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Attempts to understand the transition process of psychotherapy have traditionally relied on observational research that is disconnected from the everyday needs and activities of psychotherapists or their professional practice. Psychotherapists use a variety of methods based on some kind of standard. The paradigm allows the psychotherapist and the client to participate in a procedure that has the potential to be positive or helpful. According to Anderson, Lunnen, and Ogles (2010), theoretical frameworks or models must have a logic that gets to the core of what it means to be a person in a certain time or place (p. 148). In other words, theories inform psychotherapists understanding a broad range of approaches to the change process while techniques or interventions come out of the therapeutic relationship psychotherapists develop with their clients. This paper explores motivational interviewing and family system (Satir model) techniques based on psychotherapy. Moreover, the paper demonstrates how I would use self to inform my practice of therapy.
Drawing on Miller (2009), Motivational Interviewing (IT) can be defined as a directive, brief, and client-centered psychotherapy aimed at increasing the intrinsic motivation of clients for a targeted behavior change. MI places much emphasis in building rapport with the client in the initial phases of the counseling relationship. The core tenet of MI is the identification, exploration as well as resolution of ambivalence regarding altering behavior. Three essential elements of MI encompass conversation regarding change, collaborative, and evocative. MI is characterized by a particular clinical or _x0093_spirit_x0094_ way of being. Collaboration is described by Corey (2012) as a partnership between the client and the therapist, based in the experience and point of view of the client. Collaboration is aimed at facilitating trust and building rapport in the assisting relationship, which can be problematic within a more hierarchical relationship. Evocation, on the other hand, entails drawing out the individual_x0092_s own ideas and thoughts as opposed to imposing one_x0092_s opinion. In other words, the therapist should draw out the ideas and thoughts of the client rather than imposing his or her opinion. Principle of MI includes express empathy, support self-efficacy, roil with resistance, and develop discrepancy.
The primary role that I have to hold in the motivational interviewing is the directive function. With this role, my primary objective is to elicit personal or intrinsic motivational sentiments marred with sensible behavioral shift basically from the customer. I am also tasked with the role of creating customer discrepancy; this is mainly aimed at enhancing motivation that will consequently foster a positive and desirable change.
Essentially, motivational interviewing technique triggers the capability to ensure productive change which everyone has. Although it should be recorded that some individuals can change often change on their own without any aid, some people would need some support or formal treatment over the span of period of their betterment (Corey, 2014). Also for the customers that have very less willingness, the technique acts as an imperative prelude for subsequent therapeutic activities.
Ambivalence plays a key part in the process of motivating the client. Therefore the key basic principles of motivational interviewing are five. They address ambivalence thus enabling the facilitation of the change process. The key opening strategies which need to be applied when dealing with the client should as well be offered. People who have the behavior of abusing drugs and substances usually know the dangers associated with this kind of behavior, but the keep on using the substances. This kind of individuals may have the desire and want to stop this kind of behavior, and at the same time, they may not want to (Yalom, 2003). They then opt for the treatment program, claiming that their problems are not that much serious than the others. Such kind of feeling of desperation is referred to as ambivalence feeling; they are very natural.
The central problem with the client is the ambivalence. Thus it is essential for us to put into consideration our client's ambivalence. Lack of motivation could be the cause of ambivalence. If interpreted as resistance or denial, there could be friction between you and the client. Motivational interviewing technique aids the exploration of specific conflicts that are associated with motivation and which could to a hindrance to the progress. Each of these dilemmas also offers the opportunity that could be applied to use the technique to enable the client to explore and resolve opposing attitudes.
Empathic motivational interviewing develop a conducive environment which is supportive and good to the examination of the issues and triggering main issues that are personal and which can bring about change. As a clinician or the expert, you should understand the client's values, feelings and the diverse and unique perspectives (Corey, 2012). The attitude that you display should be one of agreeing though not just an upholding of anything, in this case, you should put in mind that ambivalence for change in behavior is anticipated. There should be a trusting connection between you as the expert in this case and the client for a successful motivational interviewing.
Empathy is the basis of motivational interviewing or counseling, but it should not be mistaken with what empathy which is getting in touch with the client or exchanging your past experiences imply. The main component of expressing empathy is reflective listening.
The clients should realize and understand the discrepancies between their present situation and the future hopes to enhance motivation for change.
