Overview
REPLIES
The student must then post three (3) replies of at least 200 words. Each reply must incorporate at least 1 scholarly citation(s) in APA format. Any sources cited must have been published within the last five years. Acceptable sources include the course textbooks, journal articles, books, the Bible, etc. Websites are NOT preferred sources!
***Three replies that directly address related threads; Each reply is a unique contribution that reflects thoughtful analysis of topic and thread.
****Spelling and grammar are correct. Sentences are complete, clear, and concise. Paragraphs contain appropriately varied sentence structures. Where applicable, references are cited in current APA format. A minimum of 1 scholarly citation is present. Minimum word count of 200 words is met or exceeded.
Please reply to the following 3 discussion posts...
1. St H. Posted
What are the potential “pitfalls” when an ambivalent client meets a helper who has the “righting reflex?”
The righting reflex is when the counselor identifies a problem and solves the problem for the client (Rollnick et al., 2010). In the righting reflex, the counselor feels like he/she needs to persuade or convince the client to change (Miller & Rollnick, 2013). When a client experiences a counselor who is practicing the right reflex he/she could experience feelings of anger, defensiveness, uncomfortableness, and powerlessness (Miller & Rollnick, 2013). Instead of the righting reflex, the therapist can use skills of asking, listening, and informing (Miller & Rollnick, 2013). The informing is done with the permission of the client and then the client needs to be asked about their thoughts on how this information could affect them (Rollnick et al., 2010). Using these skills of asking, listening, and informing can help enhance the therapeutic alliance, empower the client, and assist the client in feeling heard.
Briefly name and discuss the four key interrelated elements of the spirit of MI
The underlying spirit of MI is described as partnership, evocation, acceptance, and compassion (MINT, n.d.). According to Dr. Jenkins (n.d.) MI is more of a way of being a therapist as opposed to doing therapy. MI is a way of approaching a client. Along with the spirit of MI there are four primary elements of MI which are engaging, focusing, evoking, and planning (Miller & Rollnick, 2013). Engagement focuses on the development of the therapeutic alliance (Miller & Rollnick, 2013 ). Focusing is centered on focusing the counseling session on the changes that the client wants to make (Miller & Rollnick, 2013). Evoking is assisting the client in identifying their motivation to change (Miller & Rollnick, 2013). Planning is the development of specific plans for what the client will do (Miller & Rollnick, 2013). Using these skills along with the spirit of MI can assist the client in enhancing their motivation to change.
The effective MI physician MI demonstration
In the video, the doctor exhibits the spirit of MI. Developing a partnership is seen when the doctor asks the client about their view of the problem without judgment. The doctor then works to evoke change. Evoking is assisting the client in identifying their motivation to change (Miller & Rollnick, 2013). Evoking was done when the doctor asked the client what level of motivation on a scale of 1-10 she thought she could change and then asked her why not a 2 or 3. This question was to assist the client in developing their motivation for change. Acceptance was demonstrated by the doctor when she validated the client's feelings about how difficult it is to change. Compassion was demonstrated when the doctor continued to validate the client's emotions and offered help if the client wanted the help.
Use the Stage of Changes to explain a person’s need for Christ and how to move forward to preparation
The transtheoretical model of change describes stages of change including precontemplation, contemplation, preparation, action, and maintenance (Frieman et al., 2017). In the contemplation stage of change, the person is thinking about making a change but is weighing the pros and cons of making a change (Friman et al., 2017). According to Dr. Jenkins (n.d.), evangelism strategies can be identified to assist the person in being ready to accept Christ. In the contemplation stage of their need for Christ, the person can recognize their need for a savior but is unwilling to commit to change. One MI technique that could be used is rolling with resistance. With rolling with resistance the clinician/minister avoids arguing with the person or against the behavior (SAMHSA, 2019). When rolling with the person’s resistance to Christ the person would not argue the case for Christ but instead listen to and evoke the person’s own needs for Christ. MI can be beneficial when working in therapy and when working with others to see their need for a savior.
References
Friman, M., Huck, J., & Olsson, L. E. (2017). Transtheoretical model of change during travel behavior interventions: An integrative review. International journal of environmental research and public health, 14(6), 581. https://doi.org/10.3390/ijerph14060581
Jenkins, D. E. (n.d.). Motivational interviewing [video]. Liberty University. Retrieved [August 23, 2023] from https://canvas.liberty.edu/courses/519051/pages/wa...
Miller, & Rollnick, S. (2013). Motivational interviewing : helping people change (Third edition.). The Guilford Press
MINT (n.d.). Understanding motivational interviewing. Motivational Interviewing Network of Trainers. Retrieved [August 23, 2023] from https://motivationalinterviewing.org/understanding...
