Thread Response 1

Reply to Kenya

Greetings and Great Day, Dr. Springer & Esteemed Classmates,

Below you will find my initial post for Module 7:

 

Discussion Thread: 4 - Application Using Motivational Interviewing Concepts

 

As a motivational interviewing counselor, I maintain an empathetic, nonjudgmental, and collaborative approach, and am skilled in helping Marci identify her own motivations for change. I employ techniques such as open-ended questions, affirmations, reflective listening, and summarizing (OARS) to enhance self-efficacy and address ambivalence, serving as a supportive facilitator rather than an authoritative figure.

· In general, would Motivational Interviewing be a good practice for her?

Motivational Interviewing (MI) is a highly effective evidence-based practice for individuals with substance use and alcohol addictions (Miller & Rollick, 2023). Yes, MI can assist individuals like Marci in resolving ambivalence, building motivation for change, improving treatment engagement, and reducing substance use by encouraging them to explore their own reasons for change rather than confronting them directly. It can be used as a stand-alone method or in conjunction with other therapies, is applicable across various levels of care, and helps address resistance productively (Hart & Ksir, 2022).

· If yes, give two or three examples from the narrative of why it would be helpful.

Motivational Interviewing (MI) in the context of family substance use dynamics is valuable because it shifts the approach from pressure to empathetic collaboration. For instance, Marci acknowledges that since she began using marijuana, her previously positive and trusting relationship with her parents has deteriorated. Consequently, she started to hide her behavior and became dishonest about her substance use, which led to increasingly negative self-perception. In addition, her academic performance declined and her general interests diminished. It was not until her arrest that Marci began to experience genuine remorse and guilt regarding the impact her drinking—particularly her marijuana use—had on both her relationship with her parents and her aspirations to become an attorney. Over time, she has become more aware that using marijuana has affected her motivation, academic work, and spiritual life, though she has also attempted to downplay these effects. MI can serve as an effective tool to reduce family conflict, rebuild trust, and empower individuals with substance use disorders (SUDs) to discover their own motivations for change, foster intrinsic motivation, and enhance treatment engagement by exploring ambivalence and building self-efficacy within the family system.  

· Second, write a good "change plan" (review chapter 7) that you could share with Marci. Include in your change plan at least two Scripture verses that could be motivational for her, based on her narrative.

A change plan plays a vital role in Motivational Interviewing (MI) for substance use, as it transforms intention into actionable steps, strengthens Marci’s confidence in their ability to change, addresses ambivalence by outlining specific strategies, provides a clear framework, and is a key predictor of improved outcomes. It assists clients in progressing from contemplating change to taking concrete action by identifying obstacles and utilizing available support. As Marci’s practitioner, I would like to present a “change plan” that I would implement to evoke change, confidence, and hope (Miller & Rollick, 2023) by way of a sample scenario:

1. The Changes Marci Wants to Make

Through our MI conversations, Marci expressed the following personal goals:

· Reduce her alcohol and cannabis use, especially when stressed or socializing.

· Improve her academic functioning and reduce the consequences of substance use on her grades and attendance.

· Strengthen family relationships, particularly with her parents and younger brother.

· Develop healthier coping strategies for anxiety, loneliness, and academic pressure.

· Feel more in control of her decisions and less “pushed around” by her environment or emotions.

2. Why These Changes Are Important to Her

Using DARN change talk—Desire, Ability, Reasons, Need—Marci voiced why change matters:

· Desire: “I want to feel more stable and not so dependent on alcohol to calm down.”

· Ability: “I’ve cut back before, so I know I can do it again.”

· Reasons: “If I keep going like this, I’m afraid I’ll fail out or disappoint my family.”

· Need: “I need to get a handle on this before it gets any worse.”

Together, these motivations create her personalized foundation for lasting change.

3. Steps Marci Is Willing to Take Right Now

MI emphasizes small, achievable, client-directed actions. Marci identified the following initial steps:

1. Track her substance use daily using a simple phone app or journal to increase awareness.

2. Limit drinking to no more than  two drinks per occasion, no more than  once per weekend.

3. Avoid mixing alcohol with cannabis and identify events where both tend to occur.

4. Develop a Stress Reset routine—5–10 minutes using grounding, breathing exercises, or a brief walk.

5. Attend weekly counseling sessions for support, reflection, and skills practice.

6. Reach out to at least one supportive friend when she feels urges or pressure.

7. Create a study structure (same time each day) to improve consistency and reduce chaos.

  4.  Potential Obstacles and How She Plans to Handle Them

With MI, obstacles are explored  without judgment, allowing Marci to generate her own solutions.

