For this week’s case study question, you needed to have a familiarity with the transtheoretical model, or stages of change theory. This model identifies five stages of change, occurring in the following order: pre contemplation, contemplation, preparation, action, and maintenance. Motivational interviewing often makes use of the transtheoretical model, because MI often helps clients connect with their motivation for change and set goals that move them toward it.

Let’s examine the five stages as they relate to the client in this week’s case study.

Precontemplation - Folks in this stage are not consciously aware that they need or even want to make a change. These clients may demonstrate resistance in treatment. The client in this week’s case study does not occupy this stage of change because her statements suggest that she is aware that a problem exists.

Contemplation - This is the correct answer! The client is aware that a problem exists, but she has not demonstrated a concrete understanding of her alcohol use and she does not have a plan for changing it.

Preparation - People in this stage have a more thorough understanding of what behavior they’d like to change and how they’d like to change it, but they haven’t begun to make the actual change yet. They may spend time gathering information to get ready for the action stage. The client is not yet preparing for a specific change, and so this is not the correct answer.

Action - People in this stage are making the change... (More)

This week’s case study was a tricky one, requiring you to consider elements of substance use, systemic stress, motivational interviewing, and Maslow’s hierarchy. Let’s break it down together.

This week's client will benefit from a comprehensive approach that sees her substance use within a broader context of isolation, loss of motivation, and financial stress. That being said, the National Institute of Health defines heavy drinking (for folks assigned female at birth) as “consuming 4 or more [standard drinks] on any day or 8 or more drinks per week.” (Read more about the guidelines here: https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking)

There isn’t one set number that definitively indicates when someone’s alcohol consumption is problematic. This is dependent upon their unique physiology and whether their quality of life is suffering in connection with drinking. However, this client is well above the heavy drinking estimate and seems to indicate an Alcohol Use Disorder.

At its core, this question required to you understand each step of Maslow’s Hierarchy and prioritize your intervention to one. It also required you to understand that Maslow’s Hierarchy is somewhat similar to a stage model in that you can’t meet an upper-level need without fulfilling the basic ones. So, although your client is craving self-actualization (“life doesn’t have much zest anymore”) and belonging (“she used to feel respected by people around her”) the answer to the question is actually physiological needs. This is the first level of the pyramid, and for this client, it is currently being threatened by risky health behaviors.... (More)