Q1. Lauren is at the age of 16 and is currently passing through the complexity of adolescence. She had few clinical complications along with some behavioural issues tagged with her lifestyle which is constantly providing her crisis both physically and mentally. However, during the time of conversation the prominent issue of mood fluctuation has been noticed in Lauren. As per the idea of Haverfield, Theiss & Leustek (2016), mood fluctuation is the mood swing of an individual within a very short span of time into a spectrum of feelings like anger, happiness, depression, agony, laughter and more. There are different reasons behind the occurrence of such issues like any external agent, environmental factor or in-born orientation of the mind of an individual. However, in the case of Lawrence, the issue of mood fluctuation is not associated with the in-born mental orientation.
Lu et al. (2016) has researched regarding the human psychology and psychiatric issues and has conspicuously mentioned that in-born issues of mood swing can be identified with the analysis of the genogram and family background of a patient. The family background has been analysed in the case of Lawrence and it has been identified that there is no chance of inheritance of the issue of mood fluctuation in her. However, Lauren being a girl of sixteen has a habit of drinking alcohol for a litre or more per week. This has a tremendous effect over her thinking pattern and psychiatry. Weitzman et al. (2015) has stated that people experience a trigger of mood swing in the process of alcohol detox. However, in the course of being with alcoholism, the issue of mood fluctuation is noticed as the addict loses the grip over emotional control and gets more pessimistic. The issue of mood fluctuation of Lauren is directly linked with her alcohol intake.
Q2 (a) Rob has his intention to invoke a behavioural change in the lifestyle of Lauren and he has intention to do the same not from the angle of a friend but not by implying guardianship over Lauren. This is one of the most appreciable facts which should help Lauren to make up her mind. In the provided scenario and by analysing the conversation between Lauren and Rob, it is quite prominent that the root cause of the depression and lethargy of Lauren is her habit of alcohol consumption. Hence, the drinking habit of Laurence should be changed. Vaughan & Hogg (2014) has mentioned that, in the course of adolescence, an individual has better integrity with friends than that of their patients. The friend circle, per and personal association have greater influence over the mind of an individual than that of the parents. Hence, from this angle, the attitude taken by rob is quite helpful.
When Lauren mentioned that she and her friends used to drink a cask of wine, at that time she felt that this information might be licked to her patients. In that context, Rob assured Lauren that the entire discussion should be kept secret between two of them. This has created a space of assurance and safety for Lauren. Moreover, as influenced by Rollnick, Miller & Butler (2008), the feeling of being secure and comfortable of being safe is one of the major factors which is tagged with rehabilitation of any type of addiction. The same thing has been provided by Rob. Hence, Lauren should feel more comfortable to open up her mind in front of Rob and to state all information about her alcoholism and to listen to the words of Rob more carefully. This should help her to change her behavioural pattern about her liquor intake.
Q2 (b) Rob has taken active part in the management of the adolescence problems of Lauren and with the analysis of their conversation, it is clear that Rob has his intention to invoke a change in the lifestyle of Lauren by involving her into the practice of physical activity by getting abstained from alcoholic beverage. Though Rob has created a space of dependence and comfort with Lauren, yet some of the behaviour of Rob has been identified as unsupportive for Lauren to change her behaviour. Rob tried to convince Lauren to abstain from taking alcohol by putting pamphlets and brochures. In a few cases, the conversation has taken a formal shape of monologic communication. As per the idea of Brown & Sawyer (2016), in the case of monologic conversation, one of the participants sparks and the other has to listen by not being involved in the course of conversation.
This is usually noticed in the case of lectures. After a certain time, Lauren felt that is getting lectured by Rob. This has made her depressed and she has lost interest in speaking about her issue and well-being. Hence, the style or mode of communication of Rob can be criticised here and it can be analysed that this may act unhelpful to detach herself from alcoholism. Moreover, Wuyts et al. (2018) has mentioned that monologic communication takes the shape of dictatorship, which is often rejected by the individuals with the adolescence problem. The same thing has been identified in the case of Lauren as she felt the words of Rob just like her mother and step-dad. In This context, Lauren broke into tears and intended to drop the conversation as that was no more pleasing to her. Hence, it can be analysed that this type of communication of Rob may not help Lauren to change her habit in the near future and she must not involve herself in the course of physical activity.
Q3. After analysing the conversation of Rob with Lauren, it can be recommended that he needs to change his style of communication with the patients like Lauren to make them motivated towards changing their lifestyle. Lauren has lost her motivation from getting involved with her previous habits like playing netball, doing regular schooling and from her studies as well. Moreover, she was passing through a complication of adolescence which has turned her to take the habit of drinking alcoholic beverages with her close friends on the weekends. Additionally, she was not ready to listen to her parents as she felt that her parents are making impositions over her. As per the idea of Clark et al. (2008), friendly and informal communication can help a person to get emotional support in the critical phase.
