Client's Readiness for Change: TTM & SDT in Action - Free Paper Example

The Client’s Readiness for Treatment and Change in Terms of the Trans Theoretical Model of Change (TTM) And Self-Determination Theory (SDT)

Trans Theoretical Model of Change (TTM) and Self-Determination Theory (SDT) have widely been used as the most common methods in modelling of individual behavioural change. According to Grant (2017), there is a significant relationship between a single source (motivations- whether intrinsic or extrinsic) and the stage of change. In this case, Tanya’s readiness for the change process or treatment can be related to the pre-contemplation stage. This is because during the period when her child was born until the time she seeks her doctor, she has shown numerous efforts to change (reduce weight) but becomes demoralized based on her abilities to change. This is similar to Tamparo and Lindh (2017) argument, where individuals in in this stage behaves just like how Tanya does besides being uninformed or under-informed about the consequences of the problem. For instance, Tanya tries to lose weight for the last five years, but she is not able to manage to do so because of being demoralized by her ability to lose her "treats" (rich food and sweets).

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The client is yet to show preparations for the treatment process that involves losing weight but heavily relies on behavioural procrastination of her own self; this is depicted after the doctor terms Tanya as being pre-diabetic. She may be considered at the contemplation phase, where she understands the pros of losing weight (to avoid the worsening of her pre-diabetic condition during her anticipated pregnancy and cons of "treating" herself with the rich and sweet foods (Rolfe et al., 2001). This stage will take long for this client to engage herself in action-oriented programs because of the profound ambivalence resulted from the balance between the benefits and costs of changing (Schön, 1987). According to Bruce & Zac (2015), such clients have to undergo various procedural mechanism like self-re-evaluation, environmental re-evaluation, self-liberation, stimulus control, among other measures that will help reinforce them.

Tracing the roots of Self-Determination Theory (SDT) it is crucial to understand that a humanistic psychological approach will be the most influential in this case as it will help understand this client's efforts in achieving self-efficacy and self-actualization (Geldard D. & Geldard K., 2016). In preparedness for change and treatment, a good therapist in Tanya’s case should focus at helping the client understand the “why” behind her desired goal because this will help increase her readiness for the changes (loss of weight). She is reluctant to “dive” into the action stage; this could be treated through application of SDT which centres its belief on inherent growth tendencies (repeated efforts, commitment and agency in ones live) for persistent positive features (Rolfe et al., 2001). It is seen that the desire for a second child introduces an extrinsic motivation to Tanya. She starts to evaluate and re-evaluate the pros and cons of losing weight; we see her getting concerned about her pre-diabetic condition that is anticipated to worsen during her pregnancy.

Critically Reflect on And Evaluate Motivational Interviewing (MI) And Brief Solution Focused Therapy (BSFT) Skills and Strategies to Inform Appropriate Treatment Within Your Modality for The Client

In brief solution-focused brief therapy (BSFT) uses a similar default solution pattern to treat or help change the client’s problem patterns that are considered to have been developed in a default manner. In our case, Tanya has ambivalence to eating rich food and sweets, as a therapist applying motivation interviewing will significantly help change her behaviour. Therefore, various skills, strategies, or principles need to be incorporated for successful treatment of the client’s problem.

Using Empathic Skill

This is a learnable and specifiable skill that provides for a reflective listening in understanding the meaning of another person (Grant, 2017). Our goal will be to establish a trusting relationship with Tanya for a successful MI. Based on our modality, sharp attention will be critical throughout the process to help understand our client’s statement and generate continuous hypothesis to her underlying problem or meaning. For instance, based on our empathic strategy; Tanya’s feelings will be respected and accepted in whichever means, there will be a collaborative and non-judgmental relationship, and sincere compliments rather than denigrates to her emotions and feelings. This will ensure an open and safe environment surrounds the therapy for conducive examining weight loss issue and eliciting our client's methods and reasons for the change. Through this skill, the therapist will be in a position to understand that the decision to change belongs to the client. Therefore, his role will be to gently persuade, listen other than telling, and provide support continuously during the recovery process (Tamparo & Lindh, 2017)

Using a Discrepancy Development Strategy

This strategy is of primary importance in enhancing motivation for change because clients gain knowledge on their perceived discrepancies based on the situation they’re currently experiencing and that of their future hopes (Wampold & Imel, 2015). in our case, our goal based on this strategy will be to help focus Tanya's attention on how "treating" herself with rich food and sweet differ from the ideal condition of utilizing healthy diets like vegetables, fruits, food with little sugar, and fats. Increasing of our client's awareness will be our chief strategy in this case by highlighting the negative community, familial, or personal consequences of excess weight and helping her confront the eating habit that caused the consequences.

