15Jan 2022 by
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The purpose of this discussion post is to compare and contrast principles of change theory and motivational interviewing and how these principles inform therapeutic interventions. The change theory also referred to as the Transtheoretical Model of behavior change was developed by Prochaska & DiClemente in 1984 to help understand peoples readiness for change while Motivational Interviewing (MI) was originally developed by Miller and Rollnick in 1991 to help treat substance abuse and addiction disorders (Wheeler, 2022). Today MI is not only used in addiction treatment but is increasingly been used in health care and public health settings as greater emphasis and focus are being shifted to health promotion and disease prevention health practices.
Central to the transtheoretical model of change and motivational interviewing is the issue of change. Transtheoretical model of change considers stages of change while motivational interviewing considers an individuals motivation at various stages of change. Transtheoretical model posits that people begin to perceive more benefits than disadvantages from adopting positive behavior changes as they move through the later stages (Liu et al., 2018). MI employs skills and strategies that encourage people to work through their ambivalence about behavior change and to explore discrepancies between their current behavior and their desired behavior change (Boland et al., 2022). In MI, there is a collaboration between the provider and the client where the provider realizes that they dont have all the solutions to client problems but instead need their clients expertise on how the change would happen (Abildsnes, et al., 2021).
The principles of motivational interviewing and the change theory can guide therapeutic interventions developed and implemented in clinical practice. Through the use of the four principles of motivational interviewing namely expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy the provider can be able to identify the type of interaction that will best serve the patient, encourage them to engage in change talk, and empower them to take concrete steps to change maladaptive behavior to desired behavior (Zakhari, 2020). By supporting self-efficacy and fostering an environment where the client feels that they are not being instructed or directed to make necessary changes, clients become more committed to making changes for their own benefits at their own pace (Zakhari, 2020). Motivational interviewing and the change process empowers clients to be active participants in their treatment plan, increase compliance, and motivate clients to follow their treatment plan, thereby leading to success in treatment and prevention of relapse (Abildsnes et al., 2021).
Sound knowledge and expertise in motivational interviewing are important during practice for any PMHNP especially those interested in substance abuse and addiction psychiatry. Evaluating the desire for change should always be a key part of any mental health evaluation and utilizing findings from this evaluation in developing a treatment plan ensures, patient compliance and positive patient outcomes. Assessing patients to determine where they are in the change process will ensure the provider determines the patients readiness for change. It also helps the provider identify the barriers to behavior change, implement interventions for behavior change, and help patients anticipate relapse.
Abildsnes, E., Elin Andresen, N., Storbaekken, S., Beate Samdal, G., Mildestvedt, T., & Meland, E. (2021). How is motivational interviewing (un)related to self-determination theory: An empirical study from different healthcare settings. Scandinavian journal of psychology, 62(5), 709716. https://doi.org/10.1111/sjop.12757
Liu, K. T., Kueh, Y. C., Arifin, W. N., Kim, Y., & Kuan, G. (2018). Application of Transtheoretical Model on Behavioral Changes, and Amount of Physical Activity Among University’s Students. Frontiers in psychology, 9, 2402. https://doi.org/10.3389/fpsyg.2018.02402
Wheeler, K. (2022). Psychotherapy for the advanced practice psychiatric nurse. A how-to guide for evidence-based practice (3rd ed.) Springer Publishing Company.
Zakhari. R., (2020). The Psychiatric-Mental Health Nurse Practitioner Certification Review Manual. Springer Publishing.