This paper discusses alcoholism, its behavior on individuals and its association with relevant health conditions. With the changing health care system, health care providers, nurses, and counselors have stepped into the arena of health promotion. A scenario case study was put together to depict the need for counseling individuals with risky behaviors and how it impacts their health. Recommendations and goals were incorporated into the clients counseling. Millers interviewing technique was used to guide the counseling session conducted with a person afflicted with alcoholism with the end resulting in behavior changes. Motivational interviewing is an approach based upon principles of experimental and social psychology, attribution, cognitive dissonance, and empathy placing emphasis on internal acceptance for change. Cognitive dissonance is created by contrasting the ongoing problem behavior with the behaviors negative effects. Empathy is incorporated to channel the conflict into a behavior change solution.
Introduction
With the changing health care system and an increased emphasis on cost-containment, the role of the nurse is expanding more and more into the arena of health promotion. Primary health care visits offer opportunities to identify and intervene with risky or harmful drinkers to reduce alcohol consumption. Nurses are in a unique position to influence the health of patients, communities, and nations using scientific and theoretical knowledge in health promotion counseling. More than 20% of clients receiving care can be categorized as risky drinkers but few receive the appropriate evaluation and less than 50% of alcohol screening is reported or used (Rose et al., 2008). This may be due to the fact that...
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...blem as well as their treatment. Miller suggests that client resistance is a product of the interaction with the counselor who uses confrontational interviewing style. Rather than counselors trying to convince the client to change, the counselor should draw out arguments for change. Such technique is the use of empathy in their style. Several studies supported that therapists behaviors influence clients treatment outcomes. It has been found that the more counselors confront the clients drinking the more the client will drink (Miller, 1993).
The one recommendation geared to the theory is describing what is considered motivational. The skill of Motivational interviewing is a counseling style not subjected to being used loosely with practitioners attempting to motivate his/her client in health promotion without the proper use of the theories steps.
Motivational interviewing (MI) was developed in 1983 from a personal experience of one of the therapist, and it has been used since then. The definition of MI changed over the years. Currently, it is an evidence-based practice in the treatment of substance abuse users. This method focuses on establishing a collaborative guideline, based on patient’s values, to motivate the person for internal exploring of the issue and resolving it (MI, n.d)
prime example of how imposing your own beliefs and values can cause ethical issues. If a counselor finds a client is challenging to work with there are a few different approaches they can take to get more out of the client. One important action a counselor can take is changing how the counselor interacts with the client. A publication on managing resistant clients found if counselors focus on organic interaction with the client and allow all course of actions to take place naturally this establishes a less resistant client and therapy is more effective.
Severe mood swings, violent rages, memory loss—each of these problems were a part of my family life during the past two or three years. These problems are the result of alcoholism. Recently, a member of my family realized his abuse of alcohol was a major problem to not only himself, but also to those around him. He would lose control of his temper and often would not even remember doing it the next day. Alcohol became a part of his daily life including work, home, and any other activities. His problem was that of a "hidden" and "high-society" alcoholism. When he was threatened with the loss of his job and the possibility of losing his family, this man knew it was time to get help. After he reached his lowest point, he took the first step towards recovery—admitting his problem.
The initial screening process is important because patients often try to cover up their dependency issues or may be in denial about their drinking problem. After a thorough examination and history taking, the nurse provides three important steps to treating the alcoholic: intervention, detoxification, and rehabilitation. During the initial patient assessment, the nurse will document numerous symptoms such as autonomic hyperactivity (sweating or a fast pulse), increased hand tremor, insomnia, nausea or vomiting, hallucinations or illusions, agitation, anxiety, grand mal seizures, tactile disturbances, auditory disturbances, visual disturbances, headache or fullness in the head. Lab work is usually ordered to check for liver and other body functions. The nurse will maintain physiological stability during the acute withdrawal phase from alcohol and will promote patient safety. Appropriate referral, follow-up, and patient support, as well as information about condition/prognosis and treatment will be provided to the patient. Since co-existing or underlying disorders are common, some individuals may be suffering from other underlying psychiatric conditions and have been using alcohol as a form of self-medication. If this is the case, proper diagnosis of any co-existing psychiatric conditions (depression, bi-polar disorder etc.) will be made. Because alcoholism
Motivational interviewing (MI) is a form of interviewing to promote change talk. It is not a way to make people do things they do not want to do, but instead is a way to motivate them into accomplishing the good changes they have been thinking of. The spirit of motivational interviewing is that it is collaborative, evocative and it honours patient autonomy. Collaboration addresses the specific situation where client behaviour change is required, and this is achieved by working together, as counsellor and client, to find the answer. Unlike motivational interviewing, heath care often gives the client what they lack, whether that be medication or an answer to fix their problem. MI invokes what clients already have within to find the answer they are looking for, which is why it is evocative. Lastly, MI requires a certain degree of attachment
Many do not clearly understand how serious alcohol abuse really is. According to CDC (Centres for Disease Control and Prevention), “Excessive alcohol use is responsible for approximately 88,000 deaths in the United States each year”. In addition to that, the NIH (National Institute on Alcohol Abuse and Alcoholism) claims that alcohol is a risk factor for cancers like liver, breast, mouth, esophagus, and many more. According to Steven Reinbersg’s article titled as “Third of Americans Have Alcohol Problems at Some Point”, more than “30 percent of Americans say they have had problems with alcohol”, proven by studies. Numerous Americans take advantage of alcohol frequently, but do not realize what kind of side affects it can bring for themselves. Though, alcoholism is often brought to awareness, one may feel like they are not educated enough about it.