Based on Grant (2017) analysis, underscoring the discrepancies related to the difficulties of helping a client perceive discrepancies will be done carefully by choosing and strategically reflecting on effective tactics. For instance, using this modality the behaviour from the client will be separated by helping her understand the benefits of personal goals (example include marital happiness, good health, and financial success because her pre-diabetic condition will be reduced). Focusing and amplifying on our client's discordance will help her clear, consistent commitment and concerns for change. Additionally, other than talking, using tools can help reveal discrepancies to Tanya, for example, showing her a video related to the importance of adhering to healthy diets and other testimonies of happy clients will help her connect the incidence to her situation (Schön, 1987).

Rolling with Resistance

Similar to how arguments are avoided, this strategy provides legitimate concerns on lack of involvement and poor treatment in the therapeutic process. Thus, through this strategy a therapist handling Tanya's problem has first to understand the her perspective; for instance, she understands that she has to lose weight, but she finds it hard to give up on her "treats," this will allow the therapist in charge to take a new and surprising way by taking advantage of Tanya's situation without confronting her. According to Geldard and Geldard (2016), using various models like simple, amplified, and double-sided reflection, shifting focus, reframing, and agreement with a twist will help the therapist react to our client's resistance appropriately.

Avoid Argument

An argument may sprout up because of the clients who are unwilling or unsure about changing, especially those with rebellious, provocative, or hostile nature (Neff, 2019). A precipitated resistance will occur when the therapist tries to convince the client that there exists a problem and that change is needed. In this case, our modernity aims at “walking” with the client, if Tanya isn’t willing to give up on her rich food, then the therapist should not badger her to take healthy diet by exerting great efforts of persuasion targeting this direction because this will result in resistance other than instilling motivation for change (Grant, 2017). Therefore, starting with the client where they are will be effective as it will provide a basis for altering her self-perception on weight loss using substantially more effective ways.

Self-efficacy support strategy

Many clients find it hard to believe that they can start and maintain behaviour change because of their poorly developed sense of self-efficacy. This is a similar case with our client (Tanya). This strategy is strengthened by the recognition of the client's abilities and capacity to meeting her goals and bringing them to the forefront. If Tanya prefers another mechanism of losing weight, then the therapist should discuss this treatment or change option with her, sharing testimonies of how persons in similar conditions successfully managed to change, using other clients for a role model purpose, and letting her understand that it's her responsibility to change and that long-term success starts with a single step (Neff, 2019). Nonetheless, our client’s self-efficacy can be boosted using education which may alleviate guilt, shame, and instil hope that change can be achieved through appropriate tools and methods.

Reflect on And Consider the Importance of Client-Centered Cultural Awareness and Responsiveness

Client-centred cultural awareness and responsiveness provide the basis for evaluation by assessing the client's sociocultural background that ensures effective treatment plans are implemented. Through this multi-dimensional approach, therapists are in a position to apply relevant cultural factors to the behavioural change process (Power et al., 2015).

Culturally responsive counselling will be provided to clients as this model incorporates cultural competence. For instance, the process will ensure our client, in this case, is engaged because they are in contact with the treatment programs which increase clients' therapeutic relationship (Schön, 1987).

According to Power et al. (2015), there is the maintenance of culture in behavioural health treatment facilities; like for our case, Tanya won’t undergo a Philippines therapeutic process rather she has to be familiarized with the treatment and evaluation process as per the Australian culture.

The importance of cultural awareness and responsiveness is experienced due to endorsed collaboration between the client and the counsellor during the interviews, planning, assessment, and treatment. In our case, Tanya has time to discuss her expectations with the doctor; this means for treatment plans to be made a collaborative approach has also to exist which is only met when there is cultural awareness between the two.

References

Chapter 3—Motivational Interviewing as a Counseling Style. Available at: https://www.ncbi.nlm.nih.gov/books/NBK64964/

Geldard, D., & Geldard, K. (2016). Basic personal counselling: A training manual for counsellors (8th ed.). Frenchs Forest, NSW: Pearson Australia. [EBook available]

Grant, A., McKimm, J., & Murphy, F. (2017). Developing Reflective practise A guide for medical students, doctors and teachers. Retrieved from https://ebookcentral.proquest.com

Neff. K. (2019). Self-Compassion from https://selfcompassion.org/

REM: A Collaborative Framework for Building Indigenous Cultural Competence by Power, T. et al. (2015) in the Journal of Transcultural Nursing, Vol 27, Issue 5, pp. 439 - 446

Rolfe, G., Freshwater, D., Jasper, M. (2001) Critical reflection in nursing and the helping professions: a user’s guide. Basingstoke: Palgrave Macmillan.