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Methods of Intervention HMNS 10097
Stages of Change Assignment
Christopher Maxwell

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Section 1
Case Study
Mary is a 50-year-old Caucasian woman who has been struggling with alcohol addiction
for almost 15 years. Growing up, Mary’s childhood was difficult. She was abandoned by her
birth father and raped by her step father. During young adult hood, Mary was beginning to find
success. She had a good position at the RBC bank in downtown Hamilton when health
complications started. She was diagnosed with Crohn’s disease which forced her to quit her job.
Difficulties in health also caused her to have a miscarriage. Relying on her husband’s income
was difficult as well because he also was in some addictions trouble, and the marriage was going
through rough times. As a way to make ends meet, Mary started working at the local bar under
the table because it did not effect her ODSP income and she did not have to work a rigorous
schedule, so she could work around her health problems. This quickly led to Mary staying late
after work to grab a drink, making her weekends about having drinks at home and ultimately,
caused major problems in her marriage. One night, Mary mixed her medication with alcohol and
ended up getting drunk to a point that she left the bar with another man that she mistook for her
husband. Her husband knew where the guy she left with lived, and showed up to the house just in
time before she was forced into sex with random strangers. This caused a falling out in the
marriage, where the two mutually agreed that things were only getting more toxic between each
other. All the while, her son has seen all of this and had to live through it during his adolescent
years. Mary and her son live together, in a run down triplex house. Her son has stated that it
would be very helpful that they try and move out to start anew.

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Today, Mary has taken steps to conquer her alcoholism, but is still struggling. When
health problems flare up, or money issues become more urgent, it causes Mary to rely on
drinking to try and numb the pain and stress. With her 21 year old son’s support, she does want
to make the change. She understands it’s a threat to her health to continue drinking and she
understands that drinking does not help anything, and that it only makes things harder. The
interview can be found in the appendix.
Problem
Mary cannot break her addiction to alcohol. She has attempted rehabilitation methods
many times but feels she is in need of more external help from a social worker. In addition, she is
unable to gain any extra financial income which makes moving out difficult for her and trying to
support her son through school nearly impossible, which adds to the stress and causes her to
drink more.
Section 2
Stages of Change
Mary is currently in the preparation stage, although she has cycled through all of the
stages many times. Mary displays eagerness to make change, she addresses her issues and she
speaks confidently about success and handles her failed attempts at achieving soberness. The
preparation stage is defined as “people have made a commitment to make a change. Their
motivation for changing is reflected by statements such as: “I’ve got to do something about this
— this is serious. Something has to change. What can I do?” This is sort of a research phase:
people are now taking small steps toward cessation. They are trying to gather information

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(sometimes by reading things like this) about what they will need to do to change their
behavior.” (Volz, 2009).
I believe that Mary has progressed through the precontemplation stage and the
contemplation stage as she has acknowledged that her problem behaviour needs to be changed
and her ambivalence towards the issue is gone as well. I would even argue that Mary has started
to work on tasks under the Action stage as she is starting to take larger steps towards correcting
behaviour. She is not quite there yet because she still needs to work on creating a concrete plan
to follow, but she is progressing well. She understands that her addiction problem has multiple
aspects that are affecting her life and that she has to tackle one issue at a time in order to make
progress.
Mary can successfully move into the Action stage if she continues to consciously make
progress the way she has. She should also be meeting with myself regularly, working with other
counsellors and taking advantage of opportunities in the community. She has expressed a dislike
towards rehabilitation centres and prefers to avoid Alcoholics Anonymous so the big step we
have to work on is changing her attitude towards those resources or finding effective alternatives.
Once she can understand that she just has to let the system help her, she will be able to truly
graduate into the Action stage, but as of now she is still displaying signs of uncertainty towards
these programs. However, Mary is eager to work with new resources and guidance provided to
her and she displays a need for less structured programs. As mentioned, Mary understands that
she cannot overload herself by trying to handle all of the problems that alcoholism has caused
her at once. An explanation of Domain Specificity will help further her understanding of the
multiple issues drinking has caused her.

