EDCO 740 DB Evoking in Motivational Interviewing
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Feb 20, 2024
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Give an example of Marci’s “change talk.”
When clients make statements that support the idea of change, it is referred to as "change talk" or
"self-motivational statements" (Miller & Rollnick, 2013). An instance of "change talk" can be found in the case narrative when Marci shares her emotions following her arrest. Marci expresses
feelings of guilt and remorse regarding how her alcohol and marijuana use is negatively impacting her relationship with her parents and impeding her journey to becoming a lawyer. To summarize, Marci believes that her marijuana use harms her motivation, family connections, education, and spirituality (Addiction Case Narrative, 2021).
Give an example of Marci’s “sustain talk.”
Clients often engage in "sustain talk," expressing their reasons or excuses for resisting change (Miller & Rollnick, 2013). This type of talk contradicts change talk and holds different implications (Miller & Rollnick, 2013). For instance, Marci exemplifies sustained talk by acknowledging that she has not used marijuana since her arrest, but still doubts its harm. She finds pleasure and relaxation in marijuana use, and if she could avoid consequences, she would continue using it. Marci believes that alcohol and marijuana provide solace when she feels inadequate in meeting her own and her parent's expectations (Addiction Case Narrative, 2021).
Where is her ambivalence coming from? Why do you think it is there?
Clients who find themselves in a state of ambivalence are faced with conflicting desires - the desire to change and the desire to remain as they are. However, this ambivalence is a normal and crucial step toward initiating change (Miller & Rollnick, 2013). Marci's ambivalence seems to stem from her struggle to maintain a positive relationship with her parents and pursue a career as a lawyer, while also indulging in destructive behaviors such as binge drinking and smoking
marijuana, which she finds pleasurable and relaxing. Marci finds herself torn between her love for her family, her aspiration to become a lawyer, and her enjoyment of these self-destructive habits. These internal conflicts are causing Marci discomfort and emotional turmoil. It is similar to the turmoil one experiences when torn between two lovers or when desperately yearning for something that is bound to have negative consequences (Miller & Rollnick, 2013).
Write one sentence for each letter of OARS that you could use with her.
Open-end Question
Can you share with me any challenges you have faced while attempting to make changes?
Affirming
Your previous accomplishment of abstaining from smoking for half a year deserves applause. It serves as evidence of your resilience and ability to embrace transformation.
Reflections
I understand that you have been reflecting on your bond with your parents and the influence your
usage of alcohol and drugs has had on it.
Summarizing
I understand that you are conveying that your relationship with your parents, as well as your drive and academic achievements, have suffered due to your alcohol and substance abuse. Am I understanding you correctly?
How could you use MI’s process of “evoking" to help her resolve any ambivalence and encourage her in a direction of change?
To evoke "change talk" in a client, various techniques can be utilized. These include asking questions, employing the importance ruler, exploring extremes, reflecting on the past and future, and delving into goals and values. However, the most straightforward method of eliciting "change talk" from a client is simply to request it. This can be accomplished by posing open-
ended questions that necessitate the use of "change talk" in their responses. To foster a shift from
"sustain talk" to "change talk," the DARN CAT's MI strategy can be employed. Pócs (2021) defines DARN as preparatory "change talk" and CAT as mobilizing "change talk." Armed with this understanding, I would utilize the DARN acronyms (desire, ability, reasons, need) to generate "change talk" (Miller & Rollnick, 2013). Here are a few example questions employing DARN that I would pose to Marci, aimed at resolving her ambivalence and motivating her toward change.
D
esire: What changes would you envision in your life one year from today?
A
bility: Is there something that you believe you could potentially alter?
R
easons: What benefits could you experience by refraining from using marijuana?
N
eed: To what extent do you value the restoration of trust from your parents?
Try to find two Scriptural references that could apply to the process of evoking, and how you would seek to use them in working with Marci.
As a Christian practitioner, I hold the belief that incorporating scripture into counseling sessions holds great significance. However, it is crucial to approach this with sensitivity, ensuring that the
client is not offended in any way. Therefore, it is important to identify the right moment to introduce scripture, as forcing it upon an unprepared client can impede the progress of the counseling process. While the case study indicates that Marci is a churchgoer, it is wise to first
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gauge the strength of her faith before integrating scriptures into our sessions. If Marci displays readiness, I would consider applying two specific scriptures, namely I Corinthians 15:33 and Isaiah 43:19, to Marci's unique circumstances. I Corinthians 15:33 advises, "Be not deceived: evil communications corrupt good manners'" (King James Bible, 1769/2023). By posing the question of what Marci perceives as bad company, this scripture prompts her to reflect on her situation. This reflection may reveal that her excessive drinking episodes solely occur when she is in the presence of her so-called friends. Consequently, Marci may begin to realize that her friends are not beneficial to her well-being, as their approval of her excessive drinking serves to corrupt her moral compass.
"Behold, I will do a new thing; now it shall spring forth; shall ye not know it? I will even make a way in the wilderness, and rivers in the desert" (King James Bible, 1769/2023, Isaiah 43:19). This verse serves as only one of the countless assurances bestowed upon us by God. Its resonance in Marci's heart will ignite a profound transformation, for it holds within it the power of hope. It is hoped that Marci desperately seeks, for it is hoped that will ignite the flame of determination within her, birthing a fresh perspective and inspiring her yearning for change.
References
Addiction Case Narrative (2021). Case study: Marci. https://canvas.liberty.edu/courses/208993/assignments/3314015
King James Bible
. (2023). King James Bible Online. https://www.kingjamesbibleonline.org/
(original work published 1769)
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change
(3rd ed.). New York, NY: Guilford Press. ISBN: 9781609182274.
Pócs, D. (2021). Online motivational interviewing counseling approach to reduce tobacco use
. (Doctoral dissertation, site).