Rollnick, S., Butler, C. C., Kinnersley, P., Gregory, J., & Mash, B. (2010). Motivational interviewing. BMJ : British Medical Journal (Online), 340https://doi.org/10.1136/bmj.c1900
SAMHSA (2019). Tip 35: Enhancing motivation for change in substance abuse treatment. Substance Abuse and Mental Health Service Administration. https://store.samhsa.gov/product/TIP-35-Enhancing-...
2. St R Posted
What are the potential "pitfalls" when an ambivalent client meets a helper with the "righting reflex?"
Potential pitfalls exist when an ambivalent client meets a 'righting reflex' helper. Miller and Rollnick (2013) define a 'righting reflex' as "a desire to fix what seems wrong with people and set them back on a better course" by directing them (p. 6). An ambivalent client engages in a 'change talk' and 'sustain talk.' They oscillate between two choices of wanting something and not wanting it or, rather, wanting two incompatible things. When an ambivalent client meets with a "righting reflex" helper, the client will likely argue for the oppositional side. A 'righting reflex' helper would want to assert their directing style by articulating what needs to be done and how to do it to realize change. The ambivalent client is familiar with the choice of action suggested by the helper and adopts the 'sustain talk' in their argument. There will be an oppositional pattern of conversation. Both client and helper end up in a battle of wits where each wants to outsmart the other.
Briefly name and discuss the four key interrelated elements of the “spirit of MI.”
The four interrelated elements of the ‘spirit of motivational interviewing’ are partnership, acceptance, compassion, and evocation. Miller and Rollnick (2013) assert that these elements have experiential and behavioral components. Motivational interviewing thrives on a partnership where the helper and the client work collaboratively to ensure change. The helper is expected to do less than half of the talking with the client, who is the expert of themselves doing most of the talking. The role of the helper is to create a conducive atmosphere that activates change of behavior in the client. The interviewing helper requires a profound acceptance of what the client brings. Acceptance hangs upon absolute worth, accurate empathy, autonomy support, and affirmation. The interviewer must accord absolute worth by expressing unconditional positive regard for the client’s opinion, actions, and behaviors without judging them. Accurate empathy occurs when a helper sees the world as the client would see it by taking the internal perspective of the client. Acceptance also involves autonomy support, where the client's autonomy and self-direction are upheld. Another important aspect of acceptance is affirmation, which seeks to acknowledge a person's strengths and support. A third element of the spirit of MI is compassion, which calls upon the interviewer to promote the client's welfare and prioritize their needs. Lastly, the element of evocation emphasizes that people who need a change usually have the required resources to effect that change. The counselor should concentrate on the strengths and resources of the client to evoke them rather than focus on the deficits.
Watch the video The Effective Physician: Motivational Interviewing Demonstration, look at chapter 2 of the Miller & Rollnick text, and then discuss how the physician follows all four elements of the spirit of MI.
In the assigned video, the physician is following the four elements of the 'spirit of motivational interviewing' in a quite fulfilling way. Firstly, the physician shows partnership by allowing the patient to lead the interviewing session. The physician does not apply a directing style where the patient remains passive through the session but instead asks questions, and the patient responds (MerloLab, 2009). Secondly, the physician associates the patient's son's ear infection with smoking and asks the client how the son is exposed. When the patient replies that she is the one smoking at home, the physician does not judge her behavior but shows unconditional regard for the patient's behavior. Also, the physician shows respect for the client's opinions and self-direction. Thirdly, throughout the interviewing session, the physician promotes the welfare and needs of the client. As much as the physician knows what is best for the client, she does not impose them. She allowed me to book another appointment to discuss treatment and intervention options when the client was not ready to discuss this topic. By these actions, the physician demonstrates compassion. Lastly, the physician utilizes evocation during the session. She focuses on the client's strengths and resources, referring to a time when the client managed to quit smoking. The physician concentrates on the potential resources and strength of the client to quit smoking.
Dr. Jenkins talks about how we can use the "stages of change" model with those who are ambivalent about accepting Christ. Pick either "Precontemplation" or "Contemplation" (you can internet search for "stages of change" pretty easily, or go to The Stages of Change. Briefly explain what a person who is in that stage without Christ looks like and how we can help them move towards the "Preparation" stage.