The communication style of Rob is like lecturing and Lauren found a resemblance of it with her parents’ instructions. Hence, it can be recommended that Rob should change the style of communication and should take up participative conversation to make Lauren interested in taking part with the same. Rob should conduct interaction more friendly with Lauren and should not just instruct her to do physical activities or change her drinking pattern. Rather, it can be recommended that Rob should leave choices or potions in front of Lauren to make her interested to think about them. This demands more time and interactive activities as well.
Q4. Transtheoretical model of behavioural change
The drinking habit and lack of motivation in doing physical captivity of Lauren is needed to be changed. In this context, the application of transtheoretical models has a greater role. As per the idea of Prochaska, Redding & Evers (2015), transtheoretical model is generally applied in the providence of rehabilitation from habits like smoking, drug abuse of alcoholism. Hence, this has a relationship with the issue of Lauren. Liu et al. (2018) has mentioned that the model has been developed in six stages which includes precontemplation, contemplation, determination, action, relapse and maintenance as well. In the stage of precontemplation, the patient remains at the condition of being completely uninterested in changing the target behaviour. However, in the stage of contemplation, the awareness impulses acts minutely over the mind of an individual and the person takes interest towards the matter. Lauren is now at the stage of contemplation, where she is interested to know about her illness and root cause of her lack of motivation. However, she is not in the stage of determination to change her lifestyle. This transit from contemplation to determination is quite a critical task and for Lauren this should be done by Rob in order to bring her in the course of doing physical activity and regular schooling. Active interaction is needed to push Lauren to give up alcoholism. However, strict monitoring should be kept to prevent the issue of relapse of the previous habit which will help her to move towards maintenance.
Lauren has turned less motivated towards doing physical activity and about her studies and she has accepted that she is physically ill to do so. This needs to be changed. In this context the application of the ARCS model can be mentioned. As per the idea of Drench et al. (2012), ARCS model includes four stages which include attention, relevance, confidence and satisfaction. The attention of Lauren should be drawn towards physical activity and regular schooling. Active participation and metal support should help the same. On the other hand, the relevance of this vacation should be explained to her. This will certainly develop confidence in her mid which will further provide her satisfaction.
Brown, H., & Sawyer, R. D. (2016). Dialogic reflection: An exploration of its embodied, imaginative, and reflexive dynamic. In Forms of Practitioner Reflexivity (pp. 1-12). Palgrave Macmillan, New York.
Clark, N. M., Cabana, M. D., Nan, B., Gong, Z. M., Slish, K. K., Birk, N. A., & Kaciroti, N. (2008). The clinician-patient partnership paradigm: outcomes associated with physician communication behavior. Clinical pediatrics, 47(1), 49-57.
Drench, M. E., Noonan, A. C., Sharby, N., & Ventura, S. H. (2012). Motivation, adherence and collaborative treatment planning. In M. E. Drench, A. C. Noonan, N. Sharby, & S. H. Ventura (Eds.), Psychosocial aspects of health care (3 rd ed., pp. 114– 141). Upper Saddle River, NJ: Pearson Education.
Haverfield, M. C., Theiss, J. A., & Leustek, J. (2016). Characteristics of communication in families of alcoholics. Journal of Family Communication, 16(2), 111-127.
Liu, K. T., Kueh, Y. C., Arifin, W. N., Kim, Y., & Kuan, G. (2018). Application of transtheoretical model on behavioral changes, and amount of physical activity among university’s students. Frontiers in psychology, 9 (2), 2402.
Lu, K. D., Manoukian, K., Radom-Aizik, S., Cooper, D. M., & Galant, S. P. (2016). Obesity, asthma, and exercise in child and adolescent health. Pediatric exercise science, 28(2), 264-274.
Prochaska, J. O., Redding, C. A., & Evers, K. E. (2015). The transtheoretical model and stages of change. Health behavior: Theory, research, and practice, 97 (2), 445-448.
Rollnick, S., Miller, W.R., & Butler, C.C. (2008) Motivational Interviewing in Health Care: Helping Patients Change Behaviour. New York: Guilford Press. pp 3-21.
Vaughan, M. G., & Hogg, M. A. (2014). Social cognition and social thinking. In Social psychology (7th ed., pp. 38-313). Frenchs Forest, NSW: Pearson Australia.
Weitzman, E. R., Ziemnik, R. E., Huang, Q., & Levy, S. (2015). Alcohol and marijuana use and treatment nonadherence among medically vulnerable youth. Pediatrics, 136(3), 450-457.
Wuyts, D., Soenens, B., Vansteenkiste, M., & Van Petegem, S. (2018). The role of observed autonomy support, reciprocity, and need satisfaction in adolescent disclosure about friends. Journal of adolescence, 65 (2), 141-154.
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