Lecture: Motivational Interviewing Content: During these lectures a number of different aspects of motivational interviewing came up. Initially the principles of motivational interviewing were looked at these include; avoid argumentation, express empathy, support self-efficacy, roll with resistance, develop discrepancies. We then discussed how this might be done with a client.

To work with a client efficiently using motivational interviewing techniques it would be important to know where they are on Prochaska and DiClemente’s wheel of change. There are six stages to this wheel and these stages are; Pre-Contemplation, Contemplation, Preparation, Action, Maintenance and Relapse. Once the clients status on the wheel has been established, a variety of techniques would be used to implement the principles.

Some of these techniques which are considered central to this kind of counselling are asking open-ended questions, making simple reflections on what the client says to show that you are listening, affirmation to show empathy and support for the client, elaboration so that you may explore some of the clients ambivalence and develop discrepancies, double-sided reflections can also be effective at this. Amplified reflections can sometimes be used to promote self efficacy as can summaries.

During these lectures we also did a lot of role plays of all these different techniques to ensure that there were no misunderstanding of how these techniques would work in a counselling session with a client. Critical Reflection: Whilst enjoying the majority of these lectures and finding them very informative and useful, I did find that some of the techniques used here would not be very useful in all counselling situations with a client who is abusing drugs.

I do not think you could use this kind of counselling techniques in isolation, as I feel some clients would not appreciate having everything the discuss with you in a counselling session reflected back to them. However I would have to say that the wheel of change is a very effective way of working with drug abusing clients as it gives you a very clear framework to work within and if you are clear on where the client is at on this wheel, it would ensure that the work that was done with that client would be effective and relevant to the stage that the client is currently at in their drug usage.

Application of Theory to Practice: These lectures have been very beneficial when working with active drug users who are thinking of change. I have found since these lectures my work has become much more effective for the clients I work with, this has been because of my awareness of the wheel of change. I have found this invaluable as it has given me a framework within which to view where the client may be at in terms of their readiness to deal with their drug usage. This has meant that I am now looking at what the client is currently ready for and have not been rushing the client to whatever stage I think they should be at.

I have also found that when undertaking an intervention with a client, I have now found my ability to assess the clients actual situation has improved immensely through the use of the different skills I have picked up from these lectures. I have found the use of techniques such as reflections and open-ended questioning have been invaluable in this way. Personal Learning and Self Development: I have learned a lot about myself through these lectures. I have found that I may not have been as effective in my previous interventions as I may have hoped for.

This I think has been mainly down to my rushing the clients a little too much in the direction of change at a stage when they where not completely ready for this. These lectures have shown me that I will need to work on my listening skills but im hoping with the use of techniques such as the wheel of change and reflecting back what the client is saying, this will help me determine what the client is ready for and will stop me from moving the sessions in a direction the client may not be ready for. Lecture: Holistic Therapy Lecturer: Peter Kelly

Content: During this lecture we looked at a variety of factors that can affects a person’s stress level and how they can cope with these stressors in their lives in a holistic way. Initially the different levels were discussed, these include being understressed, Eustress, overstressed and being distressed. We then discussed some of the signs of stress which can consist of loss of concentration, feeling tired, irregular sleeping patterns, irritability, sudden lack of confidence, panic attacks and a withdrawal from social situations.

After this the lecture moved on to how stress can effect a person in that it can have physical, cognitive, emotional or behavioural effects. Each person has their own specific determinants for their stress levels in that the have to look at their own self esteem, their past experiences and family background, their moral values and personality and what social support network they have to rely on. They could also however have a professional stressors which could include what kind of job they have, if they have any supervision or support networks if they are being given effective training and development and if they are part of a cohesive team.

After this burnout was discussed and what attitudes can contribute to this these included feeling that you are the only person who has the right ideas, blaming yourself if anything goes wrong, being a perfectionist, not being able to delegate, feeling you have more to do and less time to do it in. There are three stages to burnout they are, early stress arousal, struggle and resistance and exhaustion and breakdown.