The contemplation stage is the second stage in the 'stages of change.' A person in the contemplation stage weighs the pro and cons of change and are aware of the adverse effects of their behavior but are not sure whether the long-term benefits associated with behavior change will outweigh the short-term benefits of sustaining the status quo (Substance Abuse and Mental Health Services Administration [SAMHSA], n.d.). Without Christ, such individuals may remain forever in decisional imbalance and not be motivated to change. They do not recognize that Christ can empower them to change and think the power must come from within themselves. Although there must be a genuine and deliberate personal desire to change, divine power is needed to effect the change. Motivational strategies can be used to help a client in the contemplation stage transition to the preparation stage. A critical motivational strategy at this stage is normalizing ambivalence, where clients are assured that conflicting feelings, uncertainties, and reservations are common. On the bright side, clients should believe that Christ will give them the power to change, and they should be confident that "He which has begun a good work in you will perform it until the day of Jesus Christ” (King James Version, 2020, Philippians 1:6).
References
Substance Abuse and Mental Health Services Administration, SAMHSA. (n.d.). Using motivational interviewing in substance use disorder treatment. Retrieved August 24, 2023, from https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-02-02-014.pdfLinks to an external site.
MerloLab. (2009, November 25). The effective physician: Motivational interviewing demonstration [Video]. YouTube.https://www.youtube.com/watch?v=URiKA7CKtfcLinks to an external site.
Miller, W. R. & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.
King James Bible. (2020). King James Bible Online. https://www.kingjamesbibleonline.orgLinks to an external site.
3. Lu V posted
Motivational Interviewing
The potential pitfalls in interacting with a helper with “righting reflex”
The moment an ambivalent client encounters a helper showing righting reflex, there is space for potential pitfalls. The righting reflex refers to the helper’s tendency to try and solve the clients’ issues or problems without fully comprehending their needs and preferences. As a result, this can lead to pitfalls; for instance, there can be the development of a power imbalance where the client can feel unheard or invalidated and hence hinder the helping process, going against the basic principle of motivational therapy. It is crucial for helpers to actively listen to clients and validate their experiences and feelings while creating a supportive environment where clients can be motivated to express their emotions and experiences. Another pitfall is that clients can always depend on the helper to solve their problems rather than develop their problem-solving skills. A helper with the right reflex may fail to provide the client with self-awareness and problem-solving development opportunities to promote self-dependency.
Elements of the “spirit of MI.”
Collaboration: Collaboration emphasizes the benefits of working with clients to solve their concerns and generate the desired outcome (Naar & Suarez, 2021). Collaboration enhances teamwork, where the client and the helper align to achieve a certain goal.
Acceptance: Here, the helper acknowledges the complete worth of the client and therefore creates a non-judgmental environment where the client feels supported and understood holistically (Naar & Suarez, 2021).
Evocation indicates the process of drawing out the client’s values, motivations, and goals. This element is guided by the notion that the client’s resources and motivation for change are within them, and exploring them will guide the success of the motivational interviewing (Naar & Suarez, 2021).
Compassion: This involves promoting the client’s welfare while prioritizing their needs. It involves understanding and emphasizing the client’s struggles, creating a safe environment where they can explore their ambivalence and promote their motivation for change (Naar & Suarez, 2021).
How the physician follows all the elements of the “spirit of MI”.
In the video, the physician follows the steps of the spirit of the MI. Firstly, the physician engages in active listening to the client’s experiences. The physician tries to comprehend the client’s perspectives and does not create a power imbalance where the client can feel unsafe. Secondly, the physician is actively involved in collaboration; they make decisions together with the client and set achievable goals together. Thirdly, the physician practices autonomy by allowing the client to practice their autonomy by encouraging and allowing them to take positive steps by themselves. It is important to encourage clients to continue positively discussing their experiences to enhance change talk (Miller & Rollnick, 2012). Lastly, the physician initiates self-reflection by evoking change talk and showing optimism that the client will change. This creates a positive atmosphere where the client encourages self to begin another positive path.
The pre-contemplation stage
A person in the pre-contemplation stage lacks of readiness to change and lacks awareness or interest of the need for change. A person in this stage might lack interest in understanding or exploring the Christian faith; therefore, they can become resistant or unbothered by conversations based on spirituality. In helping someone in this stage go through the preparation stage, first, it is important to create trust, where it can be possible to understand their beliefs and values. It is more realistic to introduce the person to accept Christ at a slow pace. For instance, talking about my personal experiences with Christ, giving them Christian books can slowly introduce them to exploring Christ and new values. Encouraging small steps can go a long way to creating long-lasting changes and acceptance of Christ.
Reference
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. Guilford press.
Naar, S., & Suarez, M. (2021). Motivational interviewing with adolescents and young adults. Guilford Publications.