The Motivational Interviewing and Stages of Change approach is complementary to the cultural values of Native American people and emphasizes listening, learning, and respect. Addictions in this day and time can be contributed to many factors and effect every ethnicity of people. Substance addiction has even affected the smallest ethnicity of people, Native Americans since their encounter with white people. Motivational Interviewing (MI) has even helped Native Americans through counselors learning and implementing the techniques. Even though clients are naturally resistant to change, utilizing the three pillars are very effective in helping even Native American people because expressing empathy shows that you care and developing discrepancy between client’s present behaviors and values & beliefs.
Counselors today need to be trained in MI and cross culturally trained also to better serve individuals. I would through MI be empathic and express it through reflective listening, paraphrase what I hear from the client, ask them let me see if I am hearing you correctly, You are saying….., I would communicate respectfully with the client, be supportive and establish a non-judgmental therapeutic relationship with the client. There are some great CBT techniques alone with homework assignments to help deal with the shame and embarrassment that a client is feeling about their substance use or other problems that are going on. CBT can be self talk with positive statements to themselves, daily mood and thought record and etc. There are so many techniques that can be utilized with MI to help a client even through shame.
As a counselor, I will utilize the following principles known also as pillars with MI to help motivate my clients: expressing empathy through reflective listening, developing discrepancy between client’s present behavior and values & beliefs, rolling with resistance by avoiding arguments & confrontation also adjust to the resistance, and last support self-efficacy by affirming clients strengths and allowing freedom and choice. First pillar that would be utilized is expressing empathy. Expressing empathy means to understand my client, know and respect where they are in the stage of change, and using reflective listening by using reflection, paraphrasing, or summarizing what has been stated by the client. For example, so let me get this right you said …….. , Did I get that right? Okay, let me see if I understand what you are feeling right now.
In other words walk a mile in their moccasins and know where they are coming from. Second, pillar that would be used is developing discrepancy by getting the client to see that their behaviors that they are exhibiting does not reflect what they have stated that is their values, beliefs, and morals. I would listen to my clients, reflecting, and ask open ended-question. According to Capuzzi & Stauffer (2012), “When a client is able to experience an internal discrepancy between his or her current behaviors and his or her values, beliefs, and goals, the change process can begin. This is due in large part to the underlying principle of cognitive dissonance (p.131). Third pillar is rolling with resistance which is where a client is resistant to change than as a counselor I would not argue with the client, I will ask the client to tell me more about their view point so that I can understand where they are coming from more. Most important avoid labeling a client.
I would ask open-ended questions to invite them in to talk more about what they believe is their reason for not wanting to change, engage in problem solving, or maybe reflecting back their values, beliefs, and goals (Capuzzi & Stauffer, 2012). Last pillar is support self-efficacy which is fostering the client’s belief that they can make the necessary changes successfully, making sure the client knows that they are responsible for deciding to change and carrying out the change, let the client know my belief that they can change, and guide client to explore alternative problem solving solutions or approaches to change (Capuzzi & Stauffer, 2012).
In conclusion, I learned that if a counselor is trained in MI and understands how to deliver the techniques with clients that it would be an effective technique with clients to motivate the stage of changes. For instance, “data from the current survey collected in a Native American community suggest that MI may be well suited as an intervention to prevent underage drinking and that a MI research program to reduce underage drinking would be generally well tolerated in this reservation community (Tonigan, Miller, & Villanueva, 2007).
Capuzzi, D., & Stauffer, M. (Eds.). (2012). Foundations of addiction counseling (2nd ed.). Upper Saddle River, New Jersey: Pearson. Tonigan, J. S., Miller, W. R., & Villanueva, M. (2007). Response of native american clients to three treatment methods for alcohol dependence Retrieved from http://search.ebscohost.com.library.gcu.edu:2048/login.aspx?direct=true&AuthType=ip,url,cookie,uid&an=28650827&db=ehh&scope=site&site=ehost; http://xs6th8dt4r.search.serialssolutions.com.library.gcu.edu:2048?sid=CentralSearch:EDJ&genre=article&atitle=Response+of+Native+American+Clients+to+Three+Treatment+Methods+for+Alcohol+Dependence.&volume=6&issue=2&title=Journal+of+Ethnicity+in+Substance+Abuse&issn=1533-2640&date=2007-06-01&spage=41&aulast=Tonigan&aufirst=J