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Section 3
Definition of Strengths Based Model
The Strengths Based Model is a model in which Social Service/Social Workers are
starting to use as a new way to present information and work with problem behaviour. It works
from a perspective that highlights strengths and encourages clients to work with their positives
rather than trying to focus on their negatives. For example: a client is able to work well alone but
can’t handle the idea of groups. Rather than traditional social work models which would focus on
the idea that this client is antisocial and needs to be ‘fixed’, Strengths Based would look at this
client’s ability to work well independently and try to build success off that. Problem behaviours
and challenges are considered obstacles that can be overcome, rather than a focal point. When
traditional social work focuses so hard and precise on troubled behaviour, generally that
behaviour is created into a bigger issue than it actually is. The Strengths Based Model works in a
cycle (Hammond, Zimmerman, 2014), as it passively works on issues because it focuses actively
on building strengths into even greater assets and does not bring attention to the weaknesses.
Personal Strengths
Firstly, Mary has some tremendous personal strengths. Having a history with this
behaviour, she has developed a great sense of self-awareness. Mary is able to identify her
emotions and take responsibility for her mistakes when she is required to. Mary also is able to
communicate effectively with others, showing that she can sort her emotions and articulate her
true feelings. She is able to comfortably talk about anything which makes working with her
smooth. Even when she feels like she has encountered issues on her path to recovery, she is able
to push through her phases of depression with her supports.

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Environmental Strengths
Mary uses most of her environmental strengths effectively. She reports to counsellors,
does active research and does her best to take feedback from all sources. She also does a good
job of staying active in the community. Even if its not related to solving her drinking behaviour,
Mary keeps herself busy by shopping and spending time with friends and family. Mary has a
close relationship with her mother. Mary had a brother who passed away from a drug overdose,
but she was always close with him and their mother. Now, she confides in her mother and looks
to her for support and guidance as this issue has effected her family before. Mary’s ability to put
her faith into people is a good sign that she does not feel alone and understands it is okay to ask
for help. Often, she volunteers at her mother’s retirement building to keep busy by building
relationships with the residents and giving herself purpose.
Personal Obstacles
Mary’s personal obstacles are few but powerful. Mary has bouts of depression and health
issues. Mary has had some major surgeries in her life and she lives with Crohn’s disease, so day
to day life on a physical level can either be really good or terrible. On those terrible days, it
proves very difficult for Mary to continue on as the positive spirited person she is. Usually when
her health issues flare up, so does her depression. Mary falls completely victim to her body
shutting down and working against her which drives her away from her ability to sort her
emotions and work with her mental processes. These two powerful obstacles are almost
unavoidable. Mary understands that she has to do everything she can to push through these
situations and not give up on those days. Mary needs to give herself credit for her progress made

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rather than feel helpless, but understandably that’s a difficult thing to do when you feel
physically handicapped.
Environmental Obstacles
Mary’s environmental obstacles are people and agencies that do not work from a
Strengths Based Model or praise her for positive behaviours. Motivation helps Mary a long way,
but there are still many people that focus too much on the problem and not about the progress.
Her separated husband does not see or appreciate the steps she has taken. Woman Kind is
structured as an incarceration rehabilitation centre, where women are not allowed to leave until
specified hours, are only allowed to participate in programs when they display good behaviour
and are bound to a curfew. Her experience with that agency has shown her she struggles with
traditional social work models. Fortunately, Mary is starting to understand where the positive
agencies, people and resources that will work for her are located.
Strengths Based Plan for Mary
Mary has already started to take her first steps in a Strengths Based Plan that she has
almost created herself. She has built on her self-awareness greatly since her last attempt at
reaching sobriety. It is my job to help guide Mary and keep her on the track she is currently on.
Step 1. Praise for Self-awareness
 Continue to reinforce and encourage her independency and her ability to analyze her self
 Maintain contact with Mary and discuss progress regularly
 Allow Mary to understand that she is the expert, cater to her needs as she presents them
Step 2. Guidance

