Joanna's Case Study: Motivational Interviewing Intervention

Joanna’s case study

After watching the video about Joanna’s case study, I have chosen Motivational Interviewing
(MI) as an appropriate intervention. This essay devises a case articulation in relation to
Joanna based on Motivational Interviewing viewpoint. The essay will analyze possible
present and past situations related to the issue. Strategies are provided in this essay to resolve
potential barriers. Interventions are based on evidence with rationales to apply in Joanna’s
context and are supported by references. A treatment plan is formulated on counseling
objectives and framework of how these goals are implemented. The discussion identifies
potential challenges; suggest strategies and literature to overcome the obstacles towards
recovery. Defined goals during counseling and devised treatment plans via case management
are being structured to support Joanna.
Develop a case conceptualization/formulation about the case of Joanna from your
chosen theoretical perspective. Include the history of her problem(s), her current issues
or concerns, her interpersonal/life functioning. Note any risk factors you have identified
and your behavioral observations that are relevant to your formulation.
Smedslund (2019) stated that MI is a client-centered semi-directed mode of intervention. It
increases fundamental motivation to change by discovering and solving ambivalence, and this
type of intervention is widely used throughout the world to treat patients in order to change
their challenging behavior by applying MI during counseling phase. This type of intervention
is involved in the effective management of substance abuse, negligent parenting in
combination with legally established agreements governed through family drug courts
(Reading, 2010).
Hall, Gibbie, and Lubman (2012) claimed that behavioral change focuses on the significance
of inspiration, ambivalence, and refusal to accept change. MI fundamentally is a counseling
method which increases patient's (Joann’s) drive through guiding principles. The therapist
helps to rectify resistance in response, understand the patient's motivation. Active listening
and empathy are essential during the intervention process. The therapist may face resistance
from Joanna at the time of providing necessary advice. When clients are given pieces of
information to adopt a healthier lifestyle by reducing substance use or stop the harmful
behavior, such type of conduct can be expected, and a therapist can develop and able to
encourage for a healthier lifestyle. Motivating behavioral change (2011) claims that it helps

patients to identify reasons behind changes. Behavioral change is challenging, especially
overcoming substance dependence. MI is a therapeutic intervention many clinicians use to
assist patients in identifying specific purposes. MI involves the patient's participation in
physical activity, and patients abide by medical treatment. In MI, the therapist prevents
threatening, conflicts, direct attempts to disagree, motivate, or inform the patient to
accommodate positive changes. Expressing empathy, developing discrepancy, moving with
resistance, promoting self-efficacy are crucial elements and collaborative approach which are
applied to address patient’s issues like Joanna.
Bizzarri, Rucci, Vallotta, Scandolari, Zerbetto et al. (as cited in Abasi, & Mohammadkhani,
2016) noted that women who use substances are weak in psychiatric, social, and economic
domains. Quality of life declination is another significant mental health index which creates
risk in patient’s life like Josna.
Both Joanna and Adam stooped using speed and opium a couple of years ago, and they
relapsed again. Joanna complains, she feels tired. The risk factor includes financial problem
as Joanna has indicated poor financial management, unpaid bills, and rental arrears. Also,
most of the finances are spent for purchasing drugs. Child Protection involvement for the
safety and protection of children may be required due to Joanna’s parenting capacity and
parental drug abuse. Joanna has expressed suicidal ideation. However, she has no plan to do
so. There are risk factors in all domains of the family such as mental health, social and
psychological, education of the children, the relationship between Joanna and Adam,
parenting, self-care, emotional wellbeing of the children. Possible ongoing drug abuse,
historical sexual abuse (went on for many years) by Joann’s uncle (Jonna has never disclosed
this to anyone because she fears that no one is going to believe her) are the significant risk
factors.
She is identifying the reasons which are contributing to causation and maintenance of
Joanna’s issues and the role of change in her life.
Ponce, Williams & Allen (as cited in Engstrom, El-Bassel & Gilbert 2012) stated that the
association of force from family members for childhood Sexual Abuse might cause negative
impacts on values and beliefs about persons, connections and the humankind. Childhood
sexual abuse can enhance the risk of family violence experiences. These can cause to hopes

and her acknowledgment of violence in intimate connection which after another bound
women’s interest in a positive relationship and better communications with close partners.
The victims of childhood sexual assault and neglect may face numerous difficulties in
adulthood, for instance, diagnosis of mental health syndromes, addictions and bad physical
wellbeing (Bonomi et al., Cohen et. al. & Lynskey et al, as cited in Herrenkohl, Hong, Klika,
Herrenkohl, & Russo, 2013). Lynskey and Fugerson further claimed that childhood sexual
abuse is associated with depression and anxiety. Adults who faced adversities during their
childhood they have higher chances of depression in their adulthood. Stewart, Morris,
Mekkings, Komar (2006, as cited Abasi, & Mohammadkhani, 2016) stated that history of
sexual assault is related to women's substance use and patients might use this for
psychological distress that began in their history. Audrian-Mcgovern, Al Koudsi, Rodriguez
(as cited in Abasi, & Mohammadkhani, 2016) claimed that children of addicted parents are
genetically at the highest risk of becoming alcoholic and drug abusers. Also, role modeling
plays a significant contribution to substance use in children.
Temme, Fenester, and Ream (2012, as cited in Temme & Wang, 2018) stated that mood and
awareness are believed to be linked with lapse; harmful mood enhances the chance of relapse
and reduces emotive feelings and consciences. When a person like Joanna is depressed, she
may be unaware of the cues of deterioration.
Long-term childhood sexual abuse has indicated the worse mental and physical wellbeing in
adulthood. These increase the chances of dangerous actions like smoking addiction, drinking
issues, and substance abuse which may reduce the engagement with preventative health care
and premature demise ( Beitchman, Zucker, Hood, & daCosta; Felitti et al.,1998, Coles, Lee,
Taft, Mazza & Loxton, 2015). Coles, Lee, Taft, Mazza & Loxton(2015) have stated that co-
operative mode of treatment needs to be established, such as counseling facilities focusing on
child abuse, sexual violence which are predominant underlying issues. Patients may need to
access legal and protective services. Therapist and other professionals should react gently
after hearing the information about violence and its effect. Communication aptitudes, for
example, replying to patient indications are also important in these regards. The support
should enclose questions and safeguard for the safety of Joanna. Information should be
provided to enable Joanna to make her own decisions on her own time. The intervention
process needs to develop pathways to cooperate care requirement to Joanna’s ongoing
education and training.