Motivational Interviewing in a Multicultural Setting

Motivational Inter assureing in a Multi heathen SettingMotivational Interviewing in a Multi cultural SettingLawrence, mamma is a city blue in cultural smorgasbord and heritage. The Hispanic population al angiotensin-converting enzyme boasts seventy three percent and continues to grow (Brown et al, 2013). This brings extraordinary challenges to the remedy ambit that consult directly to Hispanic cultural values. There argon alike challenges that Hispanics organization that are tally to substance do. Literature states that Latinos are more prob commensurate to binge drink and utilise drugs more heavily (Franklin Markarian, 2005). Lawrence overly has a very(prenominal) young Latino population, resulting in the mellowest proportion of the population be under five and eighteen years old in Massach subroutinetts (Jaysane Center, 2002). This is imperative to note in a city that reports a eminent level of substance phthisis among youth. Of many of the challenges that Lat inos formula with substance use, they are one-third less probable to enter residential treatment in the state of mamma (Caroll et al, 2009). This illustrates a community that has a prominent adopt for substance use treatment, yet is swanworthyly having that necessitate unmet. As a sociable bleed intern, I will oblige the opportunity to practice with Latino thickenings and families inwardly my community through in home therapy work. Therefore is alert, as a social worker, to better get by the Latino inviteeele within Lawrence and the punishing-hitting factors that cap baron set them apart from other customers within cure settings.Latinos in Therapeutic SettingsLatinos represent a very diverse crowd each having a unique narrative of social, political, and economic factors that allow caused their migration into the United States, or their families migration. This diversity continues to manifest across ethnicity, race, generations, language, but peculiarly nat ionality. Many Latinos identify first and fore or so by their country of origin and will often differentiate, I am Puerto Ri tush oer the official I am Latino. However, though individuals hold this diversity ascribed to their subgroup, many Latinos share core cultural values that are found on mutual experiences such as migration history, access to education and employment, as closelyhead as socioeconomic status. Due to acculturation and other psychosocial stressors, language, and poverty, Latinos may be particularly vulnerable within treatment and treatment organizations (Caroll et al, 2009). These divided up experiences can impact communication styles such as the willingness to disclose light-sensitive information which in turn impacts the clinical setting as traditional therapy models often assume direct disclosure from the invitee. This prepares a dysfunctional surroundings in which Latino invitees, ones that do not follow Westernized norms, risk purpose therapy to be invasive and opposing with their core cultural values. Therefore it is vital for social workers to consider cultural differences within the clinical setting. Mental health services among foreign-innate(p), monolingual Spanish- verbaliseing Latinos remains low when compared with bilingual Latinos born in the United States (Anez et al, 2008). This is because mental health suppliers are challenged to develop cultural and Spanish friendly services that will effectively address the pursue of a diverse Latino community. Substance Use FactorsSubstance use is a significant job among Latinos, who represent the largest ethnic minority group in the United States. However, treatment-related disparities wee-wee been identified as world pertinent to Latinos. Specific factors that bring on been identified as contributing to these disparities include the followers cultural and language barriers, poverty, stigma, the lack of bilingual and bicultural staff, and the lack of treatments that are exposed to Latinos needs (Anez et al, 2008). The necessity for trained professionals who get down the world power and empathy work with the distinct needs of Latinos is great within the therapeutic process. These noted discrepancies are of great concern because it is well documented that Latinos give extendd morbidity and death rate rates, blue incidences of suicide, school dropout, alcoholic beverage use, illicit substance use, and HIV transmittal (Anez et al, 2008). Regardless of an apparent need for mental health services very few members of the Latino community actually seek professional help. It appears that these services are not considered to be a primary source of support. In fact, fewer than one in eleven Latinos contact mental health specialists, and often seek services from a primary care provider first (Anez et al, 2008). This illustrates a client group that is currently at an unmet need for alcohol and drug use treatment. Latino clients might have a reason clients frequently complain that they feel abused, intimidated, and harassed by non-minority power (Sue, 2006). Latinos as a group are largely marginalized within greater society it does not help to do so within the therapeutic setting. Many social work theories originate from a monocultural standpoint, when social workers unconsciously inflict these standards without regard for other cultures, they may be engaging in cultural oppression (Sue, 2006). brotherly workers must enter the therapeutic setting witting of their own prejudices in order to learn and grow from them.Latino Youth in TherapyLawrence reports a in high spirits level of substance use among youth. In 2002, a survey was conducted within the city which collected the responses of 2,206 high school students resulting in respondents revealing that the majority of substances used are alcohol (52.9 percent), inhalants (39 percent), cigarettes (25.2 percent), and marijuana(19.9 percent) ( Jaysane Center, 2002). The repor ted substance use rates among Lawrence youth can increase the risk of dropping out of school for many, as the drop-out rate of high school within the city has been very high in current years. Rates as much as fifty percent of high school classes dropping out between their freshmen and senior years have been reported ( Jaysane Center, 