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Tené Everett

Feb 19 3:50pm| Last reply Feb 24 9:29am

Reply from Tené Everett

Evoking Ambivalence in Motivational Interviewing: Application to Marci’s Case

Motivational Interviewing (MI) conceptualizes ambivalence as a normal and necessary part of the behavior change process rather than a form of resistance (Miller & Rollnick, 2023). Individuals struggling with substance use often experience simultaneous desires to maintain current behaviors and to change them, resulting in psychological conflict. Hart and Ksir (2022) note that emerging adulthood is a developmental stage characterized by identity exploration, peer influence, and experimentation with substances, all of which heighten ambivalence when negative consequences arise. In the Addictions Case Study: Narrative on Marci, this tension is evident through competing motivations that MI’s process of  evoking can help bring to the surface and resolve.

Required Discussion Prompts

· Give an example of Marci’s “change talk.” Marci demonstrates change talk when she expresses fear that her arrest could define her future and jeopardize her academic and career goals. This reflects desire and reason change talk, which indicate an emerging recognition that her current behavior is inconsistent with the life she wants (Miller & Rollnick, 2023). Hart and Ksir (2022) explain that when individuals begin to connect substance use with threats to identity and long-term aspirations, motivation for change becomes more internally driven.

· Give an example of Marci’s “sustain talk.” Marci’s sustain talk is evident when she minimizes her DWI by calling it “just bad luck” and normalizes her drinking by stating that “everyone does it in college.” These statements function to justify continued use and protect her from the discomfort associated with acknowledging the seriousness of her behavior (Miller & Rollnick, 2023). Hart and Ksir (2022) note that cultural norms around college drinking often reinforce this type of cognitive rationalization.

· Where is her ambivalence coming from? Why do you think it is there? Marci’s ambivalence stems from the conflict between the short-term social and emotional benefits of substance use and the growing awareness of its legal, academic, and relational consequences. According to Miller and Rollnick (2023), ambivalence develops when individuals value both change and the status quo simultaneously. Hart and Ksir (2022) emphasize that emerging adults often struggle with this tension as they balance peer acceptance with future goals, making ambivalence a natural part of the change process.

· Write one sentence for each letter of OARS that you could use with her.

· O (Open-ended): “What worries you most about where things could go if another incident happened?”

· A (Affirmation): “It took courage to be honest about this, and it shows you care about your future.”

· R (Reflection): “Part of you feels this was just a mistake, and another part is afraid of what could happen if nothing changes.”

· S (Summary): “You enjoy the social side of drinking, but you are also scared of losing your independence and disappointing your family.”

· How could you use MI’s process of “evoking” to help her resolve any ambivalence and encourage her in a direction of change? Evoking would help Marci resolve ambivalence by drawing out her own values, goals, and reasons for change rather than imposing external pressure. Through open-ended questions and reflective listening, the counselor can strengthen discrepancy between her current behavior and desired future, thereby increasing intrinsic motivation (Miller & Rollnick, 2023). Hart and Ksir (2022) suggest that this identity-based reflection is particularly powerful for young adults facing legal consequences.

· Try to find two Scriptural references that could apply to the process of evoking, and how you would seek to use them in working with Marci.

· Luke 10:36–37 (NIV): Jesus asks a reflective question rather than giving a directive, modeling evocation through inquiry. This parallels MI’s use of open-ended questions to promote self-discovery.

· Proverbs 20:5 (NIV): “The purposes of a person’s heart are deep waters, but one who has insight draws them out.” This verse reflects the MI principle that motivation already exists within the client and can be drawn out through empathic dialogue.

References

Hart, C. L., & Ksir, C. (2022).  Drugs, society, and human behavior (18th ed.). McGraw-Hill Education.

Miller, W. R., & Rollnick, S. (2023).  Motivational interviewing: Helping people change (4th ed.). Guilford Press.

The Holy Bible, New International Version. (2011). Zondervan