Scholarly article on topic 'Motivational interviewing in social work practice Melinda Hohman'

Motivational interviewing in social work practice Melinda Hohman Academic research paper on "Sociology"

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Journal of Social Work
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Academic research paper on topic "Motivational interviewing in social work practice Melinda Hohman"

This is a well-written book that shows a good understanding of the theory underpinning crisis intervention and the practice associated with it. The book is divided into 10 chapters, seven of which address specific theoretical approaches (psychoanalytic, developmental, behavioural, cognitive, systems, radical and social constructionist). The penultimate chapter addresses post-traumatic stress disorder before the final chapter offers an attempted integrated theoretical framework (although I would argue that what is presented is a model rather than a theory). For me personally, I think it is a great pity that an existentialist approach to crisis is not included, especially as it can combine the best elements of the other approaches, offer a spiritual dimension (crises are often of an existential or spiritual nature, in so far as it is generally when our sense of who we are and what our lives mean becomes disrupted that we experience a crisis) and provide a holistic understanding of crisis situations.

It is interesting that the author chooses to adopt a 'therapy' discourse to conceptualize crisis intervention. Radical social work, which features in Chapter 7, was rightly critical of 'treatment' approaches to social work which instil a hierarchical relationship within a medicalized discourse. 'Therapy' is less medicalized than 'treatment' but still implies that it involves bringing about change in a uni-directional way. I prefer to see crisis intervention as a process of empowerment based on learning -that is, to work within a liberatory education discourse, rather than a medical one. Loughran does discuss empowerment, but she appears to assume a 'zero sum' understanding of power - that is, it is assumed that if one person gains power (the client, for example), then another (the social worker) loses it. This is an oversimplification of a complex issue which fails to appreciate the importance of empowerment - especially in a crisis situation where, by definition, significant change becomes a possibility. An empowerment approach does not reduce the worker's power, but it does reduce the likelihood of such power being abused or misused (Thompson, 2007).

Overall, this is a book that is very worthwhile because it offers helpful insights into crisis work and helps to put the significance of crisis theory and intervention back on the agenda. However, it could have been a much stronger book if it had moved away from a traditional therapy model towards an empowerment approach. Crises offer opportunities for people to learn new, empowering coping methods and life strategies, rather than to receive 'treatment'.

References

Thompson, N. (2007). Power and empowerment. Lyme Regis: Russell House Publishing. Thompson, N. (2011). Crisis intervention (2nd edn.). Lyme Regis: Russell House Publishing.

Melinda Hohman, Motivational interviewing in social work practice. New York: The Guilford Press, 2012, 178 pp., £23.95 (hbk), ISBN 9781609189693.

Reviewed by: Muireann Ni Raghallaigh, University College Dublin, Ireland

As a book that focuses specifically on the use of motivational interviewing (MI) in relation to social work, this is a very important contribution to the literature.

Journal of Social Work 13(1)

Social workers may frequently think of MI as a method of working with clients experiencing addiction problems. However, Melinda Hohman, with the help of various contributors, highlights the value of this approach in working with a diverse range of issues including, for example, intimate partner violence and child protection. It is refreshing to see that the examples that are used span the micro-, mezzo- and macro-levels of social work practice. Thus the book is appealing to those working in diverse settings, whether with individuals, groups or communities. The practice examples are nicely balanced with theoretical elements, with the various chapters drawing on a range of social psychological theories, which are clearly explained.

The book begins by highlighting the relevance of MI to social work practice, emphasizing in particular the congruence between the values of MI and the values of professional social workers. It then provides a very accessible discussion of what is at the heart of MI, including the principles, the skills and the theoretical underpinnings. From there, Chapters 3-8 focus on particular elements or principles of MI (such as engagement and assessment, expressing empathy, developing discrepancy, rolling with resistance). These chapters follow a specific structure. The principle is explained and discussed in detail, with very good use made of research evidence. This is followed by a case example where a section of an interview between a social worker and client/clients is provided and analysed, with the key MI skills clearly labelled within the dialogue. These examples provide an excellent resource to those learning motivational interviewing for the first time and to those honing the skills that they already have.

