Assignment 2: Essay

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Introduction
The report aims to discuss regarding the Transtheoretical model of changes by applying an
evidence-based framework. Through studies comparing smokers who quit on their own versus
those who required further treatment in the late 1970s, Prochaska and DiClemente developed
the Transtheoretical Model which is also known as the Stages of Change Model in order to
explain why some people were able to quit on their own. Based on the case scenario, the report
discussed about evidence named Claudia who was trying to reduce the alcohol intake due to
pregnancy (Hashemzadeh, et al., 2019). Hence the author has tried to acknowledge the
understanding for identifying the stage of Erikson’s psychosocial stage of development and also
the key element of the Spirit of MI with illustrating the motivational interviewing techniques
that HCP utilize to assist. Initiating with the main background, report ends with an appropriate
conclusion.

Case Scenario
Patient named Claudia is in her second year of her physiology degree who has taken an
appointment in order to decrease the alcohol intake in her body due to her pregnancy. And
often time she even blacks out due to excessive intake of alcohol and so she got concerned
about her drinking habits. On determining by the health care professional, it was said that
Claudia is in her preparation stage for the transtheoretical model of change and also need to
build a relationship via therapeutic communication and need to progress through several stages
of change towards 5th stage known as maintenance.

Erikson’s Theory of Psychosocial development

Social experiences have a significant impact throughout the lifespan according to Erikson's
theory. The development and growth of human beings is influenced by social interaction and
relationships, according to Erikson. And at every stage of Erikson's theory, conflict serves as a
turning point in people's development, and each stage builds on the previous stage (Chung,
2018).

Psychosocial Stages: A Summary Chart

Age Conflict Important Events Outcome
Infancy (birth to 18 months) Trust vs. Mistrust  Feeding Hope
Early Childhood (2 to 3 years) Autonomy vs. Shame and Toilet Training Will
Doubt
Preschool (3 to 5 years) Initiative vs. Guilt Exploration Purpose
School Age (6 to 11 years) Industry vs. Inferiority School Confidence
Adolescence (12 to 18 years) Identity vs. Role Confusion Social Relationships Fidelity
Young Adulthood (19 to 40 Intimacy vs. Isolation Relationships Love
years)
Middle Adulthood (40 to 65 Generativity vs. Stagnation Work and Care
years) Parenthood
Maturity (65 to death) Ego Integrity vs. Despair Reflection on Life Wisdom

(McLeod, 2018)

Taking into account the case of Claudia, it could be noticed that Claudia is in her Stage 6 which
lies from young adult years from 18 to 40 and the name of the stage is Intimacy vs Isolation. In
this stage, successful relationships lead to strong relationships, while failure leads to loneliness
and isolation (Wu, Sang, Zhang, & Margraf, 2020). People are exploring their personal
relationships during this stage of early adulthood. Erikson argues that having a strong sense of
identity is essential to forming intimate relationships. Those who lack a strong sense of self
suffer from loneliness, isolation, and depression more often (Maree, 2021).

Mentioning regarding Claudia’s condition, it is possible that she is suffering from alcohol
addiction as a form of isolation too which leads to divert her mind to consumer more and more
alcohol. Hence this could be the reason of her continuous changing behavior and even though
she has a long-term boyfriend, but it is observed that she even blacks out after immense
consumption of alcohol which could be the reason of her stressful life (Cherry, 2022).

Key element for the spirit of MI

Motivational interviewing is demonstrated under a series of principles which focuses on a
collaborative therapeutic relationship where the independency of the patient is respected as
well as patient's intrinsic resources for change are elucidated by the therapist (Resnicow &
McMaster, 2012). In the motivational interviewing in which the therapist is known as a
facilitator in spite of expert where the person follows a nonconfrontational approach in order
to facilitate the patient towards making any change. As a result, the overall spirit of MI has
been represented as collaborative, evocative and honors the autonomy of patient (Arbuckle, et
al., 2021).

