1MENTAL HEALTH What? During one of my workshop, I had to take interview of Chris Mitrevski, a registered nurse with substance abuse disorder. The details that I got regarding the client before the interview was that the nurse has been referred to to the Drug and Alcohol Services for assessment regarding alcohol abuse and its impact on her professional performance. Several occasions were reported where the nurse was found to come to the hospital smelling of alcohol. During the interview, I was involved in inquiring regarding the alcohol misuse, the time since the nurse started drinking, the cause behind it, its impact on performance and the extent to which the client was dependent on alcohol. On reflecting on the overall interview process, I found that he was a heavily addicted consuming about 4-5 glasses of wine every night. I also became aware about the motivation behind consuming excess amount of alcohol. His consumption of alcohol occurred after his partner died in a vehicle accident and as he was finding difficult in sleeping, he used alcohol to go to sleep. Throughout the interview, the client was inattentive occasionally. However, he was giving clear responses. However, I gave the client time so that he reveals all to understand the overall impact of alcohol misuse on his overall health. In addition, the most difficult was to convince client to quit drinking and taking counselling regarding it. So what? Based on collection response regarding the cause of excess alcohol consumption, I could relate the nurse’s alcohol drinking with his life stressors. As he had to go through the death of his partner, the rationale behind drinking became clear.Keyes et al. (2014)defines that unexpected death of loved ones is a traumatic experience that is most commonly associated with substance use and psychiatric disorders and alcohol is often used as a strategy to cope with loneliness and
2MENTAL HEALTH sudden change in life courses. Although the interview helped to understand the reason behind alcohol misuse and the benefit that the nurse got by drinking alcohol, the most difficult part of the interview process was to make the client believe that he was using a wrong method to cope with his emotional problems and sleep difficulty. The client was trying to justify that although he is drinking on a daily basis and is dependent on it to cope with his current mental state and go to work, it is not affecting her nursing performance. As part of the professional requirements of conducting an interview, I had the duty not to engage in argument and direct confrontation with the client. I could not oppose the client directly too (Bagøien et al., 2013). Hence, in such situation, it was difficult for me to understand the most effective technique to challenge the views of the client and not confront him too. Despite following the interview strategy of maintaining respect of patient and asking questions according to the pace of client, the strategy to address ambivalence of client regarding alcohol misuse was a major challenged for me in the entire interview process. However, I was abletoaddressthisissueusingtheconceptsofmotivationinterviewing.Motivational interviewing is client-centered method to enhance intrinsic motivation to change in client by resolving ambivalence and improving patient’s view regarding making changes in his habit (Bagøien et al., 2013). I engaged in resolving ambivalence by engaging in honest and safe dialogues and helping the client to recognize discrepancies in lifestyle and coping styles through empathetic communication. By this strategy, I was finally able to convince the nurse that she needs to take support to at least minimize the amount of alcohol consumed so that it had no adverse impact on her professional performance in the future.
3MENTAL HEALTH Now what? Based on the experience of taking interview with a client with substance abuse, I have developed my skills in using appropriate techniques to conduct interview with such clients. I became aware about the communication strategies that I should take in case of ambivalent client. As I took time in convincing client regarding changing his behaviour, in future I have planned to take short workshop or training in this area so that I am more confident in understanding how to help substance abuse client to develop hope and faith about recovery. I aim to use the acronym ‘RULE’ (Resist, understand, listen and empower) to resolve issues for client with substance use disorders.
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4MENTAL HEALTH References: Bagøien, G., Bjørngaard, J. H., Østensen, C., Reitan, S. K., Romundstad, P., & Morken, G. (2013). The effects of motivational interviewing on patients with comorbid substance use admitted to a psychiatric emergency unit-a randomised controlled trial with two year follow-up.BMC psychiatry,13(1), 93. Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study.American Journal of Psychiatry,171(8), 864-871.