Summer 2023 week 2 assignment

Motivational Interviewing

The acronym RULE stands for Resist the Righting Reflex, Understand the Patient’s Own Motivations, Listen with Empathy, and Empower the Patient. Motivational interviewing is a counseling technique that emphasizes increasing a patient’s incentive to change. An efficient counseling technique known as motivational interviewing (MI) increases motivation by resolving ambivalence (Frost et al., 2018). It represents a transformation from the stage of pre-contemplative change.

Evidence-based psychotherapy known as Motivational Interviewing (MI) is frequently used to treat substance use disorders and conditions involving motivational change. MI is a team-based, goal-oriented communication strategy that emphasizes the language of change. By obtaining and examining the patient’s own justifications for and against change, the therapist can increase a patient’s motivation for a goal (Martino et al., 2019). When treating MI patients, the therapist has a non-judgmental attitude, accepts ambivalence, concentrates on the patient’s desire for change, and is willing to put up with resistance to change. Other psychotherapies, such cognitive behavioral therapy, can incorporate MI as well.

Components

The various components of motivational interviewing are:

• The process of engaging is one in which the client and the supplier create and establish a beneficial connection and a cooperative partnership. The foundation of the connection required for effective motivational interviewing is therapeutic engagement (Martino et al., 2019).

• Focusing is the procedure the provider uses to establish and uphold a clear direction throughout the dialogue around one or more change goals. It focuses on the topic that the client originally came to discuss.

• Evoking is the process of discovering a client’s own driving forces or goals for change. It happens when a specific change is the emphasis, and the practitioner elicits the patient’s own thoughts and feelings about how the patient will carry out the change.

• Planning happens once a person is motivated enough to start thinking and planning about how the change will happen rather than if or why it might not.

Motivational interviewing is a highly successful strategy for acquiring precise and thorough data that supports and enhances the case management process’ evaluation phase. Case managers can more easily identify their clients’ needs for health and a healthy lifestyle by using motivational interviewing (Martino et al., 2019). Building rapport and gaining trust with customers as a result allows for the development of successful and desired change in them.

MI and Coping

Motivational interviewing assists the therapist and client in building a supportive connection with the goal of helping the client establish a positive attitude toward change. This will give the individual more confidence to fight their addiction. Motivational interviewing (MI), a person-centered approach, makes use of collaboration and empathy to elicit a person’s individual motivation for behavior change (Morgenstern et al., 2017). A variety of chronic ailments have been treated with it, and it addresses issues including lifestyle changes that have favorable effects on managing stress and chronic illnesses like chronic pain.

Discriminatory Analysis

The video of ineffective motivational interviewing did not provide a focus on the patient’s view of the situation and the provider did not provide reasonable guidance to allow the patient to reflection her situation. The provider was also not able to elicit reasons for change that would help influence the opportunity to make a behavioral change (Morgenstern et al., 2017). Providers should avoid lecturing the patient as this is an effective approach in motivating the positive change. Most often, patients already have the idea and information about the negative outcome that comes with the behavior, what the patient need is a someone who will listen to them and provide support as well as helpful resources.

The video that reflects ineffective motivational technique is very confrontational and puts the client in a very uncomfortable position. The main goal of the health care provider in a motivational interviewing session is to ensure to avoid accusations and argumentation because it will put the patient in a defense mode and this would prompt the patient to withheld important information and resist to participate in a positive change (Oveisi et al., 2020). The provider in the video also did not listen to the client’s expression of frustration and his perception of the problem. She always disregards the opinion of the patient, and this have a negative impact on the perception of the client to be encouraged to adopt a positive change.

It was apparent that the provider discourages the patient by confronting ad lecturing the patient. The provider did not take any advantage and opportunities to discuss behavioral change but instead engaged in lecturing and confrontation which puts the patient into a very uncomfortable position (Oveisi et al., 2020).

What can be done differently in this case is to be collaborative and non judgmental instead of being confrontational and aggressive. It is important to listen intently to the client and her concerns. It is important communicate to the patient the genuine desire help them make positive change instead of judging the patient. Empathy is a very important component of motivational interviewing it is important for the provider to communicate and express that he or she understands the client’s struggles and that she wants to help. This would help the patient identify that someone is really helpful and is interested to extend help ad guide the patient through the change.

 

                                      Summary and Plan Development                                                                                                                                                              

     The following are some of the key lessons learned from the videos on motivational interviewing: Rolling with resistance enables the participant to explore her ideas and avoids a breakdown in communication between the participant and counselor.

·       Refrain from promoting change (Pederson et al., 2021).

·       Avoid confronting resistance head-on.

·       The participant is a key resource in locating solutions and answers.

·       Resistance is a hint for the counselor to act differently.