We then spent some time deliberating over how a person could cope with stress and some of ways that came up were learning to relax, talking rationally to yourself, to exercise and to get organised, watch your habits and to have some quiet time. We then discussed the different kinds of holistic therapies that were around, some of these include acupuncture and meditation. We also tried simulating what a holistic session could be like. Critical Reflection: I enjoyed this lecture for a variety of reasons. I found it very nformative in that it made me aware of what could increase a persons stress levels and how to recognise some of the symptoms of this over stress. It also made me aware of burnout and how this can impact on a person not only professionally but personally. I had not thought about the personal element to this before and was extremely interested in this. I did however find that the simulation of a possible holistic session a little ineffective in the session that we had as it was a busy room and difficult to focus on finding a calming influence to fully receive the benefits of this session.

I felt that a demonstration such as that would have been better in a smaller space on a one to one basis. Application of theory to practice: I have found since this lecture I have been able to apply what I have learned to my work. I have found that I am now conscious of my own stress levels and as such am finding that when my stress levels are rising , I am now taking a step back and relaxing rather that continuing which has increased my productivity. I have also become aware of the different signs of stress and have found that this has helped me help some of the clients I work with.

As I am now aware of how a person may behave when they are overstressed or distressed, I am now able to talk to them effectively about this and have been able to recommend some things they may be able to do to rectify this situation. Personal Learning and Self Development: I have learned a lot about myself through this lecture. I have found that while I recognise the benefits of quiet reflection in distressing a person, I found it extremely difficult to carry out in practice and this is something I feel is important that I work on for myself.

I found that my ability to assign myself specific times to this difficult as I felt that I had other things to do, however when I pushed myself beyond these initial thought I found the experience very beneficial. I also found this lecture very effective in that it made me very aware of my own stress levels and what methods I had been using to deal with this stress and as a result of this lecture I have been finding alternate ways of dealing with my stress levels in a more effective manner. Lecture: Hepatitis Content:

In this lecture we looked at the forms and nature of hepatitis. To do this we initially discussed the liver and stated that it had a variety of functions which included; it stores glycogen which can be a rapid source of energy, it detoxifies the body of unwanted drugs, it helps regulate chemical, hormonal and cholesterol levels, it makes coagulant factors which makes the blood clot if you bleed, it helps deconstruct used red blood cells, it makes certain proteins which are essential for the control of body fluids and it stores excess minerals and protein.

Hepatitis can have a lethal effect on the liver in that it is an inflammation of the liver, it can be caused by drugs, viral infections or alcohol. There have been six types of hepatitis identified so far. These different types also can have different routes of transmission. Hepatitis A and E are mainly caused by poor sanitation in developing countries. Hepatitis B,C,D and G are transmitted by blood or blood products or sexually. Hepatitis C was then examined in detail. Hepatitis C was not discovered until 1989, there are believed to be 170 million people worldwide infected with hepatitis C.

There are 6 genotypes found of the virus depending on what part of the world you come from. In Ireland we mainly find genotypes 1,2 and 3, there are no vaccines available, nearly 80% of people infected will end up with chronic illness, this means there will either be scarring of the liver or more seriously cirrhosis or cancer. There are also some factors which can worsen the symptoms, which include drinking alcohol, using recreational drugs, having other viral infections such as HIV or having genotype one.

Some of the sources of infection are injecting drug use, sexual, transfusion, unknown and occupational. Injecting drug users are four times more likely to have hepatitis C than HIV. Harm reduction is very important for drug users to decrease their chances of being infected. There are also a number of different tests available to people to determine if they have the virus and after that what genotype they have. Before treatment a person must be off all recreational drugs and have had a favourable result from a liver biopsy.

They also must not be pregnant, have cardiovascular diseases or have a severe liver disease. Treatment length depends on what genotype the person may have. Critical Reflection: This lecture was tremendously relevant and informative in my opinion. It was very enlightening in terms of how the liver functions and how much this is impaired by hepatitis. I also was fascinated to hear how the person involved can help their situation both in the prevention stage and when they have been diagnosed with the virus.

