HSV532_Theories of Alcohol and Drug Counseling (1)

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THEORIES OF ALCOHOL AND DRUG COUNSELING 1 Stages of Change vs. Motivational Enhancement Student Name: Institution Affiliation: Course: Instructor Name: Date:

THEORIES OF ALCOHOL AND DRUG COUNSELING 2 Stages of Change vs. Motivational Enhancement Motivational Enhancement and Stages of Change are valuable tools in helping individuals make positive changes in their lives, especially when it comes to behaviors like substance abuse or other mental health issues. Motivational Enhancement focuses on enhancing motivation, while the Stages of Change model provides a framework for understanding the stages individuals go through during behavior change, allowing therapists to tailor interventions accordingly. The discussion of this assignment will be centered on option 1, that is, stages of change and motivational enhancement. As noted by Dakwar et al. (2020), Motivational Enhancement is a goal-oriented therapeutic approach developed to assist individuals in resolving ambivalence and bolstering their motivation for change, with a primary focus on addressing substance abuse and addiction. At its core, Motivational Enhancement adopts an empathetic and non-confrontational style of therapy. It emphasizes the importance of expressing understanding and compassion while working collaboratively with clients. In the view of Dakwar et al. (2020), Motivational Enhancement employs various strategies, such as developing discrepancies between an individual's current behavior and their desired goals, steering clear of confrontations or arguments, and effectively managing resistance through techniques derived from motivational interviewing. This therapy is instrumental in nurturing self-efficacy and goal-setting, often accomplished within a relatively short-term framework spanning 4 to 12 sessions. Motivational Enhancement is frequently integrated as a vital component of comprehensive treatment plans designed to address substance use disorders and foster positive, lasting changes in individuals' lives. On the other hand, Stages of Change Model, also known as the Trans-theoretical Model, offers a valuable framework for comprehending the intricate process of behavior change.

THEORIES OF ALCOHOL AND DRUG COUNSELING 3 Developed by Prochaska and DiClemente, this model is composed of five primary stages which includes Precontemplation, Contemplation, Preparation, Action, and Maintenance, with an optional sixth stage, Termination. As noted by Chang et al. (2022), what sets Stages of Change apart from other models is its acknowledgment that individuals may transition between these stages, underscoring the fluid nature of change. Therapists utilize this framework to tailor interventions precisely to an individual's stage of readiness for change, facilitating progress from initial unawareness or denial of a problem in the Pre-contemplation stage to taking tangible actions and maintaining positive behavioral change in the Maintenance stage. Notably, the model destigmatizes relapses, recognizing them as inherent components of the change journey ( Chang et al., 2022). Its adaptability and effectiveness have made it a widely applied tool in diverse therapeutic settings, including addiction treatment, mental health counseling, and health behavior change. Stages of Change and Motivational Enhancement share a fundamental focus on behavior change, particularly in addressing issues like substance abuse. Both approaches prioritize client- centered care, emphasizing empathy and support within the therapeutic relationship. As noted by Krebs et al. (2018), both theories involve goal setting to facilitate progress and recognize the fluid nature of change, acknowledging that individuals may move back and forth between stages. However, they differ in their theoretical underpinnings and practical applications. Stages of Change provides a theoretical framework for understanding the process of change through distinct stages, while Motivational Enhancement is a structured therapeutic approach that employs motivational interviewing techniques to enhance intrinsic motivation for change ( Krebs et al., 2018). The therapist's role varies, with Stages of Change primarily focused on assessing readiness for change, while Motivational Enhancement actively engages in motivating clients for

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THEORIES OF ALCOHOL AND DRUG COUNSELING 4 change through specific techniques. Ultimately, the choice between the two depends on the client's needs and the therapeutic goals, with Stages of Change offering a conceptual model and Motivational Enhancement providing practical interventions to enhance motivation and facilitate behavior change. Both the Stages of Change model and Motivational Enhancement are related to the process of behavior change, especially in addressing issues like addiction, but they differ in their specific stages and applications. The Stages of Change Model offers a structured framework for understanding the process of behavior change. According to Chang et al. (2022), this theory begins with the Precontemplation stage, where individuals are oblivious or resistant to their problematic behavior. As they progress to Contemplation, they start recognizing the need for change, assessing the benefits and drawbacks. In Preparation, active planning and goal setting take place. The Action stage marks the actual implementation of changes, signifying a crucial step in their transformation. Maintenance follows, emphasizing the consolidation and prevention of relapses. Some versions, though optional, include a Termination stage, indicating full integration of the new behavior into one's life. This model serves as a roadmap for individuals seeking personal growth and behavioral transformation. Motivational Enhancement does not have distinct stages like the Stages of Change model. Instead, it employs motivational interviewing techniques to enhance an individual's intrinsic motivation for change throughout the therapeutic process. According to Dakwar et al. (2020), Motivational Enhancement focuses on assessing and enhancing a client's motivation, readiness for change, and self-efficacy. It involves techniques like reflective listening, developing discrepancies between current behavior and goals, avoiding arguments, and rolling with resistance. While the Stages of Change model provides a framework for understanding the stages

