Posted at 12.13.2018
Critically analyse your practice of the Motivational Interviewing strategy with specific mention of your classroom learning and work placement
On reflection I've learnt a good deal about the MI approach, putting the classroom learning into practice, then looking at my performance on the DVD is a important part of my learning process. Although being familiar with many of the techniques, which act like skills I already maintain, the actual procedure was not used to me.
In quick MI allows a normally client lead Person Centred Approach to have direction by allowing clients to discover their ambivalence acknowledging that change can be done and cultivating their innate causes to make necessary changes that are appropriate to them. I have recognized that for myself I'm going to need to apply, review and develop my techniques & understanding with utilizing this model.
It is emphasised with MI that the soul of the methodology is conceivably more important than techniques used. Personally i think really the only way to describe this phenomena is to recognize that the nature would be how the therapist reveals themselves & just how that he/she utilises the techniques. With MI it's the client's responsibility to solve their ambivalence finding intrinsic motivation to change problematic behaviours, not the therapists to impose or suggest change. The counselling approach is normally a soft, tranquil eliciting style, which places importance on the working romance being a partnership.
The extreme compare to MI would be confrontational strategies, which may try to break a client's denial through authoritative derogatory shaming approaches stripping away individuals defences and rebuilding their identities with societies or organizations philosophies.
The therapeutic procedure of a pure Person Centred counselling model essentially depends upon the three central conditions of Congruence, Empathy and Unconditional Positive respect these conditions contribute to the existence of the Counsellor influencing the relationship formed with your client.
With addiction treatment adjustments where time constraints are common Motivational Interviewing makes it possible for more composition & path being put on the normally client lead Person Centred Strategy. By expanding discrepancy between customer beliefs and difficult behaviours direction may be accomplished. Regarding to "when discrepancy becomes large enough and change seems important, a seek out possible methods for change is initiated" (p. 11).
I have previously included some use of MI into my practice however, I'm aware sometimes my agencies plans and procedures are in conflict with the MI heart. Recently, I've had to check on my own incentives in using MI, making certain I'm not employing it as a kind of manipulation to go clients into adherence with businesses regulations, which would blemish the spirit of the MI methodology.
The compatibility of the MI approach in my place of work is questionable in some areas. Our treatment modality is a 12 step abstinent based mostly strategy, which immediately comes up two issues with the MI nature. Firstly, not all clients may wish total abstinence and those who do may decide to achieve it for some reason that is not 12 step orientated. It really is agency policy that all clients sign up for 12 step fellowship conferences every evening throughout their treatment period.
In our treatment setting up the MI procedure has shown to be useful in several areas when clients at first get to treatment nervousness levels are high if not tackled can result in dropout. Application of MI here can help the client focus on the influencing factors that motivated these to contemplate treatment in the first place. Furthermore, MI is recognized a beneficial method of use with upset clients especially the principals of moving with resistance and the manifestation of empathy.
Although the clients have went to our treatment service for a variety of reasons, it is difficult to put them all in a single bracket regarding the "stages of change" model. Taking into account their liquor / drug use a large proportion would be in either contemplation or dynamic change. Some clients may display signs of amount of resistance to improve around other areas of these life which may include being in a romance with somebody who is still active in addictive behavior. Many clients likewise have difficulty with assertiveness, which is going to be necessary to develop to allow them to help maintain habit free lifestyles. It really is an activity of change for clients conversely several distinct necessities are attained with varying examples of resistance by specific clients.
The first example I'll use is a male client of 42 years of age who have been dependent upon substances for twenty years. He shows high degrees of curiosity about the abstinent strategy registering high by using a Likert diagnosis tool to evaluate his Willingness, Potential & Readiness regarding an abstinent life-style. With regards to his compound use, I'd determine him to be in the action stage of Prochaska and DiCliemente "The levels of change" (see appendix A).
He has a partner who still is a substance end user; he exhibits high degrees of level of resistance to changing this area of his life and feels that he'll have the ability to change her view on compound taking once he returns home following the completion of his treatment. I have been affirming the client consistently with the changes he has designed to his behavior whilst in treatment and with permission from him, pointing how his changes are based on the 12 step abstinent established strategy. What I'm trying to accomplish is too strengthen his notion in himself relating to this particular approach. By doing this I feel that there are inconsistencies further growing between his two cognitions "I wish to remain element free, yet I want to go home to my spouse who is a substance individual. " As he's now starting to question his own thinking, I could observe that the cognitive dissonance is starting to have an impact I'm hoping he will seek to improve the high-risk dissonant cognition by remaining in Bournemouth to wait aftercare.
A client we recently possessed at our facility who presented for cannabis use, and admitted his main motivation to be in treatment was to avoid heading to prison exhibited repellent behaviours towards the treatment modality. His resistance would manifest in ways of walking out of group remedy, getting up and travelling whilst clients were showing personal tasks & generally exhibiting no admiration for how many other clients were attempting to achieve. The use of MI in this situation was quite difficult as a primary approach in line with agency coverage and procedures had a need to take place first. We'd attempted on several events never to take too much notice of the unacceptable behaviours he provided which could be considered rolling with amount of resistance, however eventually needed to enforce an ultimatum. In circumstances such as this I came across it very hard almost impossible to stay in a totally pure orientated nature of MI.
To say that I've learned the "concepts & principles" of MI will be a significant over estimation. I have furthered my understanding of the contributing elements of MI including the "stages of change model", the techniques used to work with ambivalence & level of resistance. Most importantly, I have learnt above all else MI is approximately allowing your client to be the expert and for me to keep an eye on the type of language that I take advantage of. The soul of MI I've no real problem with other than perhaps on occasions avoiding the "expert capture" generally I really do present myself within the heart of the model.
The application of this particular model I'm using at work in a tentative way, quite simply I'm putting it on using situations where perhaps I feel confident to use it. An example of this would be, when clients seem to be to be making rash decisions to leave treatment or are showing ambivalence about an abstinent methodology.
After researching the DVD it is clear to me that we lack assurance in the application of the MI way. I do however feel though that practice and researching my practice can only just help with me developing my implementation of this approach. Personally i think that I have to become more mindful of the dialect I take advantage of whilst dealing with clients. Since it became apparent if you ask me whilst critiquing the DVD that I can without realising get caught in traps. An example of this might be by the end of the treatment I asked my consumer easily could give him something to eliminate. On reflection, I possibly could have asked him how he felt he could evaluate his decision on obtaining a shed.
My future development is going to involve applying & critiquing my practice, what I have started to look for at my work setting in my practice which of might work colleagues is to identify what clearly is not MI.
Some observations I have acknowledged not only with this approach are the honest issues that can occur between benevolence & autonomy. After some consideration, the example I used previously in this task with a male customer whose partner remains in energetic craving. His autonomy was to return home after treatment completion my interest or benevolence has been the safety of your client. As a specialist, I know it would be dangerous for him to come back home to somebody who remains positively taking illicit drugs. The question is do Then i use MI as a way to manipulate the client? My answer is yes of course I do. Questionably is this really in the pure nature of the way?