Page 7 - The Client Volume 2
P. 7
THE CLIENT VOLUME II PAGE 7
KNOWLEDGE SHARING
Motivational Interviewing
A Co�e Element O� Case Management
Adenike Stephenson
Regional Case Management Coordinator
Ministry of National Security
Motivational interviewing (MI) has MI was developed by Willaim Miller and Setting the Stage
emerged as a promising approach in Stephen Rollnick, who outlined four
various behavioural interventions, fundamental principles of the approach: The Case Manager creates a
including substance abuse, health expressing empathy, developing discrepancy, therapeutic environment that
promotion, and offender treatment. rolling with resistance, and supporting promotes openness from the client.
Existing literature on the approach self-efficacy. These principles form the The sessions occur in a comfortable
purports that, based on its successful foundation of MI practice and guide therapists setting, whether at the client's school
use, especially in alcoholism in fostering a collaborative, non-judgmental or home. The Case Manager appears
treatment and offender therapeutic relationship. Empathy involves comfortable and non-threatening,
rehabilitation, it has immense value active listening, reflective responding, and maintaining an open posture and eye
in addressing violent behaviour. This genuine concern for the client's perspective. contact to convey warmth and
article will discuss the theoretical Developing discrepancy entails highlighting acceptance. It is important to note that
underpinnings of MI, its core discrepancies between current behaviour and the first session with the case
principles, and specific strategies future goals, thereby motivating change. manager must be face-to-face, but it
adapted for violence risk reduction. Rolling with resistance involves reframing can be done online once rapport has
Moreover, we examine challenges and resistance as usual and exploring its been established with the client.
opportunities in implementing MI underlying reasons without confrontation.
within the context of current Supporting self-efficacy involves affirming Establishing Rapport
programmes of the Ministry of clients' strengths and beliefs in their ability to
National Security (MNS). change, fostering a sense of agency and The Case Manager starts by
competence. expressing genuine interest in the
Violence remains a significant public client’s well-being and asking
health concern worldwide, with While much of the MI literature has focused open-ended questions to understand
devastating consequences for on substance abuse and health behaviours, their perspective. This sets a tone of
individuals, families, and there is growing interest in its application to collaboration and partnership,
communities. Traditional approaches violence prevention. Drawing from studies on encouraging the client to share openly
to violence prevention often focus on offender rehabilitation and HIV risk reduction, without fear of judgment.
punitive measures or several MI techniques can be adapted for
cognitive-behavioural interventions violence risk reduction. These include Exploring Ambivalence
targeting specific risk factors. exploring ambivalence towards violent
However, there is growing behaviour, identifying personal values and The Case Manager listens attentively,
recognition of the importance of goals incompatible with violence, and reflecting on the client’s feelings and
motivational factors in shaping enhancing coping skills and social support exploring the reasons behind their
behaviour change, particularly in networks. To improve engagement and ambivalence towards behaviour
high-risk populations. MI, initially effectiveness, MI can also be integrated into change.
developed for addressing substance violence prevention programs, such as anger
use disorders, has gained attention management and conflict resolution Eliciting Motivation
for its effectiveness in promoting interventions.
behaviour change across diverse The Case Manager gently guides
contexts. The MNS first implemented MI in Case clients to explore their values, goals,
Management of At-Risk Youth under the and aspirations. The Case Manager
MI is rooted in the principles of Citizen Security and Justice Programme. The helps clients connect their behaviour
person-centred therapy and the success of that intervention led to adopting with their broader life goals and values
transtheoretical model of change. It the Case Management Approach as a mainstay through empathetic listening and
emphasises collaboration, empathy, of the Ministry's Social Intervention reflective questioning.
and evocation, enhancing intrinsic Programmes. Accordingly, MI continued to be
motivation and resolving ambivalence used as a tool for Case Managers as they Developing Discrepancy
towards change. Central to MI is the moved into targeting students being
belief in individuals' capacity for case-managed under the Inter-Ministerial The Case Manager helps the client
change and the therapist's role in School Support Strategy, a partnership recognise the discrepancies between
facilitating this process through a between the MNS and the Ministry of their current behaviour and desired
non-confrontational, empathetic Education and Youth that seeks to identify, outcomes, highlighting the negative
stance. By eliciting and reinforcing engage and support students with behavioural consequences of their maladaptive
clients' motivations for change, MI challenges in Grades 4 to Grade 11 of schools behaviour while affirming their
seeks to empower individuals to take served by the communities declared Zones of strengths and aspirations.
ownership of their behaviour and Special Operations. In using the approach,
make informed choices. Case Managers go through the following
