Case Study: Shelia

¶ … speak Holistic conceptualization considers biological, psychological, social, political, spiritual implications integrates Stage Change Model suggested treatment plan/interventions. Holistic conceptualization: Stages of change model The stages of change model indicates that people go through specific 'stages' when contemplating giving up a negative behavior pattern: pre-contemplation, contemplation, preparation/determination, action/willpower, and maintenance (Motivational interviewing and stages of change, 2014, SAMHSA). "By identifying where a person is in the change cycle, interventions can be tailored to the individual's 'readiness' to progress in the recovery process.

Interventions that do not match the person's readiness are less likely to succeed and more likely to damage rapport, create resistance, and impede change" (Motivational interviewing and stages of change, 2014, SAMHSA). In the case of Shelia, who has relapsed after undergoing treatment for her heroin and cocaine addictions, she would be said to be in the 'contemplation' stage of embarking upon change once again. During the 'avoidance' phase, the addict has no desire to change at all and does not identify his or her behaviors as problematic.

Given that Shelia has sought rehabilitation, admits she has lost jobs due to her addictions, and has also lost custody of her sons, she does seem to have some motivation to change. She has also recently discovered she is HIV positive, making her health even more a priority. But Shelia has not entered the preparation phase for change. She is currently living with a boyfriend who is a drug dealer and appeared disheveled and tired during the interview with her counselor.

The counselor must find a way to help Shelia extricate herself from her current living situation, either by Shelia moving in with one of her supportive family members or finding a placement in a home specifically for women with substance abuse issues. Shelia must find her own source of financial support in the form of a job, which will further incentivize her to stay clean and enable her to obtain an apartment without the financial support of a boyfriend.

During the action and willpower stage, Shelia must take actual, proactive steps to change, such as going to NA (narcotics anonymous meetings), keeping her doctor's appointments, and doing what is necessary to obtain custody of her children according to the judge. She should also be directed to places where she can seek additional counseling to cope with the trauma of past sexual abuse. The action and willpower stages are when the addict demonstrates constant, consistent commitment to make changes.

Finally, during the maintenance phase, the addict must continue to support the positive behaviors that resulted in a significant life change: going to work, seeking counseling for addiction and depression, and receiving medical support for treatment of HIV as well as addiction, in the case of Shelia. "Motivation is multidimensional and not easily assessed" (Motivational interviewing and stages of change, 2014, SAMHSA). Treating addiction means addressing the concerns of the 'whole person,' not merely treating the symptoms of addiction itself. The addict's environment and.