Obstacle: Peer pressure during social events

· Plan: Attend earlier, leave when drinking escalates, or bring a sober friend.

Obstacle: Using alcohol to cope with anxiety

· Plan: Use breathing/grounding skills; practice 10-minute delay before deciding to drink.

Obstacle: Feeling lonely or overwhelmed

· Plan: Text her support person; schedule a self-care activity; utilize campus counseling.

Obstacle: Academic stress

· Plan: Block study time, meet with academic advisor, use school resources.

5. People and Resources That Will Support Her

· Counselor/Practitioner (Myself) – partnership, MI-guided support, skills practice

· Parents and brother – emotional encouragement, practical help when needed

· Two supportive peers (identified in session) – accountability and alternative activities

· Campus Counseling Services – anxiety coping strategies, crisis support

· Recovery-friendly activities – yoga, art studio, intramural sports, organized by the university

6. How Marci Will Know the Plan Is Working

MI emphasizes self-defined success indicators. Marci identified:

· Fewer days of substance use

· More mornings without a hangover

· Better follow-through on assignments

· Improved concentration and mood

· Feeling more confident and in control

· Positive feedback from family or peers

· Reduced guilt or shame around use

7. Marci’s Confidence and Commitment

At this point, Marci rates her:

· Confidence: 6/10

· Importance: 8/10

· Readiness: 7/10

Using MI scaling, we explored why these numbers are not lower; she identified personal strengths (resilience, past success reducing use, desire for meaningful future goals) that support her commitment.

8. Follow-Up and Adjustment Plan

MI recognizes change as an ongoing, non-linear process. The plan includes:

· Weekly 50-minute MI-informed sessions

· Monthly review of:

· Goals

· Triggers

· Successes

· Setbacks (welcomed without judgment)

· Adjustments based on Marci’s feedback, readiness, and progress

· Reinforcement of her autonomy— all changes remain her choice

9. Collaborative Closing Statement (MI-Consistent)

“Marci, this is your plan—built from your own motivations, strengths, and vision for the future. I’m here as a partner to support you, not to pressure you. You’ve already shown courage and insight by identifying what matters most to you. Together, we will keep adjusting this plan in ways that honor your goals, your pace, and your values.”

Finally, in a good paragraph, discuss the following:

· Of the various treatment approaches, which have been the most beneficial to the field of addiction and individuals with addictions and why?  

· Which treatment approaches have been the most detrimental to the field of addiction and individuals with addictions, and why?

· Which treatment approaches in your opinion most closely align with a Christian worldview, and in what ways (name at least two, with Scripture support)?

Among various addiction treatment methods, Motivational Interviewing (MI) and Cognitive Behavioral Therapy (CBT) have proven particularly effective (Hart & Ksir, 2022). These approaches encourage individuals to tap into their own motivation for change, develop coping mechanisms, enhance self-efficacy, and reduce stigma by fostering collaboration and personal autonomy—elements widely recognized by research as key predictors of lasting recovery (Miller & Rollick, 2023). Conversely, strategies that depend heavily on confrontation, shame, or punitive tactics—such as early Synanon attack therapy or strict “moral failing” models—have shown to be harmful, often heightening defensiveness, deepening feelings of shame, and overlooking the complex biopsychosocial roots of addiction, thereby leading to poorer outcomes (Miller & Rollick, 2023). The 12-Step program and Motivational Interviewing align well with a Christian worldview. (Hart & Ksir, 2022). The 12-Step model reflects biblical themes such as humility, confession, support, and reliance on a higher power (James 5:16, King James Version Bible). Motivational Interviewing parallels Christ’s compassionate approach by emphasizing dignity, autonomy, and transformation (John 4:1–26, KJV). Both methods promote grace, restoration, responsibility, and hope—principles central to Christian recovery.

 

 

Reference

Hart, C. & Ksir, C. (2022).  Drugs, Society, and Human Behavior (18th ed.). New York, NY:

McGraw-Hill. ISBN: 9781260711059.

Miller, W. R. & Rollnick, S. (2023).  Motivational interviewing: Helping People Change (4th

     ed.). New York, NY: Guilford Press.