HSW401 Social Work Research Methods

Introduction

Motivational interviewing (MI), is based upon the principle of assisting individuals towards positive behavioural change via providing them with an environment which is non-judgmental, supportive, and open to the individual’s readiness, motivation, confidence and ambivalence towards the change (Frost et al., 2018). The following paper provides a succinct overview regarding the key assumptions and techniques underlying MI practice, its influence on interview planning and a critical reflection of these were complied with, while actually interviewing an individual.

Discussion

Motivational Interviewing: Assumptions, Principles and Techniques

Since the TM model for change forms the foundation of MI, it is thus based on the assumption that an individual’s motivation and engagement towards positive behaviour change is based on a number of stages. This comprises of first not agreeing to change, followed by feeling ambivalent towards change. This is then followed by an intention to change, taking action towards change and working towards sustaining that change (Magill et al., 2018; Sobell & Sobell, 2008).

Based on this assumption, MI thus focusses upon helping individuals to overcome their ambivalence and disagreement towards change by providing them an environment which is non-judgmental, supportive and open to the individual’s readiness, motivation and confidence with respect to the same. Due to this adoption of a client centered model of practice, MI is thus based on the following principles: 1) expressing empathy towards the clients, 2) developing discrepancy, 3) rolling with resistance and 4) supporting the self-efficacy of the client. The motivational interviewer complies with such principles by assessing the level of motivation, readiness and confidence in such clients; by exploring the ambivalent feelings towards change; by improving the levels of motivation of the client; by rolling with resistance demonstrated by the client; by supporting the client in enhancing their self-efficacy and by working towards enhancing their commitment towards change (DiClemente et al., 2017; Wahab, 2005; Sobell & Sobell, 2008).

Further, in order to comply with these principles, the following are some of the techniques which must be considered when practicing MI with clients (Wahab, 2005; Sobell & Sobell, 2008):

• Obtaining consent from the client for autonomy.
• Encouraging self-determination by eliciting change talk in the client.
• Exploring the client’s perception of confidence and importance of change.
• Asking open ended questions and reflectively listening the client.
• Affirming the strengths of the clients
• Normalizing the client’s lived experience
• Offering Advice or Feedback to the client
  
  

Motivational Interviewing and Social Work

Due to its ability to deliver client centred, realistic and practical change management advice, motivational interview has currently gained importance in social work practice. Social workers are often required to assist clients from diverse cultural, familial and historical backgrounds and experiences and are currently encountering adverse conditions which are likely impacting their social, physical and emotional wellbeing (Lindson et al., 2019; Wahab, 2005). Some of the client conditions which social workers have to manage include: drug abuse, smoking, self-harm, violence or inabilities to adhere to physical activity and dietary requirements. It is common to find clients with such conditions to experience ambivalence or difficulties in complying with positive changes due to their diverse and unique lived experiences. For instance, a client with issues of drug abuse, while feeling the need for change, may still face issues with relapsing. In such cases, MI is especially suited to social work practice since it enables the worker to assist the client in resolving ambivalence towards drug rehabilitation, elicit client centred behaviours towards change and work towards enhancing the internal motivation of the client to comply drug avoidance behaviours (Marker & Norton, 2018; Wahab, 2005).

Influence of MI in Interview Planning and Execution

One of the first in ways in which MI influenced the planning of this interview is by prompting the formulation of questions which are direct and aimed at eliciting client responses towards change. This is because one of the many principles of MI is support skills of self-efficacy and self-determination in clients so as to motivate them towards change management using strategies which are suited their perceptions concerning change (Soderlund, 2018). MI also influenced the execution of the interview by directing the social worker to always obtain consent from the client at every stage of the questioning process. This is because one of the many principles of MI is to respect the autonomy and unique values held by the client while developing change management practices (D'Amico et al., 2018).

Critical Reflection of Interview

Upon reflection of the interview, I was able to comfortably adopt a directive and open ended questioning style throughout my conversation with the client. I complied with the same by directly enquiring from the client regarding his current health and feelings as well as how he was coping with stress. Indeed, a key principle of MI is to engage the client using questions which are direct yet open ended so that both the client as well as the social worker can better identify the client’s strengths, motivational levels and confidence (Gillam & Yusuf, 2019). An open ended questioning style further facilitates this approach since it allows the client to share detailed responses – as observed in the client admitting to stress and smoking – which otherwise would not have been possible using close ended questions (Barrett et al., 2018). However, direct questions have often been criticized to cause discomfort in the client – which can be mitigated by obtaining consent. It is for this reason why, prior to each question concerning this health, smoking and also informing the process of note taking, I ensure obtaining consent and permission from the client respectively (Westra & Norouzian, 2018).

One of the key principles and strategies of MI is to identify and enhance the self-efficacy of the client so that he or she feels intrinsically motivated to comply with change. This can be done by adopting the Columbo Approach – where the interviewer asks conflicting questions which give the benefit of the doubt to the client (Berzsenyi, 2021). In the interview, I was able to successfully adopt this approach by directly asking the client regarding how feels about his smoking and what other strategies he can adopt for quitting the same. This method was indeed a success, since the client shared his wish to quit smoking with a score of 8 (one a scale of 0 to 10) and play sport as alternative coping strategies.

Conclusion

MI has currently emerged as an effective alternative to facilitate change management in individuals experiencing ambivalence and unwillingness to change. This paper provides a succinct yet comprehensive insight with regards to the range of questions and techniques which were chosen while communicating with a client using MI. In conclusion, due to its client centered approach, MI has been found to be well suited to handling diverse client issues during social work practice.

References

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Berzsenyi, C. E. (2021). The Columbo method—A rhetoric of inquiry practiced across professions. Journal of Professional Communication, 6(2), 7-36. https://doi.org/10.15173/jpc.v6i2.4121.

D'Amico, E. J., Parast, L., Shadel, W. G., Meredith, L. S., Seelam, R., & Stein, B. D. (2018). Brief motivational interviewing intervention to reduce alcohol and marijuana use for at-risk adolescents in primary care. Journal of consulting and clinical psychology, 86(9), 775. https://psycnet.apa.org/doi/10.1037/ccp0000332.

DiClemente, C. C., Corno, C. M., Graydon, M. M., Wiprovnick, A. E., & Knoblach, D. J. (2017). Motivational interviewing, enhancement, and brief interventions over the last decade: A review of reviews of efficacy and effectiveness. Psychology of Addictive Behaviors, 31(8), 862. https://psycnet.apa.org/buy/2017-53537-001.

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Soderlund, P. D. (2018). Effectiveness of motivational interviewing for improving physical activity self-management for adults with type 2 diabetes: A review. Chronic Illness, 14(1), 54-68. https://doi.org/10.1177%2F1742395317699449.

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