightful listening, the technique of MI exhibits itself quite early in the treatment process and can in fact have a considerable impact within one session (Rosengren, 2009). Nevertheless, the role-play discussed in this paper avoided insightful listening since the group did not fully comprehend what it implies being an insightful listener. It also fell short of showing a dedicated interest in the context of client’s life, key beliefs, individual values and thus failed to utilise this knowledge to build a motivational bridge to change of lifestyle. Egan (2007) provides a comparable view when he argues that one’s mind set and what is in their hearts are as significant as their observable presence. Practioners, in this way, therefore are able to learn about their clients and able to determine their interventions on their understanding of the give and take of the discussion. Alternatively clients understand more regarding themselves and can confront the burden of their issues and the prospects with which they are shown in a more informed manner (Egan 2007).Clearly this never happened in the group’s role-play since it was not conscious of the significance of efficient discussion; coupled with the fact that the group members were known to each other and therefore ran the danger of over familiarity with one another. Miller and Rollnick notes that identifying with the individual, or having passed through similar circumstances, may compromise the ability of the practitioner to offer the essential atmosphere of transformation because of over identification. Nevertheless, with time, the group continued being informed more and more, dialogue advanced and eventually the group connected with what every individual said, somehow with what the other individual had said. Egan (2007) stresses that the remarks of the practitioner should be related to what the client says and both ought to be open and be influenced by what the other individual says. As the group’s work on the back-story summaries and research of the role-play indicates below, in the final role-play, the remarks of the practitioner are related to the story told by the client, whereas the initial ones lacked that relation. Back-Story Research Character: Amy Age: 30 Ethnicity: White British Summary Amy (30) has 3 children and lives with partner in Corby, with no education. Amy is a victim of domestic violence and consumes alcohol to manage life. Amy being a low achiever cannot seek employment due to childcare requirements. She is dependent on her partner and has low self-esteem. Character choice The group involves 3 females whose background is ethnic minority and have various experiences living in a largely white British community. The group, in joining this assignment to the second one, researched on ethnic composition of Corby and discovered 90% of populace is white British (Guardian online, 2011).The group collectively chose a white British woman because of gender connection. This was after the group watched the scene on short film and BBC and bibliography on you tube and read books regarding domestic violence and courtesy of women’s aid two out of four women are murdered by their present or previous male partner. Domestic violence is prevalent across societies and cultures globally. Society frequently ignores it, meaning that it does not get the amount of awareness and concern it merits. The essay assesses the existing literature associated with professionals concerning interventions in domestic violence utilising person-centred transformation methods via applying MI in regard to domestic violence victims and their children. Typically, attempts to intervene in domestic violence cases have focused on females and their children as sufferers, especially for the women’s security and children’s wants. The programme should involve men in activities which would avoid the recurrence of such activities towards a current or future partner. Group Write-up 1st interview: Kabeka interviewer, Liz client, Rhoda observer 2nd interview: Liz interviewer, Rhoda client, Kabeka observer 3rd interview: Rhoda interviewer, Kabeka client, Liz observer Interviewer introduced herself setting the scene for the purpose of the meeting. The interview started with client being asked how she was feeling, however the client refused to talk about the going ons at home and thought she had no issue, believing that domestic violence is common in relationships. Amy blamed herself for the bruises in her body and explained that her partner would not hit her if she provided him with all what he wanted (pre-contemplative stage). The 2nd session began by enquiring about Amy’s progress since the last meeting. She said that she had been reflecting on issues covered in the first session and believed she caused the violence at home due to her financial dependence and if given what he wanted, there would be no violence. She realised that there was an issue but was reluctant of moving out or reporting since she loved her partner and kids. This period centred on Amy’s understanding of domestic violence, which led to drinking and what she would do to end abuse. She accepted her problem and needed help, though warning of the likely repercussions (Contemplative stage). Though at first she never thought domestic violence was causing her to drink, she later admitted it was an issue and she was signposted(action phase).Amy was to call and book herself in a women’s aid group which assists domestic violence survivors(self-efficacy).She began work, booking herself and children into a hostel. Amy never went through the maintenance phase since her partner visited with gifts, showing them love and promising never to hit her. Amy relapsed returning to pre-contemplative phase by returning home with her partner. The group continued their work with Amy though, by using different MI skills to maintain the stage she would have been. Identity work The various faces used by every person were apparent in the role-play of the group. Goffman (1959) claims that faces are masks, changing, depending on type of social association involved and on who is in front of the face. People present different faces whenever they communicate with others; usually the face seen by the world is the one we create to be seen by others. For instance, the faces we show change with different role-plays we play and a client or a practitioner in this case, and the face shown to the public act as a mask for hiding our individual self(Goffman,1959). This raises identity question: Who are we and do people ever show who they really are? Woodward (1997) claims that current life has become so hard that it needs us to assume various identities which may clash when one needs something that contravenes claims of another. Identities are flexible with various components capable of being re-enacted in new situations. The biggest hurdle in my case in role-play was being a non-directive interviewer, mostly due to lack of understanding of what reflection is; hence I paid no attention to Amy’s story and was just using what Hohman(2011) refers to as deficit worldview; clients being seen as lacking, characteristics, resources and skills, that assist transform their lives. Afterwards, motivational skills increased; enabling me catch up what client was explaining and their choice. Whereas the client engaged a defense mechanism, with much resistance, I rolled with resistance. It is challenging wearing a client mask. Acting the client, makes one sense power balance and as Tomlin & Richardson note, any suggesting practices that produce meaning include power relations; including power ,defining who is excluded or included. D’Amico et al. (2011, p.155) claim that ‘identity marks the conjecture of our past with the social, cultural and economic relations we live in now, and it is the intersection of our everyday lives with the economic and political relations of subordination and domination”. Thus while acting the client, I felt as me I was before a powerful expert having power to decide whether or not to assist me change my life. Playing the observer had no pressure and the mask was easy to wear. Nevertheless, working with various individuals, particularly from diverse background, it was clear to see what Egan (2007) termed as shadow part of listening to clients. He explains the term ‘shadow’is used since it is not practitioners’ wish to participate in such type of listening, but rather find themselves into it without knowing they are doing so; standing in the way of the open-minded processing and listening required for genuine discussion. The group work was done well and though no responsibilities were delegated to members since we all were committed to the work, something that helped us complete everything on time. We stayed late and came early to the university for some days which clashed with family commitments that some of the members have. Other challenges included some group members leaving to attend to their children, a task which had not been allocated time, thus the rest of us practised compassion for the work to be done. In conclusion, the paper has explored MI and its functioning in person-centred transformation and insightful listening as a crucial skill and its importance in MI, and how all this got integrated into the group’s role-play. The paper also examined empathy in listening to people and delved into using efficient discussion in assisting people mutually respecting each other. 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