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 Provide Mary with resources that are specifically researched for her
 Consistently reinforce the values of Alcoholic’s Anonymous even though she expresses
dislike for that program
 Help Mary keep an open mind to new ideas and solutions
Step 3. Managing Obstacles
Personal Obstacles
 Really focus on her progress on days where her depression and health issues arise
 Create incentives and rewards for Mary to indulge in during difficult times
 Help Mary understand that failure is not the end, it means there is a fresh start at solving
problems. A chance to look at things differently.
 Provide support and resources that can help Mary effectively deal with mental health
issues if it becomes more of a prevalent day-to-day problem
Environmental Obstacles
 Redirect Mary from traditional social work agencies and negative influences
 Continue to increase her relationship with her mother
 Keeping Mary active in volunteering and creating new relationships
 Have Mary advocate for others that may not understand the perspective of a Strengths
Based Model
In summary, Mary should continue on the path she has chosen. I am here to provide
resources as she needs them and intervene every so often just to check in and keep progress

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moving. Mary is aware of the resources she has and just needs to continue to utilize them. It is
important that Mary stays resilient to the negative people and agencies in the community as it is
much easier to tear someone down for their weaknesses than build someone up for their
strengths.
In general, the Strengths Based Model is perfect for Mary. Her depression can cause some
lacking self-esteem issues, but support and praise for her good work helps negate those effects
almost entirely. The only negative I foresee using the Strengths Based Model is that Mary
describes herself as very resistant and stubborn if she falls into a strong drinking period. She has
a tendency to lie, become very introverted and avoid reaching out to anyone. She puts heavy
blame and stress on herself and has stated that it takes firm work and highlighting just how bad
things are in that moment. Unfortunately, the Strengths Based Model is meant to be a passive
solution to problem behaviour by distracting clients from the negatives and encouraging the
positive behaviours. The Strengths Based Model also does not put anyone ahead of Mary as the
boss and the expert, so according to her self-diagnosis, a firm aggressive stance is needed and the
Strengths Based Model does not provide a strong firm stance when it comes to those negative
behaviours.
Person-Centred Therapy Theory
The theory that would most effectively apply to Mary is the Person-Centered Therapy theory.
This theory invented in the 1940’s heavily influenced by Carl Rogers, states that every human
has a natural potential and follows the concepts of Maslow’s Hierarchy of Needs with self
actualization as the ultimate goal. This theory assumes that people are good by nature, that
everyone has the ability to work as an individual as well as utilize resources and be a resource

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themselves. This theory understands that there cannot be someone that understands the client
more than the client (Singh, 2016). The Person-Centered Therapy theory aims to increase self-
esteem by putting the person in the forefront rather than the problem. Workers participate in all
acts of life in this theory, rather than just being available for when trouble arises. This creates a
very intimate, personal relationship between client and worker. Mary has shown a genuine
interest in change and when she receives caring behaviour that guides her in the right direction,
her response and progress is duly noted. Mary has great self-awareness skills and her concept of
reality and society are proper and her understanding of her surroundings are sound. This theory
also applies well to Mary because of her expressed dislike of AA and Woman Kind. It is clear
that heavily structured programs are not as effective for her. This theory states that therapists or
workers do not need to posses any specific skills or knowledge and that a genuine and
empowering relationship is what works best.
Again, the negatives of the Person-Centered theory are that it does not support firm and
aggressive behaviour during times of crisis. This theory works diligently, calmly and passively
much like the Strengths Based Model does which has proven to work miracles for Mary, but in a
time of immense need, some of the calm empowering will not work effectively. Rather, Mary
needs to be given an understanding of what she is doing wrong. Of course this must be done with
respectful language and it is not to be done in a way that tears at Mary’s insecurities and attacks
her failures, but she needs to have a stern worker that is not afraid to admit Mary’s problems for
her when she finds herself unable to control.

