Posted: November 28th, 2022

Essay Written Assessment – Claudia’s Case Study

ASSIGNMENT 2: Essay Written Assessment: You are required to write a formal academic essay. The essay will require an introduction, body, conclusion and reference list. All in-text citations must have a corresponding entry in the reference list. You are required to use APA (7th ed.) referencing for your essay, citing evidence in your essay and constructing your reference list. Due date: Wednesday 21/09/22 by 1600 hours (4pm) AEST Weighting: 40% Length and/or format: 1500 +1- 10% Purpose: The aim of this essay is to enable students to demonstrate an understanding of and ability to apply the Transtheoretical Model of Change (Stages of Change Model) within an evidence-based framework. In addition to this, students will identify components of Motivational Interviewing and therapeutic communication which could be utilised to Help with enabling a patient to change their health behaviours.
Learning outcomes assessed: This assessment task assesses L01, L02, L03, LO4
How to submit: Students will submit their assessment to LEO via Turnitin. You should submit your final draft to Turnitin well in advance of the due date (ideally, several days before) to ensure that you get your Turnitin originality report and have time to work on any issues identified by Turnitin Return of assignment: The assignment will be returned via Turnitin on LEO with a grade and feedback summary. Assessment criteria: Students will receive a score out of 100% – see rubric Appendix A Task: Claudia is a 20-year-old female in her second year of an exercise physiology degree at university. Claudia has an appointment at the campus medical centre as she is wanting to reduce her alcohol intake as she has just found out she is pregnant. Claudia states she has been drinking ‘way too much alcohol and blacking out’ and she often cannot remember what happened the night before. She has a long-term boyfriend and now that she is aware that she is pregnant, she is concerned about her drinking habits. The health care professional (HCP) decides that Claudia is in the preparation stage (Stage 3) of the transtheoretical model of change. The HCP will need to build a relationship through therapeutic communication and utilise Motivational Interviewing to progress Claudia through the stages of change towards stage 5, Maintenance. You will need to; a) Identify which stage of Erikson’s psychosocial stage of development Claudia is in (with rationale for your choice) and describe why she may be behaving in this way. b) Identify one key element of the Spirit of MI and describe how the HCP will use this to elicit Claudia’s reasons for wanting to change c) Describe the Motivational Interviewing techniques the HCP will use to Help and support Claudia to the Action Stage (with reference to her alcohol use) and to work towards the Maintenance Stage. d) Outline what new behaviours Claudia would need to engage in to be successful in the Action Stage and to achieve improved health outcomes long term and to reach Maintenance. e) Outline how resilience will play a role in Claudia’s quest to reduce her alcohol intake You need to utilise evidenced based literature to support your discussion. For the purposes of this paper, while seminal work (early literature) may be referenced, contemporary literature is a requirement. At least fifteen (15) credible and relevant references are required in this essay, and most should be research articles (reflecting the higher levels of evidence).
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Sample Answer:

Claudia’s Case Study
Identify which stage of Erikson’s psychosocial stage of development Claudia is in (with rationale for your choice) and describe why she may be behaving in this way.
According to the description of Erikson’s psychosocial stage of development, Claudia is in stage 6. The stage is called intimacy vs. isolation (Dimitrova et al., 2019). The stage involves developing intimate relationships with other people. The outcome is strong relationships, and the failure is isolation and loneliness. The stage involves exploring personal relationships. One of the objectives is to find people who are loving and committed to a relationship. People in this stage strive to find enduring and secure relationships (Gross, 2020). During the formation of relationships, young people are likely to display deep affection (Maree, 2021). Deep affection contributes to the risk of engaging in unprotected sex. Claudia is engaging with a long-term boyfriend and now finds herself pregnant. The pregnancy is unexpected, owing to her commitment to school work.
The reason why Claudia is in this stage is her age. According to Erikson’s psychosocial stage of development, the intimacy vs. isolation stage occurs among people between 18 and 40 years. Claudia is 20 years old and in her second year at the university. Claudia has been exploring her relationship with her boyfriend. Intimacy has led to pregnancy. Another reason why Claudia is in stage six is that she is exploring her relationship with her boyfriend. For instance, she has been intimate with her boyfriend, indicating that the two are exploring their relationship.
Identify one key element of the Spirit of MI and describe how the HCP will use this to elicit Claudia’s reasons for wanting to change
The healthcare practitioner can utilize the element of evocation. The element involves drawing out the ideas rather than imposing them (Gagneur, 2020). For instance, the healthcare practitioner must find out the reasons for quitting or reducing alcohol intake. The approach of the specialists is to allow Claudia to take charge in explaining her motivation (Gillam & Yusuf, 2019). The information will help the healthcare practitioner to determine the appropriate mechanisms to help the client overcome the alcohol problem.
Some of the strategies the healthcare practitioner can utilize to address Claudia is for her to describe the reasons for the desire to quit alcohol or minimize usage. For instance, during this critical moment of her pregnancy, she may indicate that pregnancy is the main cause of the decision. The healthcare practitioner will use the information to ensure Claudia has a long-lasting change. Maintenance is a critical success in the behavior change process (Fifield et al., 2019). Healthcare practitioners should ensure they promote positive behavior among patients.
Evocation is effective since the HCP will use it will elicit the need for change. The patient will identify the reasons why they need to change. It will be effective for the patient to identify the personal reasons why they should quit alcohol. Alcohol addiction is a common disorder that affects millions of people country-wide. To enhance successful change, the client should have personal reasons. For instance, Claudia may be determined to change for the unborn child’s safety. Another reason may be the health of the mother during pregnancy. Additionally, Claudia may be foreseeing the kind of parent she wants to become in the future. Various reasons may impact the decision to change. It is relevant for the HCP to use the opportunity to encourage Claudia to fast-track her desire for change until they realize their new envisioned life.
The HCP should spend sufficient time listening to Claudia to understand her inspiration, thoughts, and plans. The conversation is healthy since it will help the client to listen to themselves speak about the need for change. The arguments will inspire them to implement their resolutions. One of the important roles of HCP is to listen, evoke, and strengthen the motivation for change (Fifield et al., 2019). A HCP should embrace the mindset that the patient is already strong, willing, and capable of change. The role of the HCP will be supportive of actualizing the change.
Describe the Motivational Interviewing techniques the HCP will use to Help and support Claudia to the Action Stage (with reference to her alcohol use) and to work towards the Maintenance Stage.
The motivational interviewing techniques relevant to the case study include asking open-ended questions, affirmations, reflections, and summaries (Sokalski et al., 2020). Open-ended questions are essential in enhancing the conversation with Claudia. The questions allow the patient to express themselves on the issue of alcohol use. For instance, the HCP can ask a question like, how would you like things to be different? The question will allow Claudia to explain why and how they want things to be different. Another question is, what have you tried before to make a change? The question will help the HCP to know if the patient has tried to quit alcohol use in the past and why past efforts failed.
The second motivational interviewing technique is affirmations. Affirmations are statements that acknowledge a person’s strengths (Fortune et al., 2019). Affirmations are effective in building the confidence to change. For instance, the HCP can affirm that Claudia is caring, sensitive, and thoughtful since she cares about the unborn baby. The thought of minimizing or quitting alcohol use is a strength that can encourage Claudia to start the alcohol use cessation journey confidently. Another affirmation is to laud the patient for seeking help. It is rare for people to seek help, especially on alcohol use. A statement such as, I’m so glad you came into the clinic today. I know it is not always easy to seek help, will encourage the patient to continue coming to the clinic to seek help.
The first motivational interviewing technique is reflective listening. Reflective listening involves listening keenly, analyzing the message, reflecting on the message, and seeking clarification of the message (Passmore, 2022). The HCP needs to listen keenly to Claudia. Listening should involve maintaining eye contact and paying attention to the details. Reflecting on listening will encourage the client to share more information about their struggle with alcohol use.
The HCP can use summaries as a motivational interviewing technique. The objective is to demonstrate that the specialist has been listening. Summaries are essential for linking various issues that emerge in a conversation, transitioning, and reinforcing what the patient has said (Phillips et al., 2018). Summaries give patients the confidence to share information since they know a specialist is keenly listening. It allows a specialist to get more details that will aid in supporting a client in the transformative journey of embracing new behavior. It is vital to use summaries to understand why Claudia intends to reduce alcohol use, the efforts made in the past, the intended actions, and possible challenges.
Outline what new behaviors Claudia would need to engage in to be successful in the Action Stage and to achieve improved health outcomes long term and to reach Maintenance.
The new behavior that Claudia needs to embrace is total abstinence from negative behavior. For instance, she must avoid going to the bar or associating with friends who make her drink. She should change her circle of friends and associate with people who will inspire her to accomplish her goals. She can reduce the number of bottles she drinks by buying from the liquor store and taking the alcohol home. However, total abstinence is the recommended action for behavior change (Pennington, 2021). It is important to find something to do during the weekend when she is most likely to engage in a drinking spree. For instance, she can go swimming, hiking, or visit her rural home. She can take a short course in the evening, enroll in the gym, and book club. Diversionary tactics are needed to alter the old habit of excess consumption of alcohol. In the long-term, Claudia needs to divert her attention to other engaging activities that will prevent her from taking alcohol (Prochaska, 2020). For instance, finding an accountable friend will reduce the risk of consuming alcohol.
Outline how resilience will play a role in Claudia’s quest to reduce her alcohol intake You need to utilize evidenced based literature to support your discussion.
Resilience is an important element in the quest to reduce alcohol intake. One of the roles of resilience is fostering discipline in behavior change. Reducing alcohol intake involves overcoming diverse temptations and hardships (Lyvers et al., 2020). It helps a person to maintain the change despite the stressful period. For instance, Claudia will likely experience withdrawal symptoms when she starts the journey to reduce alcohol intake. She will face ridicule and pressure from her peers to continue her former habits. It will take resilience for the patient to strive toward the desired goal.
Resilience is important during the change process since it will help Claudia bounce back from adversity (Connors et al., 2020). One of the challenges she will face is finding a new circle of friends. Reducing or quitting alcohol consumption attracts loneliness. Claudia will need to find a new activity to avoid the temptation to go on a drinking spree. For instance, as a student, she needs to overcome the risk of free time, which can draw her back into old habits.
Resilience is important since it will help the client keep going despite the setbacks (Kelifa et al., 2020). Quitting or reducing alcohol consumption will involve diverse temptations. If Claudia finds she did not adhere to the alcohol reduction plan, she should bounce back and continue with the transformative journey. Resilience is a critical component since a decision to change a lifestyle will attract opposition (Kelifa et al., 2020). People who are striving for change will face stress and anxiety. For instance, there is anxiety related to the possibility of overcoming the temptations and the stress of a new life without alcohol. If Claudia were taking alcohol with her boyfriend, she would need to overcome the temptation and pursue her dreams.

