Brief Demonstration of Motivational Interviewing
-By Timothy Lyons
I will demonstrate the use of three different techniques Acceptance and Commitment Therapy, Cognitive Behavior Therapy and Motivational Interviewing. The first example is a Brief Demonstration of Motivational Interviewing.
I, the helper (H), will attempt to assist a client, in dealing with a particular problem. There will be three different sessions each using a different technique to demonstrate an integrative or eclectic helping approach to tackle different dimensions of the attending issue(s).
Intake
The Client, Trent (T), a Transition age youth of 16 Years came in to deal with some issues he had been having with his school work. He is a white male of Irish descent. With this family background I should be able to use most of the western techniques that I have at my disposal. I will also use some of the eastern influenced therapies that can cross cultural boundaries. He has been having problems in school and he no longer wants to attend up to graduation. He wants to finish the year with the home school component offered to continuing education students. He has been fighting with his mother for some time over his poor attendance, his shoddy work and resulting poor grades, his negative affect and his unwillingness to assist with any chores around the house. He has been unwilling to go to therapy prior to this time but now believes that the helper will agree with him and keep his mother in check.
In his intake interview meeting it is discovered that Trent blames his failures on everyone else around him. He has not really done the work, and he is using marijuana on a regular basis but does not see this as a contributing factor to his problems. He also feels that the school has “screwed him over” so that he will not be able to graduate on time unless he gets out. He also wants to move out of the house because his mother is “stepping on his neck” and only has a job part time at the grocery store and does not make enough money to move. It might be possible to assist the client with a Brief Demonstration of Motivational Interviewing
Motivational Interviewing
Session one will involve using a Brief Demonstration of Motivational Interviewing (MI) to assist the client to see where he is in terms of his ability to view the problem for what it is and his willingness to make a change. This effort will be combined with the stages of change model to enable the client to move toward change.
Session one- Helper (H) -Trent what can you tell me about your role in the problems that you are experiencing. Trent (T) my mom is a total douche. I can’t even believe that I have to come here. She is the reason for all this bullshit. H- You sound angry at her. T- I am. H- So really you think it’s all her fault? That you have nothing to do with this and that you should not be here for any reason. What can you tell me about your part in this? T- What are you on about man? Yeah I think it’s her fault. But I don’t know. I do realize that there is the school people and they have never helped me in this. H- You told me that you had not done some of the work and that you were smoking marijuana. Is it possible that this not doing the work and smoking pot has anything to do with your current problem? T-Well I didn’t do the work, I did tell you that. And I was smoking pot quite a bit, but I cut way back. But she is always on about the BS man. It’s like she doesn’t care about what I am going through. She is just as bad as the school. They don’t want to help either. H- I can really hear your frustration with this. Its sounds like you believe you are not being heard. T- Yeah you can say that again H- one of the things that I am trying to do here is to help you see your part in this so that I can give you the help that you need. T- What do you mean? H- When you first came in you said that it was all your mom but at the same time you have admitted to me that you didn’t do some of the work and that you were using drugs. If you were me what would you think? T- Hmm, I would think that this guy isn’t seeing something. H-what else? T- That maybe this guy was part of the problem too. H- What makes you say that? T- Well his Mom wasn’t the one smoking the pot. Also she wasn’t the reason he didn’t do his work. H- Good. That was a big leap for you. Do you see that about yourself? T- Yes, (casts his head down a bit.) H- But that’s not all bad. I think you could use my help here. Maybe help sorting out the problem. Would you accept that from me? T- Yeah I think so. H- Great let’s get started…
As the client first came in, it was important from a therapeutic standpoint to get a grasp on how well he really saw that he had a problem. In order to help him it was necessary to get him to see for himself and through his own eyes that he even had a problem. At first he was only in the pre-contemplation stage and could not see anything wrong. By asking some important questions that both confronted the client’s viewpoint and assisted him in seeing that he had a part through the MI process, the client was easily brought to a contemplation stage where he will be more willing to allow that helper to assist him. Motivational interviewing is based on the assumption that the client knows for himself what can help him. By getting him to look at it from another perspective and applying that perspective to himself, the client can see that he was part of the problem and that he might find more help in therapy. The Contemplation stage is more beneficial and it certainly has been proven to raise retention rates in the therapeutic setting.
By utilizing the techniques described I am able to help people who come to me. With Brief Demonstration of Motivational Interviewing (MI) I can get them into a position of motivation so that they are ready for therapy or more ready if they are already so. I can judge how much work I have to do to get them to the ready position if they are not there. There will be times with resistant clients where I will take more than these sessions to do this work. I will be able to utilize evidence based techniques to improve the overall success rate. I will have essential tools that have been proven to work. I can incorporate any number of ideas for therapy with different client populations and different cultures that others in the field have gone before me and paved the way for me to use.
You can read the next installment of this session at a Brief demonstration of Cognitive Behavior Therapy
References for Brief Demonstration of Motivational Interviewing
The Albert Ellis Institute. (n.d.). Rational Emotive & Cognitive-Behavior Therapy. Retrieved March 10, 2017, from http://albertellis.org/rebt-cbt-therapy/
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy (2nd ed.). New York, NY: Guilford Press.
Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational Interviewing in Health Care (1 ed.). London: The Guilford Press.