2002). There have been a number of factors attributed to the drug use of Latino youth. For example, the role of the family has been identified as being the most essential component of addiction treatment for the client. It has been shown that parents attitudes, and the use of drugs, tactical maneuver a key role in the drug use expression of twelve-seventeen year old Latino youth ( Franklin Markarian, 2005). Adolescents in particular have a potential ambivalence when it completes to quitting substances. However Latino youth also share an additional cultural ambivalence attributed with the Latino identity. Motivational Interviewing in a Multicultur al SettingMotivational interviewing (MI) is a client-centred counselling access code that uses certain techniques in order to produce motivation to change among ambivalent clients (Miller and Rollnick, 2013). Latinos can be considered ambivalent clients as a result of cultural and systemic factors that are experienced collectively as a group. ambivalence in this sense can be defined as needing to limit a change, but seeing little to no reason to do so (Miller and Rollnick, 2013). MI has been found to be highly effective in the treatment of substance use disorders. However, many Latinos do not seek needed treatment for substance use. There have been a number of cultural values that have been reported to extend to the therapeutic human relationship to varying degrees the three most prominent being personalismo (personal relationships), respeto (respect), and confianza (trust) (Anez et al, 2008). MI is a therapeutic model based upon respect and trust as it is a collaboration which honors the clients experiences and individual perspectives. Latinos have also been reported to work towards engaging in pleasant colloquial exchanges, and to avoid unpleasant ones, often trying to avoid conflict. MI permits the desegregation of these cultural values within the therapeutic setting, as it also avoids channel within the therapeutic relationship. This method differs from other more challenging styles that might advise a client about changes that need to be made, sooner MI creates a more cooperative therapeutic setting where the Latino clients internal motivation is drawn out and explored. This heart and soul that the counsel is not leading sessions or dictating the client in anyway. instead the counselors role is to guide the client, listen to the client, and offer friendship when needed. This method is ideal when workings within the Latino community, especially when most therapeutic speak toes have shown to cross with their core identity. Clients are experts on themselves no professional can know them better than they know themselves (Miller and Rollnick, 2013). If the counselor has the ability to show the Latino client their support of the clients personal expertise, it can create a positive relationship and rapport within the therapeutic setting, and in turn creates a catalyst for change.Motivational enhancement Therapy Motivational Enhancement Therapy (MET) has been proven to help individuals resolve ambivalence around engaging in treatment as well as stopping substance use. The approach inclines change quickly through motivational methods. Research found on MET methods suggests that its effects depend on the type of drug used by participants as well as on the goal of the intervention. For example, MET has been used successfully with people who are addicted to alcohol and who want to deoxidise their problem drinking (Caroll et al, 2009). Brief motivational interventions (BMIs) such as this have also been identified as being parti cularly effective methods when working with Latino adolescents who have substance use disorders, in fact, Brief motivational interventions (BMIs) have been identified as particularly promising for use in efforts to reduce or eliminate adolescent alcohol and other drug use problems (Cordaro, 2012). The client-counselor relationship and the counselors ability to engage with the Latino adolescent, has also been found to be a key factor within the motivational therapeutic setting. initial impressions count as the initial therapy session appears to be significantly correlated to the clients dropout from the intervention (Cordaro, 2012). In summary, the ability for the counselor to piddle rapport with the client from the first session is one of the most grievous factors when working with the Latino community, in particular with youth.Client ApproachThis overture fall I will begin an internship providing in-home therapy services with Lahey Behavioral health in Lawrence, Massachusetts. I will unquestionably have the opportunity to work with Latino clients and families within the community. When working in family systems, I might come across a situation in which a client within that system might have a substance use discommode that needs to be addressed. When addressing the substance use issue with either an vainglorious or an adolescent, the first impression and rapport is extremely important during the initial session, as it has been shown to be linked to successful client engagement. My focus for motivational interviewing would rely on building a positive and strong relationship with my Latino clients so as to build enough trust to persuade towards change talk. It is important for me to note that Latino clients hold an admiration for former(a) adults that is attributed to the spiritedness experience and a general detection that their wisdom holds significant value, younger generations are taught to respect their elders and greet adults with a courteous Sen or or Senora (Anez et al, 2008). Pretending my client is significantly older than I am I would approach therapy in the following way. First I would begin by asking the client how they would like to be addressed, this would provide the client the ability to structure a conversation around name or nicknames that their friends or family call them, or possible formal titles such as Senor or Senorita. It is also important for me as to be able to address the client respectfully, and to take a careful note of pronunciation. I would structure questions around cultural values, such as being a buena genta (likeable person), family values, respect, trust, and personal relationships (Anez et al, 2008). . In terms of being a likeable person, I could structure a question such as, How important is it for you to be viewed as someone who is likeable? this shows me the importance that the person holds on their image and how others view them. I would also be interested in knowing how the client inter acts in interpersonal relationships outside of therapy this can be achieved by asking, When you are first getting to know someone, what helps you feel comfortable? or What does it take for you to develop trust with someone?. This can help me gain an rationality of the clients strengths, stressors and coping mechanisms. I would also ask, How do you get by conflict? or Can you tell me about a minute of arc when your trust was broken? This can give me an understanding of how the client handles and copes with sound situations, or if the client has a resistance to talking about hard situations within a therapeutic setting. I would further ask the client what their expectations of trust are within our therapeutic setting, summarizing the session with a shared agreement using the values of trust put forward by the client. This shows the client that I value trust and the client as an expert. everyplace the course of many sessions I would continue to understand the clients value system as well as where they stand in terms of change talk. Open-ended value questions would give me an insight into what real matters to the client. I would ask the client what they value the most in life, which can sometimes help to be a motivation for change. This can especially be motivating if the client values their family, a child, being employed or having an education. Once the client has reached the point of talking about their values, I would spend time using a number scale in order to help guide conversation around where my client is in terms of changing, making sure to have all documents used with the client translated if fits the clients need. The clients identified goal during this time might be to reduce the amount of the substance used. Once a goal has been identified and set with the client, I would continue to guide the client into conversation with questions such as how life was like before drug use questions about the future, as well as what advantages and disadvanta ges are in terms of their current drug use patterns. I would summarize that session with a collaborative treatment forge that the client feels is realistic for them, and will continue to check up on how the client is doing with the treatment plan during each following session, making additional adjustments along the way and talking about the process. SummaryThe community of Lawrence, Massachusetts is home to a large proportion of Latinos and the population continues to grow, bringing with them unique challenges especially pertaining substance use and therapy. Latinos drink and use drugs more heavily, a trait that often cascades to younger generations. Latino clients are in need of substance use help, however they are less likely to enter treatment, leaving the need largely unmet. As a social work intern, who will be conducting in-home therapy for families within the city of Lawrence, it is my responsibility to check out that the cultural values of my clients are integrated into th e therapeutic setting. As a Latina social worker, clients might not be as resistant to my therapeutic methods as they might to a non-Latino social worker. As a Latina, I understand and share many core cultural values with Latino clients. Because of this, I might have the ability to build a stronger rapport, one that is essential during the beginning stages of the client-counselor relationship. However, I do not speak swimming Spanish. In fact I only have the ability to speak a limited amount of words, and a few phrases. This largely limits my ability to work with clients who are predominantly in Spanish speaking households, as I am not bilingual. There is also the possibility that I might be looked down upon because I do not speak Spanish, as if I have betrayed my culture and heritage. It is important for me to be aware that these opinions exist, and to notice that they might come up during counseling sessions. If they do I would do my best to redirect the questions back onto my cl ient in a calm and collected manner. In general, MI is the best approach when working with Latino clients as it has been proven to work with ambivalent clients as well as clients with substance use disorders. MI also fosters an environment that is inclusive towards the cultural values of Latinos, and fosters the collaborative therapeutic process between the client and counselor. When the cultural values of the Latino community are taken into consideration, it fosters change, and retains client engagement within therapy.ReferencesAez, L. M., Silva, M. A., Paris Jr., M., Bedregal, L. E. (2008). Engaging Latinos Through the integrating of Cultural Values and Motivational Interviewing Principles.Professional Psychology Research Practice,39(2), 153-159.Brown, N., Chesbro, T., Lee, D. H., Puza, H. (2013). Lawrence, Massachusetts greenbelt Plan. University of Massacusetts, 1-50.Carroll, K. M., Martino, S., Ball, S. A., Nich, C., Frankforter, T., Anez, L. M., et al. (2009). A Multisite Randomized Effectiveness Trial of Motivational Enhancement Therapy for communicative Substance Users.Journal of Consulting and Clinical Psychology,77(5), 993-999.Cordaro, M., Tubman, J. G., Wagner, E. F., Morris, S. L. (2012). Treatment Process Predictors of Program Completion or Dropout Among minority Adolescents Enrolled in a Brief Motivational Substance affront Intervention.Journal of Child Adolescent Substance Abuse,21(1), 51-68.Franklin, J., Markarian, M. (2005). Substance Abuse in Minority Populations.Clinical Textbook of Addictive Disorders, 321-339.Jaysane, A. P., Center, M. P. (2002). The Community Context of Health in Lawrence, Massachusetts.Lawrence, MA Merrimack College.Miller, W. R., Rollnick, S. (2013). The Spirit of Motivational Interviewing.Motivational InterviewingHelping People Change(3rd ed., ). New York, NY Guilford Press.Sue, D. W. (2006). Principles and Assumptions of Multicultural Social Work Practice.Multicultural Social Work Practice. Hoboken, N.J. Wiley.