“Alcoholism may be treated in several ways including hospitalization, therapy, and self-help groups” (Diamond 64). But the very first thing people with alcoholism should do before getting a treatment is to admit that they have alcoholism. Usually, people with alcoholism deny that they have this problem (Torr 26). Friends and family who try to help them with their problem end up having arguments. Even when they admit that they have alcoholism, they will insist that they can treat themselves, even though they fail trying (Diamond 63). Unless they are willing to get treated, nothing is going to happen and they will just only continue to drink alcohol, further harming themselves and the people around
The most important key point that I gathered from the video, is that motivational interviewing is a client-centered approach that allows the client to be in control of his or her outcomes. This approach demonstrates a level of respect between the client and therapist and allows the client to be authentic and remain in control of his or her destiny with the guidance of the therapist.
Also, many research reports purporting effectiveness have either failed to give sufficient detail regarding critical principles and techniques to determine treatment fidelity and/or claim to use MI (Baer, Beadnell, Garrett, Hartzler, Wells & Peterson, 2008). Similarly, in embracing the spirit of Motivational interviewing, may not only result in clients learning new behaviors but may require existing behaviors to become suppressed (Arkowitz, Westra, Miller & Rollnick,
Treatment offers the opportunity to gain more insight into the underlying issues driving the alcohol abuse and dependence. Gaining a deeper understanding of triggers and unhelpful thought patterns can increase awareness. With increased awareness, better decisions can be made and destructive behaviors can be reduced. Therapies, family sessions, and relapse prevention techniques equip clients with the tools and resources they need to maintain their sobriety. Providence Project Alcohol Rehab Centre offers best-practice treatments specifically designed to increase awareness, promote healthy coping patterns, and increase
Motivational interviewing is a counseling method that helps people decide ambivalent feelings and insecurities to find the internal motivation they need to change their behavior. It is a practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes in a person’s life. Motivational Interviewing is a collaborative, goal oriented method of communication with particular attention to the language of change. The examples of the lower risk and higher risk from the videos showcased the difference in working with different types of clients. This technique can be active in any conversation, the videos that were watched for motivational interviewing showed the casual conversation being between the therapist and the client, it was in a not judgmental way which assisted the client in the opening about their life and struggles they are currently facing. In a therapy session, the client often appears “caught” and unable to
Motivational interviewing is a great way to get clients involved. In the healthcare setting, it is a way to empower clients and help them help themselves. As shown in the BMJ learning module, motivational interviewing accepts the changes that occur in the human life which is very important for the process of change. This allows the healthcare provider and client to work together and make necessary changes along the way to reach the overall goal. It also gives the client support, autonomy, and a sense of efficacy on reaching their goal.
Once the extent of the drinking problem has been established a set goal of reducing the number of alcoholic drinks is agreed upon rather than complete abstinence. A regular structured review of the patients progress can be, and often is reinforced by other positive motivators such as self help manuals and personal reflection on the contradictory nature of their desire to drink and their view of their problems.
Due to, Alcohol is the most deadly drug in the world, and “considering the economic cost and the price in human suffering of substance abuse, it seems imperative that counselors be trained in all aspects of substance abuse, intervention, and prevention” (Stevens, 2009). Therefore, with the purpose of gaining experience attending any recovery group for my Human Behavior class assignment I went to observe an AA meeting with three of my class of Human Behavior.
Motivational interviewing is a counseling approach that attempts to engage an individual away from a state of indecision or uncertainty and towards finding motivation to making positive decisions and accomplishing established goals. The predominant thought was that lack of motivation needed to be addressed in therapy through confrontation. During this process, the therapist would first express empathy; both accept and understand the patient’s mindset. Second, develop discrepancies; list reasons why a change was needed; state the negatives associated with lack of change, and pressure the person to change as means to gain motivation. Third, Avoid Escalating Resistance; health care providers can unwarily come off as judgmental, diminish feelings and argue with the patients. Fourth, Roll with Resistance;