Question Description
I’m working on a health & medical question and need an explanation to help me understand better.
Prior to beginning work on this week’s journal, please read Chapter 5: Counselor Know Thyself in Meier and Davis (2018), as well as Chapter 4: Developmental Influences on Behavior Change: Children, Adolescents, Emerging Adults, and the Elderly and Chapter 5: Culture, Behavior, and Health in Hilliard, Riekert, Ockene, and Pbert (2018).
In a journal entry of 500-1000 words, evaluate moral, ethical, and cultural issues that you may encounter while working with the hypothetical client from the “Motivational Interviewing” discussion. Describe how the client’s level or readiness (i.e. Contemplation Stage) and psychosocial history might impact behavioral change. Support your response with information from Chapter 4 and 5 in Hilliard, Riekert, Ockene, and Pbert (2018).
Next, state the amount of progress you would find acceptable, and if you can be flexible, accepting, and gentle with the hypothetical client. Address any biases that you may have towards the hypothetical client, and explain how you would work to overcome these issues. Include one suggestion from Chapter 5 in Meier and Davis (2018).
Include at least one scholarly source from the university library to support your response. All sources must be formatted in proper APA style. If you are unsure how to create an APA style title and reference page, please visit the Ashford Writing Center.
Carefully review the Grading Rubricfor the criteria that will be used to evaluate your assignment.
Requirements: 1000 words
BARRIERS TO CHANGE AND MOTIVATIONAL INTERVIEWING
| Activity | Due Date | Format | Grading Percent |
|---|---|---|---|
| Motivational Interviewing | Day 3 (1stPost) |
Discussion | 4 |
| Week Four Journal | Day 7 | Journal | 10 |
Learning Outcomes
This week students will:
- Employ motivational interviewing skills using a case simulation.
- Evaluate moral, ethical, and cultural issues encountered in counseling settings.
Introduction
In this week’s discussion, you will have the opportunity to practice motivational interviewing skills with a simulated case scenario. In addition, you will consider the impact of personal, environmental, and cultural factors on behavior change in a reflective journal. Personal biases towards clients at various stages of change will also be explored.
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Welcome to Week Four
Time is flying by! As you know, we have approximately two weeks remaining in this course. Given this short time frame, everyone is encouraged to review previous feedback and set aside time to generate quality submissions. This week we will examine personal, environmental, and cultural factors that impact behavior change, as well as motivational interviewing.
Tips
- Be sure to review the weekly course announcements and/or university email for additional guidance.
- As you draft this week’s journal, consider how insight into your personal beliefs might influence your view of clients at various stages of change, and help you better support a client. Keep in mind that everyone has different viewpoints, opinions, and biases.
Intellectual Elaboration (Lecture)
This week’s lecture will focus on the topic of motivational interviewing. Moyer (2014) defines motivational interviewing as a “client-centered and directional therapeutic method distinguished by a focus on spontaneous language about change that emerges within an empathic interpersonal context” (p. 358). At the core of this approach is the Transtheoretical Model (see Week 3 Guidance), which posits that change occurs in stages. Depending on the client’s level of readiness, he or she may display resistance to motivational interviewing. For example, clients in the “PreContemplation” stage may be in denial, defensive, and unwilling to admit that they have a problem. In contrast, clients who identify with the “Contemplation” stage acknowledge the consequences of their maladaptive behavior, yet they present as ambivalent to making changes. This uncertainty may stem from self-doubt or other psychosocial factors. Given this information, it is important for health and wellness professionals to respect the client’s autonomy to explore the problem. The goal is for the client to be self-motivated to change. When the client is motivated to change a specific behavior, the health counselor is encouraged to partner with them to establish a plan of action. So how does one motivate a client?
There are several motivational interviewing techniques that can be used to inspire clients to make changes, such as:
- Asking Permission
- Eliciting/Evoking Change Talk
- Exploring Importance and Confidence
- Open-Ended Questions
- Reflective Listening
- Normalizing
- Decisional Balancing
- Colombo Approach
- Statements Supporting Efficacy
- Readiness to Change Ruler
- Affirmations
- Advice and Feedback
- Summaries
(Sobell & Sobell, 2008)
In an effort to illustrate these techniques, the case of Marie will be utilized.
Counselor: Marie, if you were ready to change your eating habits today, what things would you have to do in order to make this happen?
This is an example of Eliciting/Evoking Change Talk.Notice that the counselor does not assume that Marie is ready to change. Rather, the counselor encourages the client to consider what actions she needs to take. By asking this question, the counselor does not have to be the one telling the client what changes she needs to be made.
Counselor: Marie, what happens when you choose to eat unhealthy foods?
This is an example of an Open-Ended Question. Using this type of question allows the client to share a narrative and can generate a rich dialogue between the counselor and client. Open-ended questions also allow the client to be the dominant speaker.
Counselor: Marie, many people want to make better food choices but find it difficult to make this type of change.
This is an example of Normalizing. Helping the client see that they are not alone is vital. This can help the client move past ambivalence.
Counselor: Marie, help me understand. On one hand unhealthy foods makes you feel physically ill, but on the other hand, they alleviate stress.
This is an example of Decisional Balancing. This approach enables the client to explore the pros and cons of their behavior. Being aware of the benefits of the behavior can help the counselor also understand why the behavior has been maintained over time.
Counselor: Marie, you are making great strides in changing your eating habits.
This is an example of an Affirmation. Acknowledging the client’s progress can increase self-efficacy in maintaining behavioral change.
For more examples of motivational interviewing techniques and resources, click this link.
In summary, motivational interviewing is a strategy that is employed with various health issues, most commonly dietary behavior change and substance related disorders. It is a collaborative, person-centered approach that helps individuals resolve ambivalence surrounding behavioral change. Furthermore, motivational interviewing involves “openness of discussion, proficiency in client-centered counseling, identifying change and sustain talk, eliciting and strengthening change talk, reflectively hearing sustain and resistance talk, recognizing readiness toward development of a change plan, consolidating commitment, and transitioning and blending motivational interviewing techniques with other effective behavioral approaches and strategies” (Hilliard, Riekert, Ockene, & Pbert, 2018, p. 146). Despite these eight interactions, health and wellness professionals should be mindful of individual factors (mental health, health literacy, self-efficacy, health beliefs, coping skills, personality), demographic variables (age), and social/cultural factors (support) as they may impact a client’s ability to make progress.
Reflection Questions:
What challenges might arise when using motivational techniques?
How might you respond to a client who is resistant to changing a behavior?
References
Meier, S., & Davis, S. (2018). The elements of counseling (7th ed.). Belmont, CA: Brooks/Cole
Hilliard, M.E., Riekert, K.A., Ockene, J.K., & Pbert, L. (2018). The handbook of health behavior change (5th ed.). Retrieved from https://redshelf.com
Moyers, T. B. (2014). The relationship in motivational interviewing. Psychotherapy, 51(3), 358-363. doi:10.1037/a0036910
Sobell & Sobell. (2008). Motivational interviewing strategies and techniques: Rationales and examples. Retrieved from http://www.nova.edu/gsc/forms/mi_rationale_techniq…