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References
Hammond, W., & Zimmerman, R., (2014) A Strengths-Based Perspective, Resiliency Initiatives,
https://www.esd.ca/Programs/Resiliency/Documents/RSL_STRENGTH_BASED_PERS
PECTIVE.pdf
Hough, M., (2012). Counselling Skills & Theory. Hodder Education. Norfolk County United
Kingdom (Pg 124 -140)
Mehr. J., & Kanwischer R., (2004). Human Services: Concepts & Intervention Strategies.
Pearson Publishing Toronto Canada (pg 123-137)
Singh, L., (2016). Person-Centered Therapy Lecture, Mohawk College
https://elearn.mohawkcollege.ca/d2l/le/content/334275/viewContent/2635665/View?ou=
334275
The Stages of Change (2009), Transformation Children’s Services System
http://www.cpe.vt.edu/gttc/presentations/8eStagesofChange.pdf
Volz, C., (2009). Family Engagement Strategies, Transformation Children’s Services System
http://www.cpe.vt.edu/gttc/presentations/8VAModelsFamilyEngage.pdf

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Appendix
Interview with Mary
Question 1: Where do you believe this alcoholism stems from?
Answer 1: There are different things that contribute. PTSD and depression from my childhood is
a big factor. Financial stress, I want to move my son and I away from here. The landlord is a
dick, the place is falling apart, we cannot treat this place like home because of the history along
with it.
Question 2: Elaborate on the history of your current home, why is it difficult to be there?
Answer 2: As I mentioned, the landlord is awful. He does not care for us. My son has had a hole
in his ceiling for 3 years and the landlord has not tried to once fix it. A majority of my alcohol
problem has been in this house as well. My room wreaks of booze. I’ve spent so many hours
hiding in my room with a bottle of wine hoping that if I just drink, it’ll help me sleep. My son
has tried hard to deal with things as nicely and calmly as he can, but he’s 21. He has a life, and
sometimes he gets really frustrated with me but I can’t blame him for that. I’m ashamed that I
have become and alcoholic, but I’ve also developed a problem with lying to try and hide the fact
that I drink. Moving out of this house would help get the both of us in a new environment.
Question 3: It definitely seems like you’re aware of the problem and that’s good. You also have
some understanding of what you think would help, which is great. It shows that it’s an active

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thought in your head to try and conquer this addiction. What are some of the things you’ve done
in the past to try and work on this?
Answer 3: I’ve gone to many AA meetings. I’ve checked into Woman Kind which is a woman’s
shelter for addictions. I’ve undergone a 1 month of living in that shelter. It provided some
benefits but I want to rehabilitate on my own terms, I don’t want to be locked up in a shelter or
have to follow such a structured program, but my progress has waivered. I am ready to start from
anew, from step 1. My brother died from a drug overdose and it haunts me that I could be
following his path. He died young and I wish for him back everyday, I don’t want to put my
family through that.
Question 4: I’m sorry to hear that, but your plan and past progress sounds great Mary. Tell me
about some of the relationships that you have. Are you married?
Answer 4: I am separated from my husband. I have been for about 7 years now. Our relationship
was toxic, there was very little love and support for one another. Not to put the blame on anyone,
but he also had an addiction problem with drugs, so it created a great atmosphere for my
addiction to thrive in as well. My relationship with my son is broken but we are trying to repair
it. He lives at home with me and has been through every step of pain and frustration as I have
been. I’ve done a lot of lying to him but he still tries to support me. I have a good relationship
with my mother and my sister. They have also endured a lot, but they still remain supportive. In
general, my relationships are healthy. I took the time to get rid of toxic relationships with old
friends and the relationship with my husband remains at phone calls or short in person
interactions.

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Final Comment: That’s a great move on your part to be able to recognize these things. That’s not
always easy to break off a relationship like the one with your husband but you made a decision
that has proven to create a healthier environment for you and your son.