One of the founders of systems therapy and pioneers of family therapy was Murray Bowen. The family system theory was developed in the 1950s. Bowen placed much emphasis on patterns that develop in families with the aim of defusing anxiety. One of the significant generators of anxiety in families, according to Bowen is the perception of too great a distance in a relationship or too much closeness (Corey, 2003). The extent of anxiety in one family determines the sensitivities to particular themes that have been transmitted down the generations and the current levels of external stress Bowen is of the opinion that if members of a family do not have the ability to think via their reactions to relationship dilemmas and instead respond anxiously to perceived emotional demand, a state of chronic reactivity or anxiety may be created or set in place. The research conducted by Bowen led him to indicate that varying extents or degree of fusion are discernible in all families. The chief goal or family system, as pointed out Bowen is to minimize chronic anxiety by increasing levels of differentiation and promoting awareness of how the emotional system works or function.
Family system theory is based on the human problem that arises from relationships for instance in the families. Most people are encouraged to be independent or autonomous for that case they are free to make choices in life and consequently be accountable for the consequences that emerge from the choices that they make in life. This notion of being individualistic tends to ignore that fact that we were born and raised up in families.
The family system theory suggests that a person is well understood when in a family setting. These families have their common characteristics which are unique from other families. The family system theory shifts the focus from individuals to the family setting. A certain trait of behavior seen in one member of the household is likely to be a representation of how the whole family behaves. This theory comes from the observation by the counselors involved working closely with the family and the individual. This theory also suggests that a family is a system that comprises of interconnected people who are also interdependent; thus anything that affects an individual affects the whole family.
The family operates on various rules which are not written for instance a family would just know who is supposed to make the final decision. The founders of the family therapy put into consideration that a family is raised on cultural forces and values. The structural family theory presents a treatment which recognizes families. There are four steps in dealing with the problem by the structural therapist. First, the family is engaged in the problem; second, he or she aids the family to see how the exchanges get on the same not perpetuating and supporting the problem. After that, the effect of the past on the issue is exposed by the therapist who provides options that the family can opt for to foster productivity thus resolving the issue.
Use of Self Inform My Practice of Therapy
Over the last many years, therapists have recognized the use of self as one of the single most important factor in constructing or developing a therapeutic relationship. One of the strong advocates of the use of self in psychotherapy was Virginia Satir. She spent much of his time placing much emphasis on this aspect in the course of her therapy training program (Lum, 2002). Virginia Satir observed that therapists who are emotional healthy have the ability to work through their own personal issues.
The Satir Model was developed with the aim of integrating Satir_x0092_s techniques, tools, goals for therapy, therapeutic beliefs, philosophy and vision into an inclusive therapeutic method. Since its invention, the Satir Model has been increasingly been used to teach or train therapists in a broad range of powerful therapeutic skills. The model encourages the sharing of self with the aim of capturing a teaching moment rather than using it for strengthening empathy or creation of connection. Moreover, the model facilitates an increased awareness for both the client and the therapist. In this case, awareness entails being aware of one_x0092_s inner possibilities, looking at possibilities, understanding or knowing one _x0092_s self, as well as, accepting of what is. As argued out by Lum (2002), therapists are expected to be able to reflect upon oneself and observe oneself so as to develop awareness. There is a broad range of benefits associated with the increased awareness for both the client and the therapist. First, increased awareness promote therapeutic processing of issues and benefits client_x0092_s exploration.
I will use self to persuade the client and see what difference exists between their current situation and the desired future state. First, I would aid the client to fathom his negative personal, familial and the social consequences of the problem in the behavior; this is how discrepancy can be-be initially highlighted. In this process, help him, or she confronts the substance make use of that associating it to the consequences it has. This process is usually difficult; one should choose strategic reflecting to be successful in the process.
As the expert, you have to put aside the behavior from the client and aid him to go through how his targets and objectives for instance financial success and marital happiness are being overshadowed by the use of the substance. So there is the need for paying keen attention to the client's story, his connection with the friends, family and the church. If he shows concern for his behavior and the associated effects, I will need then to highlight this behavior or concern to heighten his perception and acknowledgment of the discrepancy.
The moment the client starts to understand the potential consequences of his present behavior conflict compared to his values, I will need to bring out and focus on this problem till the time he will be able to gain concern, zeal and focus on changing. Discrepancy emerges from the client's background, for instance, the black _x0096_ Americans may term addiction in their own words as _x0093_chemical slavery_x0094_ this my conflict with the pride of their ethnicity and the desires to conquer historical oppression.