References
Connors, C. A., Dukhanin, V., March, A. L., Parks, J. A., Norvell, M., & Wu, A. W. (2020). Peer support for nurses as second victims: Resilience, burnout, and job satisfaction. Journal of Patient Safety and Risk Management, 25(1), 22-28.
Dimitrova, R., Hatano, K., Sugimura, K., & Ferrer-Wreder, L. (2019). The Erikson Psychosocial Stage Inventory in adolescent samples: Factorial validity and equivalence of identity as measured from the United States and Japan. European Journal of Psychological Assessment, 35(5), 680.
Fifield, P., Suzuki, J., Minski, S., & Carty, J. (2019). Motivational interviewing and lifestyle change. In Lifestyle medicine (pp. 207-217). CRC Press.
Fortune, J., Breckon, J., Norris, M., Eva, G., & Frater, T. (2019). Motivational interviewing training for physiotherapy and occupational therapy students: effect on confidence, knowledge and skills. Patient education and counseling, 102(4), 694-700.
Gagneur, A. (2020). Respiratory syncytial virus: Motivational interviewing: A powerful tool to address vaccine hesitancy. Canada Communicable Disease Report, 46(4), 93.
Gillam, D. G., & Yusuf, H. (2019). Brief motivational interviewing in dental practice. Dentistry Journal, 7(2), 51.
Gross, Y. (2020). Erikson’s stages of psychosocial development. The Wiley Encyclopedia of Personality and Individual Differences: Models and Theories, 179-184.
Kelifa, M. O., Yang, Y., Herbert, C., He, Q., & Wang, P. (2020). Psychological resilience and current stressful events as potential mediators between adverse childhood experiences and depression among college students in Eritrea. Child Abuse & Neglect, 106, 104480.
Lyvers, M., Holloway, N., Needham, K., & Thorberg, F. A. (2020). Resilience, alexithymia, and university stress in relation to anxiety and problematic alcohol use among female university students. Australian journal of psychology, 72(1), 59-67.
Maree, J. G. (2021). The psychosocial development theory of Erik Erikson: critical overview. Early Child Development and Care, 191(7-8), 1107-1121.
Passmore, J. (2022). Motivational Interviewing–a model for coaching psychology practice. Coaching Practiced, 245-254.
Pennington, C. G. (2021). Applying the transtheoretical model of behavioral change to establish physical activity habits. Journal of Education and Recreation Patterns, 2(1).
Phillips, R., Copeland, L., Grant, A., Sanders, J., Gobat, N., Tedstone, S., … & Paranjothy, S. (2018). Development of a novel motivational interviewing (MI) informed peer-support intervention to support mothers to breastfeed for longer. BMC pregnancy and childbirth, 18(1), 1-14.
Prochaska, J. O. (2020). Transtheoretical model of behavior change. Encyclopedia of behavioral medicine, 2266-2270.
Sokalski, T., Hayden, K. A., Bouchal, S. R., Singh, P., & King-Shier, K. (2020). Motivational interviewing and self-care practices in adult patients with heart failure: a systematic review and narrative synthesis. Journal of Cardiovascular Nursing, 35(2), 107-115.

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