- A description of evidence based practice, Motivational include the following:
- The population for which the evidence-based practice is intended
- The problems for which the evidence-based practice is intended to address
- A summary of the evidence from the research articles that demonstrate the evidence-based practice’s effectiveness
- An explanation of any differences between the conditions of the study and the conditions on adults with alcohol abuse. Explain the potential impact these differences could have on successful implementation.
- A description of the steps that would be required to implement the evidence-based practice including:
- Any factors that would support each step and how you would leverage them
- Any factors that would limit or hinder each step and how you would mitigate them
- A conclusion that includes:
- Anticipated results of the implementation in your practice setting
- An explanation of whether they will be similar or different from the research results from the articles
Motivational Interviewing
Student’s Name
Institutional Affiliation
Course
Instructor’s Name
Date
Motivational Interviewing
Introduction
Counseling interventions are as important as psychopharmacologic interventions and need proper decision-making when administering. Counseling addresses emotional, work, social, and general behavioral and mental problems in diverse individuals (Frost et al., 2018). There are numerous types of counseling and each is administered based on psychiatric assessment results or based on the need of the patient. Motivational interviewing (MI) is a counseling method that is applied to help individuals resolve certain psychological disturbances and to find the internal motivation they need for behavior change (Frost et al., 2018). This method of counseling is often used in a broad spectrum of mental illnesses including addiction. It is also applicable in the management of physical illnesses such as diabetes, asthma, and heart conditions (Frost et al., 2018). The purpose of this paper is to discuss motivational interviews, their implementation, and their effectiveness.
Description of Motivational Interviewing
The selected intervention or evidence-based practice is motivational interviewing. This method of counseling is intended for adults experiencing alcohol abuse disorder, also called alcohol use disorder (AUD). It is a situation where one develops the impaired ability to control or stop alcohol use despite devastating occupational, social, or health consequences (Lee et al., 2019). High Individuals who experience alcohol use disorder are more exposed to other relayed problems such as cancer of the liver, speech problems, and brain retardation. Therefore, there is an urgent need to apply motivational interviews to address alcohol abuse disorder and improve the health of those affected (Lee et al., 2019). Motivational interview is proven by various literature as an effective intervention to manage alcohol use disorder.
Dorais et al. (2020) conducted a pilot study whose objective was to examine the effectiveness of a university-based addiction clinic where clients were treated with motivational interviewing. The study was conducted at New Leaf Clinic after receiving approval from the institutional review board. To create a sample, the researchers pulled the archival data of the client population attending six successions at New Leaf Clinic from late 2016 to mid-2018. The researchers managed to create a sample of 55 college students between the ages of 18-25 years. All participants attended the six sessions programs at New Leaf Clinic, conducted by counseling students (Dorais et al., 2020). Measures included the use of alcohol use disorder identification test (AUDIT). It is a 10-item, self-administered questionnaire designed to measure problematic or high-risk drinking behavior. The results indicated a significant reduction of high-risk drinking episodes during treatment.
Lee et al. (2019) conducted a randomized controlled trial to assess the efficacy of a brief motivational interview to address cultural and social factors to reduce heavy drinking and frequency of alcohol consumption. Participants included Latinx adults aged 18 to 65, who reported two or more heavy drinking episodes. The research was approved by the university institutional review board. The intervention was delivered in a single face-to-face session administered in 75 minutes (Lee et al., 2019). The results showed a significant reduction in heavy drinking days and frequency of alcohol-related problems. The two articles discussed above aimed to prove the efficacy of motivational interviewing.
Proof of the effectiveness of Motivational Interviewing
The proof of the effectiveness of motivational interviewing can be verified by comparing the differences between the condition of the study and the conditions on adults with alcohol abuse. For example, Dorais et al. (2020) tabled a comprehensive result from their study that reflects the effectiveness of motivational interviewing in improving alcohol abuse disorder. In the study, pretreatment reflects the conditions of adults with substance abuse disorder while post-treatment is the conditions of the study. In that study, the mean score of AUDIT was reduced by over 50% in pretreatment scored.
