Motivational interviewing and stages of change

The stages of change model suggests that clients who are in the process of changing addictive behavior move through successive stages, from limited insight to maintenance of change. These stages will be presented by the client’s attitudes and behaviors. It is the job of the clinician to identify the correct stage and employ specific interventions for the treatment to be successful. Most clients opting for an assessment will likely be in the early stages of change.  

The major tenets of motivational interviewing were designed to provide clinicians with tools to facilitate the change process in clients. Extensive research supports its effectiveness and it has become the standard in the past decade. These techniques are grounded in the client-centered approach rather than the confrontational approach to substance abuse treatment used in previous decades.

Use the module readings and the Argosy University online library resources to research motivational interviewing and the stages of change model.

Download and review the case study.

Respond to the following:

• Explain factors for determining the client’s stage of change and identify which stage of change the client is in.
• What two motivational interviewing techniques would be helpful in assessing substance abuse in this case? Give reasons and explanations.

Support your responses using your module readings and authoritative resources. Incorporate theory and factual information in your response.

Write your initial response in 2–3 paragraphs. Apply APA standards to citation of sources.

             Case Study—John

            John is a longtime alcohol abuser who has managed to function in his job as a shipping foreperson for more than twenty years despite his problem. Last month John’s company instituted a new company policy that required all employees to submit to random urine screens. John tested positive the first time he submitted the random urine drop. His company referred him for an assessment that had to be conducted before he was allowed to return to work.

            As the substance abuse evaluator, you are responsible for identifying whether or not a drinking problem exists and for recommending any necessary treatment. John presents in your office the next day with frustration related to his suspension from work. Although he understands the position of his company, indicating that many of “those guys there have drinking problems,” he is surprised that the company “is being this harsh on him.” He denied having a problem because he “does not drink everyday like some of those guys.”

            You discuss with John his perception of his drinking as well as the company’s decision to refer him for an assessment and treatment. As the session proceeds, you agree that John probably is not dependent on alcohol. However, you introduce the possibility of abuse, given the history you were provided, and his admission to “getting hammered” most days he is drinking. You explain that his drinking behavior resulted in the presence of alcohol in his urine from drinking the previous night at home. You explore this with John in an effort to help him identify some of the consequences of his drinking, even though he is not alcohol dependent. This allows John to begin to focus on the potential consequences of his alcohol use pattern.  

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            Substance Abuse Assessment

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