Considering the case scenario of Claudia, the one element for the spirit of MI is described
below:

It is easy to said that Claudia is definitely lacks motivation and her judgement does not see the
bad effects of alcohol on her health. Such things naturally made the practitioner for acquiring a
paternalistic therapeutic style as well as warn the patient regarding the risks to her health.
Relative to such consultations the time period when such kind of strategies don’t work it
becomes quite easy to give the hope for changing her drinking habit and labelled her as
unmotivated (Szczekala, Wiktor, Kanadys, & Wiktor, 2018). However, in MI as oppose to this,
motivation of the patient is focused by the worker. Hence by utilizing the spirit of MI, patient’s
independence would be respected for altering her drinking habits and the process of
motivational interviewing focus on defining several reasons for having a change from the
patient in spite of suggesting the patient that why the patient needs to change her drinking
habit. This leads to several kind of concerns that what effects would have on consuming high
amount of drinking and what values are driven by them. The apparent 'lack of motivation'
works evidently and labeled as 'unresolved ambivalence' in the MI framework. Also, the
practitioner would prefer to work on comprehending such kind of confusion by searching of
pros and cons of continuing to drink alcohol. Then the practitioners would like to work on
solving any kind of vagueness by connecting the things about which the patient genuinely cares
for having the motivation of change (Rollnick & Miller, 1995).

HCP Motivational Interviewing Techniques

When people have mixed feelings about changing their behavior, motivational interviewing is
particularly effective. People can use this approach to find motivation to change their behavior
in a positive way. The techniques used by HCP in case of Claudia are given below:

1. Open-ended Questions: Such questions help the patient to think deeply regarding any issue
and these start with what or how through which the therapist get a chance to learn more
about the patient. As the therapist could ask Claudia in the following manner:
 How would you like to make things work in a different manner?
 What have you adopted earlier to change yourself? (Ubaidi, 2017)
2. Affirmations: These are the statements through which a person’s strengths as well as
positive behavior could be approached by acknowledging it in an affirmative manner. These
help the person to build person’s confidence for their ability to change and the affirmative
response involve:
 You are definitely a resourceful person.
 You have handled yourself in a robust way to get out of that circumstance.
3. Reflective Listening: It is one of the most crucial factors which is adopted by therapists and
through reflection, a client could easily get to know if their therapist is listening or
comprehending from their point of view and provides the client to achieve any kind of
opportunity to correct any misunderstanding and elucidating their feelings (Frost, et al.,
2018).
Action stage and maintenance stage
Regarding achieving the action as well as maintenance stage in Claudia’s scenario, following are
some of the steps followed by the HCP:

In the action stage, the person is actively participated in altering their behavior and any kind of
active effort to change the behavior would be more than enough in terms of dividing them in
this stage only and most of the individuals comprehend that they are entirely responsible for
their changing behavior which needs some type of outside help which would comprise the MI
techniques to deal with. In the maintenance stage, the individual has adopted some kind of
efficiency in terms of altering their behavior where they work on the change but also become
proficient enough for seen an alteration in their behavior. Claudia would follow such rules for
been in a place for at least six months to achieve the maintenance stage (Miller & Moyers,
2006).

Role of resilience
Being resilient shows that an individual has the ability to adopt for certain conditions such as
tragedy, trauma as well as adversity and several ongoing factors which are considerable life
stressors. The role of resilience plays a huge role in determining a coping mechanism which
enables the person to protect from experiences which are overwhelming and assists in
maintaining the balance for the lives while experience difficult or stressful periods (Fleming &
Ledogar, 2010).

Conclusion
To conclude, it is observed that Claudia has to take certain kind of measures to reduce the
alcohol intake in her body by following the stages of psychosocial development as well as to
perform on number of areas for enhancing her capability to take care of herself as she is
pregnant. The report shed light on following certain kind of stages which play an imperative
role in determining the condition of Claudia.
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