AUDIT scores in pre-treatment were (M=10.49, SD=5.41), while post-treatment score was (M= 4.98, SD=4.63). Additionally, scores in alcohol consumption decreased from pretreatment (M=5.67, SD=2.14) to post-treatment scores (M=4.09, SD=2.51) (Lee et al., 2019) (Dorais et al., 2020). Additionally, alcohol dependency results showed improvement between the post-treatment and pretreatment conditions. Alcohol dependency decreased, after motivational interviewing, from pretreatment (M=1.16, SD=1.44) to post-treatment scores (M=0.33, SD=0.75).
The differences noted between the conditions of adults with alcohol abuse disorder and conditions the study participants have positive impacts on the implementation of motivational interviewing (Dorais et al., 2020). The findings reflect a reduction in heavy drinking episodes among people who before treatment, about two-thirds of participants had a score of above 15 on the AUDIT scores. None of the participants scored above 15 on the AUDIT scale after treatment.
Steps of Implementing Motivational Interviewing
The implementation of motivational interviewing involves four steps including engaging, focusing, evoking, planning. Engagement is an essential component of motivational interviewing. It involves establishing a clinician-patient relationship to enhance health behavior change (Gary et al., 2022). It is always important to ensure a safe and comfortable environment for patients to discuss their concerns. The second step is focusing, which is collaborating consideration of goals and direction of treatment. It involves establishing an agenda, including change goals. Once the patient is engaged, the therapists may focus on the needs to change, also known as the change target. In this case, the change target includes addressing substance abuse disorder (Gary et al., 2022). Focus is about the patient determining what is truly important or needs to be addressed.
The third step is evoking, which is known as the WHY process. The therapist begins to focus down and guide the patient toward a certain goal that has been identified in the focusing process. The purpose of this step is to evoke the patient’s internal motivations for a change around the focused target (Gary et al., 2022). The goals of this step include eliciting and reinforcing change talk. Improving the strength of change talk, and developing interval motivation. The fourth step is planning and involves establishing and solidifying the patient’s commitment to change. In this step, the therapist develops a change plan immediately when the patient begins to indicate signs showing that they are ready for change (Gary et al., 2022). Some of the goals to include in the planning stage include developing skills to achieve motivation, action planning, removing barriers, and exploring outside support.
Some of the facilitating factors to this process include good listening, empathy, and showing genuine interest in patients’ concerns. Health workers must show interest in patients’ concerns to motivate them (Gary et al., 2022). Empathy improves engagement by having the ability to understand and share the feelings of others. Limiting factors to this step include giving patients vague answers, closed-off body language, interruptions, poor listening, lack of effective communication skills, and lack of empathy from the therapist. Clients can only open up when these criteria are met (Gary et al., 2022). To address these issues, staff must first receive proper training about the barriers, so that they can recognize and avoid them
Conclusion
Counseling is important in addressing mental health problems. It helps in addressing social, emotional, and behavioral issues. Different literature has shown that emotional interviewing is an effective intervention for addressing these issues. Implementing the intervention is expected to improve symptoms of alcohol abuse disorder. The heavy drinking of the individuals should improve. The frequency of alcohol consumption should reduce. These expectations are similar to those indicated in the results of the research articles. The articles have indicated improvement in frequency and degree of alcohol drinking among people.
References
Dorais, S., Gutierrez, D., & Gressard, C. R. (2020). An evaluation of motivational interviewing based treatment in a university addiction counseling training clinic. Counseling Outcome Research and Evaluation, 11(1), 19-30. https://doi.org/10.1080/21501378.2019.1704175\
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. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0204890&type=printable
Gary, A., Kiper, V., & Geist, R. (2022). An introduction to motivational interviewing. Nursing made Incredibly Easy, 20(2), 32-39. https://journals.lww.com/nursingmadeincrediblyeasy/Fulltext/2022/03000/An_introduction_to_motivational_interviewing.7.aspx?context=LatestArticles
Lee, C. S., Colby, S. M., Rohsenow, D. J., Martin, R., Rosales, R., McCallum, T. T., … & Cortés, D. E. (2019). A randomized controlled trial of motivational interviewing tailored for heavy drinking latinxs. Journal of consulting and clinical psychology, 87(9), 815. https://psycnet.apa.org/fulltext/2019-47128-004.pdf\