·       New viewpoints are presented but not imposed.

                         An essential element in facilitating transformation is self-efficacy. The probability of change happening is considerably raised if a participant thinks she can change (Pederson et al., 2021). The likelihood of change being accepted by a person is a significant incentive. It is the participant’s responsibility to decide on and implement change, not the counselor. The counselor’s confidence in the participant’s capacity for change starts to manifest itself. In addition to motivational interviewing, contingency management and cognitive behavioral therapy are additional psychosocial methods. By educating individuals to notice and abstain from harmful ideas and behaviors, CBT can assist patients who are addicted to substances in overcoming substance abuse (Polcin et al., 2017).

          For instance, a cognitive-behavioral therapist can help a patient learn to identify the situations that make them crave drugs, alcohol, or nicotine and how to avoid or control such situations. Addiction counselors use the contingency strategy to offer patients real rewards for abstaining from drugs. For each drug test that is negative, benefits may be given, such as money, clinical privileges, steady employment, or even gift cards to restaurants. Despite the fact that these benefits may appear insignificant in compared to the power of addiction, research have shown that correctly designed contingency management programs can support people in maintaining their sobriety. The mainstay for the treatment of has been pharmaceutical therapy (Polcin et al., 2017).

                      Comparing buprenorphine to other opioid addiction therapies, there are a number of benefits. Buprenorphine is a partial agonist, unlike methadone, which means that it has a ceiling effect on the body’s respiratory centers. As a result, even at large dosages, it has no effect on breathing, making buprenorphine-related deaths extremely rare (Santa Ana et al., 2021). Finally, buprenorphine prevents the effects of other opioids, making it considerably less likely for users of heroin or other substances to overdose and to experience the high that comes with such use.

Conclusion

The main goal of motivational interviewing (MI) for substance misuse is to get over resistance or ambivalence in difficult-to-change behaviors. Motivational interviewing for substance misuse, which has its roots in client-centered treatment, does not impart specific methods for resolving issues. As a result, rather than serving as the only intervention, it is frequently utilized in concert with other therapy. MI has been applied to cocaine users in many contexts and stages of treatment. Additionally, it has been coupled with other therapeutic modalities including cognitive training. In this article, we examine current studies that claim MI is a successful nonpharmacological strategy for treating addictive behaviors.

 

 

References

Frost, H., Campbell, P., Maxwell, M., O’Carroll, R. E., Dombrowski, S. U., Williams, B., Cheyne, H., Coles, E., & Pollock, A. (2018). Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews. PLOS ONE, 13(10), 1–39. https://doi.org/10.1371/journal.pone.0204890

Martino, S., Zimbrean, P., Forray, A., Kaufman, J. S., Desan, P. H., Olmstead, T. A., Gilstad-Hayden, K., Gueorguieva, R., & Yonkers, K. A. (2019). Implementing Motivational Interviewing for Substance Misuse on Medical Inpatient Units: a Randomized Controlled Trial. Journal of General Internal Medicine, 34(11), 2520–2529. https://doi.org/10.1007/s11606-019-05257-3

Morgenstern, J., Kuerbis, A., Houser, J., Levak, S., Amrhein, P., Shao, S., & McKay, J. R. (2017). Dismantling motivational interviewing: Effects on initiation of behavior change among problem drinkers seeking treatment. Psychology of Addictive Behaviors, 31(7), 751–762. https://doi.org/10.1037/adb0000317

Oveisi, S., Stein, L. A. R., Babaeepour, E., & Araban, M. (2020). The impact of motivational interviewing on relapse to substance use among women in Iran: a randomized clinical trial. BMC Psychiatry, 20(1). https://doi.org/10.1186/s12888-020-02561-9

Pederson, S. D., Curley, E. J., & Collins, C. J. (2021). A Systematic Review of Motivational Interviewing to Address Substance Use with Justice-Involved Adults. Substance Use & Misuse, 1–11. https://doi.org/10.1080/10826084.2021.1887247

Polcin, D. L., Korcha, R., & Nayak, M. (2017). Development of Intensive Motivational Interviewing (IMI) and Modifications for Treating Women with Alcohol Use Disorders. Journal of Contemporary Psychotherapy, 48(2), 51–59. https://doi.org/10.1007/s10879-017-9370-y

Santa Ana, E. J., LaRowe, S. D., Gebregziabher, M., Morgan-Lopez, A. A., Lamb, K., Beavis, K. A., Bishu, K., & Martino, S. (2021). Randomized controlled trial of group motivational interviewing for veterans with substance use disorders. Drug and Alcohol Dependence, 223, 108716. https://doi.org/10.1016/j.drugalcdep.2021.108716

 

 

 

 

 

 

 

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