Assignment: Motivational techniques
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Assignment: What techniques or questions might a counselor use to help increase Jane’s motivation to cut down on her drinking without alienating Jane or losing her trust?
CASE STUDY SCENARIO
Jane has been drinking a glass of wine every evening for the past 12 years. In recent years, her consumption has increased and she is no longer aware of how much she drinks, but assures you that she finishes between five and seven bottles a week. She is able to keep a full-time job, raise two children, and manage her daily activities. Last week, she went to her physician and was informed that her liver is showing signs of damage and early stages of cirrhosis. Jane was told to stop drinking immediately. Jane’s first reaction was, “I am not an alcoholic. Alcoholics can’t hold down a job and take care of a family!” Further, liver problems run in her family, so she dismissed the problems as genetic, disregards what her physician has told her, and continues to drink several glasses of wine each night. She is unable to see her drinking as a problem and is not willing to stop at this time. Jane is precontemplative about change.
What techniques or questions might a counselor use to help increase Jane’s motivation to cut down on her drinking without alienating Jane or losing her trust?
Contemplation is the next stage of change. In this stage, clients are open to the idea that perhaps their behavior is problematic. They are considering and mentally weighing the pros and cons of change, but are not yet ready to engage in actual change. Contemplators typically are thinking about change but do not act on those thoughts. This stage is characterized by marked ambivalence about the process.
Case Study
Jane’s children begin to make comments about her drinking. She overheard her son telling his friends that his mom is a “dumb wino” because she couldn’t find her car keys, and her husband has demanded she cut back to one glass a night. Jane considers this but is terrified that she will be irritable, dizzy, and shaky like the last time she attempted to reduce drinking. Plus, how will she relax enough to be able to fall asleep? Her racing thoughts and rapid heart rate keep her up at night, and wine helps her relax enough to find sleep. She continues to drink her typical amount each night, but begins to think about ways she can reduce her intake, and considers other ways of feeling relaxed instead of drinking. She does not intend to stop entirely, but may eventually be willing to try to cut back to one glass a night to appease her family. What might a counselor say or do to honor Jane’s initial thoughts about changing while addressing her hesitance about taking action (without coercing or trying to “convince” Jane to change)?
Jane is beginning to recognize that her drinking may be a bigger problem than she once thought. She realizes that when she reduces her consumption, she experiences some concerning and uncomfortable signs of withdrawal. She is considering decreasing her alcohol intake, yet is not considering abstinence. She is contemplative about changing her target behavior and is considering reducing the amount of wine she drinks each night; however, she is not ready. She is considering the alternatives, but is not quite inclined to start behaving differently. Jane is on her way to the Preparation stage.
Preparation (previously referred to as Determination) is the stage when the client realizes that the behavior is having enough of a negative impact to warrant at least a slight change. The client is now ready to begin taking steps to actively change the target behavior. At this stage the client develops a specific plan. Oftentimes, clients will develop a change plan only after carefully examining their strengths, resources, and activities to determine what will help, and what may hinder, the change process ( Solomon & Fioritti, 2002 ). The counselor, in this stage of change, plays a vital role in supporting change talk—that is, helping the client clarify and continue to articulate the value of potentially changing the target behavior ( Mason, 2009 ).
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