For the following case study, please make sure to use four different MI strategies (e.g. develop discrepancy, express empathy, OARS, amplify ambivalence, roll with resistance, support self-efficacy, etc.) to illustrate your understanding and implementation of this approach. You must demonstrate the clinical style of motivational interviewing (MI). Additionally, be mindful to integrate trauma-informed principles of engagement (e.g., trauma awareness; emphasis on safety and trustworthiness; opportunity for choice, collaboration, and connection; and/or strengths-based approaches and skills building).
Case Study Catalina
Catalina is a 42-year old Hispanic female who recently retired from the military. She received multiple evaluations as part of her retirement, from both medical and mental health providers. She has frequent nightmares and flashbacks related to combat and carries a diagnosis of Post-Traumatic Stress Disorder. She has been seen in Primary Care for physical health issues. She is currently prescribed medication for high blood pressure, high cholesterol, and lower back/joint pain. Catalina is working to improve her health through diet and exercise, though these issues conflict with her personal identity (e.g., able bodied, strong combat veteran, etc.)
In addition to retirement, Catalina is newly remarried after dating for about a year. The family home is slightly cramped as her new wife still has two teenage children living at home. The adjustments to space and finances are manageable, though Catalina disagrees with her new wife’s parenting style, as it is quite different from her two children whom are sophomores in college out of state.. The main problem at home is Catalina has increased the volume of alcohol she consumes during an average drinking session. Her wife sought professional assistance, as she was concerned about the frequency and volume of her drinking. Catalina reports drinking approximately one fifth of vodka per evening. She has entered your care, as she is seeking support however, she remains “on the fence because I believe my drinking is under control, I am retired and I have always had a high tolerance.”
Catalina’s wife has expressed a holistic approach to recovery that emphasizes spiritual, cultural, and connectedness as important in her Hispanic community and would be necessary for the intervention to succeed. She has emphasized the need for a multi-level intervention targeting individuals, families, and the community as a whole.
1
Core Interviewing Skills: OARS
Yicel Hernandez Rodriguez
Campbellsville University
Couse: SWK 681 Addictions
Instructor: Neil Caldwell MSSW, CSW, LCADC
February 15, 2022
2
Core Interviewing Skills: OARS
I. Conversion to Open-ended questions
1. How many cigarettes do you smoke per day?
How do you feel about the quantity of cigarettes you smoke per day?
2. In the last one week, how many alcoholic drinks have you had?
How would you describe your weekly alcohol intake?
3. Have you ever been incarcerated?
What is you experience with incarceration?
II. Affirming Statements
1. Everyone has to die some way; smoking is the only pleasure I have.
You have chosen to seek help about smoking, and you will realize other ways of finding pleasure.
2. Life would be boring if I could no longer drink.
Life is likely to be more fulfilling once you focus on quitting alcohol.
3. I will probably be in and out of jail for the rest of my life
Taking a step to seek help is a good step that will help you to avoid being in and out of jail.
III. Reflecting
1. ” I don’t have a gambling problem. I just like to gamble a little too much sometimes.”
You don’t think that gambling behavior is problematic and hence does not require you to take
necessary steps to change.
2. “My parents used [drugs and alcohol] throughout my childhood. Why can’t I?”
3
You suspect that your parents’ drug-abuse behavior has influenced your current decisions to
drink and smoke. You do not think that drinking and smoking are a problem since your parents
have been doing the same since you were a child.
3. “Those squares go and work those minimum wage jobs. I make great money selling dime
bags, and pot should be legal anyway.”
You prefer selling pot to working in minimum wages job despite it being illegal.
IV. Summary
1. Let me summarize your thoughts about gambling. You accept you gamble frequently but you
do not think it has affected you. You only consider it as a problem when you gamble too much,
which you occasionally do.
2. So, if I’m following you correctly, you watched your parents use drugs and alcohol since you
were young. You do not think that using alcohol and drugs affected your parents in any way and
that is why you feel justified to use them too.
3. In summary, you despise people who work for minimum wages job. You prefer selling pot
whereas you know it can land you in jail. You are not worried about being incarcerated provided
you make a lot of money.
V. The OARS skill that was easy to practice
Among the four skills, open-ended questions were quite easy to practice. As Miller and
Rollnick (2013) put it, open questions are like an open door that provides an avenue for a person
to provide detailed information about an issue. They also advise that to develop an open
question, it is important to reflect on what the person is saying. Therefore, I would first reflect
4
about the issue I want to enquire about and then give an open avenue for them to answer in a way
they feel more comfortable. I also used open questions as a way of encouraging an engagement.
For example, by asking how the client felt about his daily smoking intake, I wanted him to not
only discuss the quantity but also how it made him feel. I also wanted to understand his
perception about smoking.
VI. The OARS Skill to Increase My Counselling Proficiency
I would choose affirmation to improve my counseling practice. I prefer affirmation
because it recognizes a client’s ability and achieve the desired change. Affirmation also assures
support and encouragement to help model behavior. Therefore, I look forward to affirm my
patients as a way of appreciating their decision to seek help and acknowledging their inherent
abilities to achieve their goals. Affirming also helps in establishing a meaningful and trusting
relationship between a counselor and the client.
5
References
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd
ed.). Guilford Press.
Purchase answer to see full
attachment
