This work will discuss about motivational interviewing (MI) the nurse’s role in helping motivation for change in client with alcohol dependence. For clarity purpose, key terms like MI and alcohol dependence shall be defined. The evidence of effectiveness of MI as a psychosocial intervention for alcohol dependence and policies underpinning the use as well as the strengths and weaknesses and ethical issues. This work will evaluate nurse’s role in providing care and treatment including health education and promotion by helping patients/client’s motivation for change. Through reflection on practise, the writer’s clinical placement practise experiences of working with alcohol ...view middle of the document...
In recent times, alcohol dependence represents an enduring problem for the individual and the wider society. (Martin, 2004).
According to Gibbins and Kipping (2006), there is general acceptance that thirty to fifty percent of people with severe mental illness also have problems with substance misuse. Research indicates that one of the common substances misused by those with severe mental illness is alcohol (Department of Health, 2002). According to Barnett et al (2007a), there is a close relationship between alcohol problems and mental health. People with mental health problems are at raised risk of alcohol problems and vice versa. Mental health problems may be a cause of problem drinking; Problem drinking may be a cause of mental ill-health problems.
Conditions in which people may try to use alcohol to cope with include: Depression and suicidal feelings, Anxiety, Obsessive-compulsive disorders, and Schizophrenia (Barnett et al (2007b). Specific physical problems associated with alcohol dependence include insomnia, sexual problems and memory loss. Withdrawal symptoms can be severe, resulting in shaking, sweating, diarrhoea, rapid heartbeat and occasionally seizures. These symptoms are often known as delirium tremens, or DTs, and can be life threatening unless medical help is found urgently. There are also social effects of alcohol dependence, like domestic violence, crime personal relationship problems which can cause problems at work and other long-term effects such as job loss, financial difficulties (Seitz & Homann, 2001).
The Alcohol harm reduction strategy for England (2004) and Choosing Health (2004) White Paper among others draws together a range of government interventions to prevent, minimise and manage alcohol-related harm. Preventing alcohol-related harm requires the accurate identification of individuals who depend on alcohol and the implementation of evidence-based interventions to reduce alcohol consumption or maintain abstinence (BMA, 2009).
Motivational interviewing (MI) is defined by Rollnick and Miller (2002b) as a directive which is client-centred counselling style that is use to elicit behavioural change by helping clients to explore and resolve ambivalence. The concept of MI originated from clinical observations about the treatment of problem drinkers (Miller, 1983). MI as a non pharmacological therapeutic approach works towards changing addictive behaviours and has been used successfully in the treatment of alcohol dependence. (Vasiliaki et al, 2006). The strategies of MI are more persuasive than coercive, more supportive than argumentative, and the overall goal is to increase the client's intrinsic motivation so that change arises from within rather than being imposed from without (Rollnick & Miller, 2002c).
The notion that behaviour change involves a process that occurs in increments and that involves specific and varied tasks as described in Diclemente & Prochaska (1985) transtheoretical model of...