At some point, I may get myself arguing with a customer who may not be willing to change his behavior or completely sure about changing. This happens mostly if the client is hostile, provocative or defiant. And again if you try to persuade the client that a problem does exist and therefore there is need to change, it may precipitate into more resistance or even a heated argument. Arguing with the client may lead into power struggle thus it will not promote motivation for a beneficial change to the client.
As a psychotherapist, resistance is a legitimate concern for it is predictive of shoddy or poor outcomes in the treatment and therapeutic processes. On one side of the resistance, possibly the client could be behaving defiantly. The other which could be beneficial is that lack of cooperation could be a sign that the customer views the ordeal completely different from you.
This will then demand you to understand you client correctly regarding his perception. Resistance usually calls for your attention regarding listening and considering the matter at hand again and again. Resistance is also an indication that maybe you have to change your strategy or just listen more carefully to the client.
When you adjust to resistance, it is just like avoiding the argument because you get another chance to respond in an entirely new way. You also express empathy and stay respectful and non-judgmental thus the client will get involved and talk more and more. Most clients do not have a well-developed self-efficacy support or sense. Thus they usually get it very hard to believe that the can believe that they can maintain or begin behavioral change. To foster self-efficacy, you need to elicit and support hope, remain optimistic and show the feasibility that you can embrace and accomplish change.
Therefore it is essential that I will first point out the client's strengths and let them be on the forefront. The suspected discrepancy existing between the desire for the change and the clients feeling of no hope about attaining the required change may lead to rationalization so that the discomfort is eliminated unless the client himself strongly believes that change is possible. This is so based on the fact that self-efficacy is a very key element of change in behavior. It is also essential that you as the one in charge or clinician you take charge of your client's goals.
The acquisition of education can raise the self-efficacy of the client. Precise, understandable and credible information aids the client to fathom how the used of substance progresses to abuse dependency. The effects of the substance use and the biology of addiction should be made relevant to the client's experience. This will most probably alleviate shame and guilt then at long last instill hope in them that recovery can be attained. This is possible but only through the application of appropriate tools and methods. If the process felt like a bunch of hopelessness to him will finally turn out to be achievable to him after being broken down.
While serving my client, I will ask open-ended questions for it will help the client in giving more details. It will help me vividly understand the client's point of view and also kind of trigger some feelings about a given situation or just feelings towards a given topic (Miller, 2012). Such kind of questions also gives room for dialogue, and obviously they cannot be responded to with just a single word and the answers are also not fixed. The clinician will be able to get more information from a single question. It keeps the communication moving and also as the expert you will not make premature judgments since details are offered. Motivational interviewing also calls for listening reflectively. This is an important component, although in some way it is challenging. You have to show that you are as accurate as possible regarding hearing and understanding the client's information as he talks.
The motivational interviewing works well when some initial strategies are applied appropriately. The strategies are founded on the above-discussed factors. The starting point in this process should be offering support to the clients so that they can be able to agree their natural ambivalence. This is a key strategy since it makes sure that you aid the customer to express his ambivalence in a good environmental. The first strategies which are four that are enacted from counseling based on the client and aids in the thorough exploration of the ambivalence and the main reasons for the change. During you earliest engagement with your client, make sure that you ascertain your client's readiness to change. It is important also to be very cautious not to indulge in premature stages. Family system theory is based on the human problem that arises from relationships for instance in the families. Most people are encouraged to be independent or autonomous for that case they are free to make choices in life and consequently be accountable for the consequences that emerge from the choices that they make in life. This notion of being individualistic tends to ignore that fact that we were born and raised up in families.
Anderson, T., Lunnen, K.M., & Ogles, B.M. (2010). Putting models and techniques in context.
In Barry L. Duncan, Scott D. Miller, Bruce E. Wampold, & Mark A. Hubble (Eds.), The heart and soul of change (pp. 143- 198). Washington, DC: American Psychological Association.
Corey, G. (2014). Theory and practice of counseling and psychotherapy. . Boston, MA: Cengage Learning.
Lum, W. (2002). The use of self of the therapist. Contemporary Family Therapy, 24(1), 181-197.
Miller, W. R. (2009). Toward a theory of motivational interviewing. American psychologist 64.6, 527.
Miller, W. R. (2012). Motivational interviewing: Helping people change. Guilford press.
Rollnick, S. E. (2008). Motivational interviewing in health care. helping patients change behavior, 203-203.
Yalom, I. D. (2003). The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients. Reflections on Being a Therapist London: Piatkus, 10.
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