Southern New Hampshire University Motivational Interviewing Case Discussion Tom, 45, occasionally went to the casino with some friends as a fun night out,

Southern New Hampshire University Motivational Interviewing Case Discussion Tom, 45, occasionally went to the casino with some friends as a fun night out, but lately he noticed himself returning there on his own, spending hours at a time at a single blackjack table. His friends asked him about it, but he brushed off their concerns. As time passed, he spent more time at the casino and often lied to his wife about it.

Based on what you have learned in this module about motivational interviewing, cognitive-behavioral restructuring, and solution-focused therapy, which approach or approaches do you think are most relevant for Tom’s situation?

Within your discussion, address the following points:

Define motivational interviewing, cognitive-behavioral restructuring, and solution-focused therapy applied to addiction.
Based on what you have learned in this module, what are two techniques within each counseling style that you think might be relevant to Tom’s situation?
Why do you think the approach(es) you chose would be helpful in Tom’s situation (be specific and detailed)?

Once you have posted, respond to at least two classmates’ posts and discuss the best course of action for Tom.

reply 1: James Mosher

Hello everyone,

To quote the text directly:

“Motivational interviewing (MI) is a relationship- and client-centered system of change by which the counselor utilizes various techniques and interpersonal skills known to be effective agents of change. MI is not a theory of counseling; rather, it is a transtheoretical approach to the change process that encompasses both an attitude and set of techniques designed to elicit and enhance a client’s internal change processes. This approach involves a spirit of collaborative communication and an interview-style format in which the counselor engages in a thoughtful exchange of questions and answers with a client to encourage and enhance motivation for change. Counselors using MI aim to foster and enhance client autonomy while offering support and empathy to the client regardless of his or her place in the change process (Miller & Rollnick, 2012). Cognitive behavioral restructuring utilizes Cognitive Behavioral Therapy (CBT) to find and alter our negative and destructive thoughts that lead to depression and other issues. Functional analysis is often used to facilitate restructuring in CBT. In addiction, CBT will usually focus on targeting triggers by examining antecedent behaviors and consequences of acting out on said triggers. Traditionally solution focused therapy was considered brief therapy or a therapeutic intervention, but it does not have to be brief. Solution focused therapy is also commonly practiced alongside another therapy, like motivational interviewing. Solution focused therapy does not use normal clinical language, and is instead focused on remaining positive and hopeful. “SFBT therapists eschew talk of diagnosis, disability, and pathology. Such talk, in spite of good intentions, frequently serves to confirm the client’s view of himself or herself as someone who is disabled. Thus, unless there is reason to believe that diagnosing would lead to a needed medical intervention, the therapist steers conversation toward the client’s desired scenario and what he or she can do to make that happen” (Capuzzi, 2020).

Based on Tom’s situation I think that motivational interviewing when combined with cognitive behavioral restructuring would the best fit for him. Motivational interviewing will allow for trust and rapport to be build between patient and counselor. As the patient becomes more comfortable he can utilize CBT approaches to managing the behaviors associated with his process addiction. Due to the fact that Tom is experiencing a compulsion to gamble some sort of CBT-based therapy will be the most effective for him. He will need to complete a functional analysis that explored what is triggering him to gamble and what are the feelings, thoughts, behaviors, and consequences associated with this. The he can work on learning coping skills to manage antecedent behaviors and interrupt the pattern of behavior. During this time the counselor should be able to roll with any resistance from Tom and make adjustments to his treatment plan based on what Tom wants.

References:

Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.

Capuzzi, D. & Stauffer M. D. (2020). Foundations of Addiction Counseling. 4th edition. Pearson.

reply 2: Hello everyone. Hope all is going well.

Motivational interviewing is a relationship- and client-centered system of change by which the counselor utilizes various techniques and interpersonal skills known to be effective agents of change. (Capuzzi et al, 2020)

Cognitive-behavioral approaches consider the role of cognitive processes such as self-efficacy, expectancies, and values in the initiation and maintenance of problematic substance use, as well as in its recovery. (Capuzzi et al, 2020) Cognitive-behavioral assumptions focus on internal, self-appraisal, and other cognitive functions that influence behavior. (Capuzzi et al, 2020)

Solution-focused emerged as a form of brief or short-term psychotherapy. (Capuzzi et al, 2020)The essence this is to focus on the accomplishments, strengths, resources, and abilities of the client. (Capuzzi et al, 2020) Rather than prioritizing the problems and deficits that typically accompany a referral to counseling, the client and family members what has gone well in the client’s life. (Capuzzi et al, 2020)

The two techniques that I think would benefit Tom are open-ended questions and reflective listening.

Open-ended questions are designed to help build trust, develop rapport, and increase collaboration and consonance in the theraputic relationship. (Capuzzi et al, 2020) Counselors will ask open-ended questions and allow the client to speak uninhibited while the counselor responds with affirmations and encouragement so that the client may continue verbal exploration. (Capuzzi et al, 2020) I feel this technique would be a good fit because it is meant to build trust and rapport with the client. Tom is having a hard time admitting to his problem even to his friends. Therefore, I believe he needs someone he can truly trust and not believe he is being judged to talk about his problem with.

Reflective listening is simply the act of repeating back to the client the content of his or her words in an unbiased, nonjudgemental manner. (Capuzzi et al, 2020) As stated previously, I believe Tom needs someone that is not going to judge him for his problem. I also think that this technique will help Tom see that he does have a problem. Once hearing someone else repeat back to him what he had just said, maybe then he will start to see the problem.

Capuzzi, D. & Stauffer M. D. (2020). Foundations of Addiction Counseling. 4th edition. Pearson.