Essay on "Harm Reduction Abstinence Motivational Interviewing"

Essay 9 pages (2453 words) Sources: 20 Style: Harvard

[EXCERPT] . . . .

This from the counseling perspective indicates that one would encourage the recovering addict to consider the true benefits of continuing to consume heroin while infected with HIV against the consequences as well as impact that this would have on their health if they continue taking the heroin while infected with HIV. The benefits of embracing alternatives to the situation as wells as the impact that it would have on their health are also explored.

Rolling with resistance

This step is important in helping the therapist to understand the reluctance of the client to embrace change as a natural process rather than a pathological one. One might expect that the user of heroin who at the same time has been diagnosed with HIV would be very scared as well as reluctant to seek alternatives. What would be really important is for the individual to readily embrace change in their behavior. At this point the confrontational0-denial trap must be avoided at all costs.

Support self-efficacy

This step is important in guiding the therapist on how to explicitly embrace the autonomy of the client. This should be maintained even if the client refuses to change. The step is important in helping the client advance towards change with success and confidence.

Avoidance of argument

This step is important in ensuring that the counselor and the client avoid direct confrontation.

The main aim of motivational interviewing is to establish a good rapport, create change conversation as well as establish a form of a commitment language for the various clients as outlined by Miller & Rollnick (2002)

The main goals of motivational interviewing are to establish rapport, elicit change talk, and establish commitment language from the client. (Miller & Rollnick, 2002).The concept of motivational interviewing is based on Carl Rogers; humanistic theories on the capabilities of people in exercising free choice as well as instigating change process via self-actualization.

The therapeutic correlation that exists between the motivational interviewers and the Rogerian is a form of a democratic relationship/partnership. The role of the counselor is purely directive and is aimed at eliciting a self-motivational statement as well as change in behavior from the drug addict in addition to the creation of discrepancy so as to enhance the motivation needed for appositive change as pointed out by Miller and Rollnick (2002).

Discussions

Harm reduction can be regarded as an umbrella term that refers to the interventions aimed at the reduction of the rather problematic effects of behavior as outlined by Marlatt (1998). Critics of the approach claim that the harm reduction choice enables as well as excuses the engagement in poor choices. Even though abstinence may be the ultimate goal of drub abuse management, harm reduction practitioners aim at meeting the client wherever they may be in regard to their level of motivation as well as ability to change. The goals of the practitioner are need to be secondary to the wants of the client (Logan and Marlatt,2010).

Logan and Marlatt (2010,p.202) pointed out that one major difference that exists between the abstinence-based programs and the harm reduction ones is their definition of the therapeutic process.

Conclusion

The abstinence method of treating opiate addiction is very efficient but is often not practical. The harm reduction techniques as well as motivational interviewing can end up empowering more clients due to their practicability. The two methods can therefore be seen as entirely different in their working but the end result is often the same. In fact they complement each other. A suitable approach would be an integrated one that involves both approaches.

References

Dolan K, Kimber J, Fry C, Fitzgerald J, McDonald D, Trautmann F: Drug consumption facilities in Europe and the establishment of supervised injecting centres in Australia. Drug Alcohol Rev 2000, 19:337-46.

Hurley SF, Jolley DF: Effectiveness of needle-exchange programmes for prevention of HIV infection. Lancet 1997, 349:1797-1801

Lenton, S. And Single, E. (2004), 'The definition of harm reduction', Drug and Alcohol Review 17, pp. 213 -- 20

Logan, DE and Marlatt, GA (2010)Harm reduction therapy: a practice-friendly review of research. Journal of Clinical Psychology, Feb2010, Vol. 66 Issue 2, p201-214, 14p; DOI: 10.1002/jclp.20669

Marlatt GA: Harm reduction: come as you are. Addict Behav 1996, 21:779-88.

Mckeganey, N (2005).Abstinence and harm reduction: Two roads to one destination?

2005, Vol. 12, No. 4, Pages 251-253 (doi:10.1080/09687630500090746)

Miller, W.R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change. New York: Guilford Press.

Newcombe, R. (1992) The reduction of drug related harm: a conceptual framework for theory, practice and research. In, O'Hare et al. (Eds.) The reduction of drug related harm. London Routledge.

Peterson J, Gwin Mitchell S, Hong Y, Agar M, Latkin C: Getting clean and harm reduction: adversarial or complementary issues for injecting drug users. Cad Saude Publica 2006, 22:733-40.

Rachlis, BS.,Kett, T., Montaner, JSG., Wood, E (2009)Harm reduction in hospitals: is it time?. Harm Reduction Journal 2009, 6:19 doi:10.1186/1477-7517-6-19

World Health Organization (2006). Integration of harm reduction into abstinence-based therapeutic communities

Rotgers, F. Empowering Clients with respect to drinking goals. Journal of Studies on Alcohol, 147, 33-36.

Wood E, Tyndall M, Stolz J, et al.: Safer injecting education for HIV prevention within a medically supervised safer injecting facility. Int J. Drug Policy 2005, 16:281-4.

Wood E, Tyndall MW, Zhang R, Stolz JA, Lai C, Montaner JS, Kerr T: Attendence at supervised injecting facilities and use of detoxification services. NEJM 2006, 354:2512-4.

Wood E, Li K, Palepu A, Marsh D, Schechter MT, Hogg R, Montaner J, Kerr T: Sociodemographic disparities in access to addiction… READ MORE

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