THEORIES OF ALCOHOL AND DRUG COUNSELING 5 individuals go through during behavior change, Motivational Enhancement is a therapeutic approach that actively uses motivational interviewing techniques to enhance motivation for change. The two are related in that they both aim to facilitate behavior change, but they differ in their specific stages and therapeutic techniques. Motivational Enhancement can be applied at various stages of change, tailoring its interventions to the client's readiness and motivation for change. In the pursuit of creating positive change to promote recovery, the Stages of Change model and Motivational Enhancement share common ground while diverging in their approaches. As noted by Magill et al. (2018) both models prioritize the client's readiness and motivation for change, recognizing that the individual's intrinsic motivation plays a pivotal role in achieving recovery goals. They also acknowledge the presence of ambivalence and offer strategies to address it. However, their fundamental differences lie in their theoretical frameworks and therapeutic techniques. The Stages of Change model provides a conceptual framework that describes the stages of readiness for change but doesn't prescribe specific techniques ( Magill et al., 2018 ). In contrast, Motivational Enhancement is a structured therapeutic approach that actively employs motivational interviewing techniques to enhance motivation. The therapist's role and the duration of therapy sessions also vary. While both models have their merits, the choice between them hinges on the client's unique needs and the therapeutic context. In navigating obstacles within the treatment process, the Stages of Change model and Motivational Enhancement share foundational principles of client-centered care, empathy, and recognizing ambivalence. Both approaches emphasizes on the significance of understanding and addressing clients' unique barriers to change. However, their divergence arises in their theoretical

THEORIES OF ALCOHOL AND DRUG COUNSELING 6 frameworks and practical methodologies. The Stages of Change model offers a theoretical lens to interpret obstacles within the context of an individual's readiness for change, with a primary focus on assessment and stage-tailored interventions. Conversely, as noted by Frost et al. (2018), Motivational Enhancement actively deploys motivational interviewing techniques, providing specific strategies such as reflective listening and discrepancy development to engage with and overcome obstacles. The therapist's role and the structure of therapy sessions also differ, as Motivational Enhancement is typically more structured and time-limited, while the Stages of Change model allows for a more extended, stage-based approach. The choice between the two methods hinges on the client's needs, the therapeutic context, and the preferred approach to addressing obstacles on the path to positive change. Human service providers play a vital role in facilitating positive change within the treatment process, whether following the Stages of Change model or employing Motivational Enhancement. In the view of Frost et al. (2018), shared in their roles is a commitment to a client- centered approach, characterized by empathy, support, and the prioritization of the client's unique needs and motivations. Both Stages of Change and Motivational Enhancement emphasize the crucial importance of assessing and understanding the client's readiness for change. In addition, providers in both approaches tailor their interventions to align with the client's stage of change and unique circumstances. The individualized approach of both theories are aimed to enhance the effectiveness of the treatment process. However, differences emerge in the provider's approach and role. In the Stages of Change model, the role often centers on assessing and tailoring interventions based on the client's stage of readiness. On the other hand, Motivational Enhancement engages providers actively in using specific techniques, such as motivational interviewing, to enhance intrinsic motivation, address resistance, and resolve ambivalence.

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THEORIES OF ALCOHOL AND DRUG COUNSELING 7 Furthermore, the structure and duration of therapy sessions vary, with Motivational Enhancement being more time-limited and structured. As noted by Chang et al. (2022), the Stages of Change model is a broader conceptual framework that can be applied over an extended period, allowing clients to progress through stages at their own pace. While both approaches recognize the importance of motivation, Motivational Enhancement places a stronger emphasis on actively enhancing intrinsic motivation as a core part of the therapeutic process. In contrast, the Stages of Change model focuses on assessing motivation and tailoring interventions but may not include specific techniques for motivation enhancement. Summing up, while the shared core values of client-centered care and empathy unite these two theories, the choice between them relies on the client's needs, the therapeutic context, and the provider's preferred methodology. In conclusion, the discussion highlights the similarities and differences between the Stages of Change model and Motivational Enhancement in the context of facilitating positive change and recovery. Both approaches prioritize a client-centered, empathetic, and supportive stance, recognizing the significance of understanding the client's readiness for change and the obstacles they face. Nonetheless, their distinctions are substantial. The Stages of Change model provides a theoretical framework for understanding the stages of readiness and tailoring interventions accordingly, while Motivational Enhancement actively employs motivational interviewing techniques to enhance intrinsic motivation, address resistance, and resolve ambivalence. Additionally, the duration and structure of therapy sessions vary. The choice between these approaches hinges on the client's needs, the therapeutic context, and the provider's preferred methodology. Ultimately, both models offer valuable tools for human service providers to assist individuals in their journey toward positive change and recovery.

THEORIES OF ALCOHOL AND DRUG COUNSELING 8 References Chang, C. F., Wang, J. Y., Kuo, T. H., Lin, Y. L., & Yang, S. Y. (2022). Stages of change in dairy intake among older adults: application of the transtheoretical model. International Journal of Environmental Research and Public Health , 19 (3), 1146. Dakwar, E., Levin, F., Hart, C. L., Basaraba, C., Choi, J., Pavlicova, M., & Nunes, E. V. (2020). A single ketamine infusion combined with motivational enhancement therapy for alcohol use disorder: a randomized midazolam-controlled pilot trial. American Journal of Psychiatry , 177 (2), 125-133. Frost, H., Campbell, P., Maxwell, M., O’Carroll, R. E., Dombrowski, S. U., Williams, B., & Pollock, A. (2018). Effectiveness of motivational interviewing on adult behaviour change in health and social care settings: a systematic review of reviews. PloS one , 13 (10), e0204890. Krebs, P., Norcross, J. C., Nicholson, J. M., & Prochaska, J. O. (2018). Stages of change and psychotherapy outcomes: A review and meta‐analysis. Journal of clinical psychology , 74 (11), 1964-1979. Magill, M., Apodaca, T. R., Borsari, B., Gaume, J., Hoadley, A., Gordon, R. E., & Moyers, T. (2018). A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change. Journal of consulting and clinical psychology , 86 (2), 140.

HSV532_Theories of Alcohol and Drug Counseling (1)

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