However I was very disappointed to discover that a person could not receive treatment unless they were over six months drug free. Although I could appreciate the reasoning behind this I think that that is a lot to ask of a chaotic drug user who has been recently diagnosed. I also was shocked to discover that a person who has hepatitis is very unlikely to receive a transplant and was surprised to discover that there is not protection for people from this kind of discrimination. Application of Theory to Practice:

I have found the information I have gained from this lecture extremely useful in my work with active drug users. I have now been able to explain how effective not sharing of any drug paraphernalia and having clean works is in preventing a person from contracting the virus. I have also found that when a person has informed me when they have been diagnosed with hepatitis, I have been able to give them clear and concise information and advice about what they may need to do or just general information about what hepatitis is and how it may or may not impact on their day to day lives.

Personal Learning and Self-development: I thoroughly enjoyed this lecture as I found that I learned a lot about hepatitis that I had not known previously. I found through this lecture that while I had a lot of information about prevention and routes of transmission and what hepatitis was I did not know a lot about treatment and what side effects the treatments would have on a person. I was quite shocked to realise how few treatments there are available and how strict the criteria is for accessing this treatment.

I found that this aspect of the lecture bothered me a lot as although I could see the reasoning behind these restrictions it still bothered me. I found that I have had to look at these restrictions on a more objective level and not personalise the impact these restrictions may have on the clients that I work with. Lecture: Alcohol and Problem Drinking Content: During these two lectures Alcohol addiction was looked at from a variety of standpoints. Initially it was considered from a historical perspective, the word alcoholic was around from as early as 1849.

A variety of the models of addiction were discussed in this lecture in relation to alcohol addiction, the moral model was looked at along with the temperance movement, after that the American Disease idea was considered with AA being discussed. Education was also examined in terms of how it works and who are the educators. Alcohol addiction was then viewed in terms of how it would be treated and what way it would be treated depended on the thinking behind why a person became addicted in the first place.

Some of the thinking here included characterological reasons, conditioning, biomedical, social learning, general systems, sociocultural and public health. After this the different treatment centres that are in existence in Ireland were mentioned and what philosophies they use. Some of the different treatment centres include St John of God’s and the Simon Community Detox which is a three week programme which focuses mainly detox followed by alcoholics anonymous. Critical Reflection: I found these lectures extremely interesting as the lecturer seemed o stress that alcohol addiction was different in a lot of ways from addiction to other drugs. He stated that alcohol addiction could be said to have more of a conditioning and social learning influences as in Ireland it was deemed to be a more socially accepted pastime to be in the pub drinking. I also found it extremely interesting to hear about the different treatment centres in Ireland however I felt he did not spend enough time discussing this aspect. I was a little disappointed to not hear in a little detail what services were provided in each of the treatment centres in relation to alcohol addiction.

Application of Theory to Practice: These lectures gave me some new ideas for working with clients who are beginning to feel that they may have a problem with alcohol. Our lecturer asked each of us to keep a record of what we drank in the course of a week and in what situation we were in when we drank whether we were at home or out with friends. I have found asking a client to carry out a similar survey of their drinking habits has been very helpful in attaining an accurate record of someone’s drinking habit along with establishing whether or not their was any routines to their drinking.

I have also found that I am now aware of what treatment centres cater for alcohol addiction and this has been a great help when working with clients with alcohol problems as I am now able to give accurate information on the services available to the client immediately rather than having to ask a chaotic client to come back to me at a later time while I try and find this information out for them. Personal Learning and Self Development:

This lecture was very effective for me in that it pointed out some of the misconceptions I had about alcohol addiction. I had not really considered all of the different theories behind why a person could become addicted to alcohol. I had assumed it would be the same for all drugs which includes alcohol and while there is a lot of similarity I was supprised to discover I had not looked at social learning and conditioning as being major theories in this area. I am trying to maintain a more open-minded outlook when working with clients who are addicted to alcohol in the future.