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Motivational Interviewing Intervention
Mary is 27 years old and has had a history of alcohol dependence for several years. Mary has a daughter Kylie, aged 3 years, who displays signs of fetal alcohol syndrome. Social work services have been involved with Mary and Kylie since her birth, culminating in Kylie being looked after by the local authority as a result of Mary arriving to collect Kylie from the local nursery while significantly under the influence of alcohol. Mary has demonstrated ambivalence regarding her ability to control her alcohol use. Mary has referred herself to a local counseling agency as suggested by the social worker and her PCP.
- Discuss how you might use the principles of motivational interviewing with Mary.
- Provide a detailed overview of how the interview may progress. Include each step of motivational interviewing in your discussion.
- Describe how a provider would recognize this patient is ready to change. Use principles of motivational interviewing to support your answer.
- post should be at least 500 words, formatted and cited in current APA style.
- Provide support for your work from at least 2 academic sources less than 5 years old.
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Motivational Interviewing Intervention
As a counselor working with Mary, a 27-year-old with a history of alcohol dependence and a 3-year-old daughter, Kylie, affected by fetal alcohol syndrome, I would utilize the principles of motivational interviewing (MI) to address her ambivalence and support her recovery. MI, a client-centered approach, emphasizes collaboration, evoking the client’s own motivations, and respecting autonomy, which is critical given Mary’s self-referral following social work and primary care provider (PCP) suggestions (Miller & Rollnick, 2023). My goal is to help Mary explore her readiness to change, considering the significant impact of her alcohol use on Kylie, who is now under local authority care due to Mary’s intoxication during a nursery pickup.
The MI process with Mary would progress through four key steps. First, in the engaging phase, I would build rapport by acknowledging her courage in seeking help, asking, “What brought you here today?” This establishes trust, crucial given her ambivalence and past social service involvement. Second, during the focusing phase, I would guide the conversation toward her alcohol use and its effects on Kylie, using open-ended questions like, “How do you feel about what happened at the nursery?” to narrow the focus on change-worthy issues. Third, in the evoking phase, I would elicit her intrinsic motivations by exploring benefits of reducing use, such as reuniting with Kylie, asking, “What might improve if you had more control over your drinking?” This leverages her love for her daughter as a change driver. Finally, in the planning phase, I would collaborate on concrete steps, such as attending support groups, summarizing, “You’re considering cutting back and exploring meetings to support Kylie’s return,” ensuring her commitment.
Recognizing Mary’s readiness to change involves observing MI principles, particularly change talk and commitment language. Readiness is evident when Mary expresses desire, ability, reasons, or need (DARN) to change, such as saying, “I want to be there for Kylie,” reflecting personal motivation (Miller & Rollnick, 2023). Sustained change talk, like discussing specific reduction goals, indicates movement from precontemplation to contemplation or preparation stages. Additionally, her self-referral suggests initial action, a sign of readiness reinforced by reduced resistance during evoking, such as nodding or elaborating on benefits (Smith et al., 2021). I would affirm these statements, reflecting, “You’re motivated by Kylie’s well-being,” to strengthen her resolve, aligning with MI’s focus on amplifying client-driven change.
This MI approach could transform Mary’s treatment by fostering a personalized plan. Her readiness, signaled by change talk and action initiation, suggests she may benefit from cognitive-behavioral therapy or family counseling to address Kylie’s needs, guided by her goals (Smith et al., 2021). By respecting her autonomy and building on her maternal motivation, I can support sustained engagement, though success depends on consistent follow-through and addressing underlying trauma, which may require further assessment.
Motivational Interviewing Intervention
References
Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change (4th ed.). Guilford Press. Smith, J. A., Brown, T. R., & Lee, K. M. (2021). Enhancing motivation in substance use treatment: A motivational interviewing perspective. Journal of Substance Abuse Treatment, 125, 108–115. https://doi.org/10.1016/j.jsat.2021.108305