The final two chapters are somewhat different. In Chapter 9, three social work practitioners provide narratives of their experiences integrating MI into their practice at micro-, mezzo- and macro-levels. These accounts will provide encouragement to social workers who might wonder if it is really possible to start using this approach, particularly when very different approaches are dominant within their agencies. Chapter 10, the concluding chapter, may be particularly useful for educators as it provides a model for teaching MI.

The book certainly has a strong North American feel to it. Only two of the 11 contributors are based outside of North America and there often seems to be an assumption that the reader is in the United States. In addition, while the book pays attention to diversity issues and the use of MI in cross-cultural settings, the diverse populations that are mentioned are generally groups living in the United States. While this is a disappointing limitation, the book is still highly relevant to educators, practitioners and students across the globe. Some of the chapters (e.g. Chapter 3 on engagement and assessment and Chapter 5 on expressing empathy) are also relevant to those simply learning basic social work/counselling skills, even when the focus is not on MI. Beyond social work, I believe that the book is also of relevance to other professionals interested in using MI in their practice (e.g. nurses, doctors, psychologists, counsellors and teachers).

Overall, this book provides the reader with a very comprehensive understanding of MI and its relevance in working with social work clients. In keeping with

Hohman's encouraging last words to 'give [MI] a try and see what happens', I suggest that educators, students and practitioners try out this book and see where it takes them.

Trish Walsh, The solution focused helper. Maidenhead and New York: Open University Press and McGraw-Hill, 2010, 255 pp., £23.99, ISBN-13 9780335228843.

Reviewed by: Patrick O'Byrne, formerly The University of Huddersfield, England

This is a most welcome addition to the Solution Focused Therapy/Helping (SFT) literature, which is a success on many fronts. In Part 1, first, it traces the development of SFT from ideas generated at the Mental Health Institute in California in the 1970s and 1980s, culminating in the work of Insoo Kim Berg, and of Steve de Shazer who was writing up to 2007. She also credits the work of 'Brief in London, and she draws on her own extensive work in Ireland. In so doing, she brings clarity to the distinctions between earlier strategic approaches and the pure solution-focused ideas of de Shazer and his colleagues, with their emphasis on promoting change rather than growth, and understanding rather than insight, while being interactional and pragmatic, rather than strategic or systemic.

Second, her exploration of the essential qualities of the helper's relationship with the helped (that of facilitator and collaborator, respecting the wisdom and resources of the person and therefore avoiding any abuse of power), is most helpful. Walsh deals impressively with ethical concerns that have been raised over the years and how current practice is even more transparent and empowering, not that it was ever disempowering.

Third, there is an excellent section on the core principles of SFT practice, on the clinical model of de Shazer et al. and on the influence latterly of constructivism, post-modernism and social constructionism. Part 1 also provides ends an informative analysis of the 'parallel knowledge bases' that a worker needs to have, such as the philosophy of behavioural and other interventions. She concludes this part with a review of the evidence base of SFT to date, a matter that frequently gets less attention than it deserves.

In Part 2 there are five brilliant chapters addressing cross-cultural practice, work with learning disabilities, practice in health care settings, work with older people and end-of-life care and, lastly, community development, group work and work in schools. Much of the difficult practice in these areas has been researched by Walsh and her colleagues, so she has clear ideas on how SFT has to be varied for some service user groups. For example, in some circumstances, the 'miracle question' has been found to be 'actively unhelpful', and scaled questions need to be simplified. She offers the 'On an ideal day...' question for work with younger people, in schools, for example, and I imagine that this question can be varied to 'On a good day... ' or 'On a better day...', depending on realistic expectations.

Walsh stresses the necessity of providing 'a human touch', partnership, information and support as well as having the key skill of 'reminding' very distressed