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Mary is 27 years old and has had a history of alcohol dependence for several years. Mary has a daughter Kylie, aged 3 years, who displays signs of fetal alcohol syndrome. Social work services have been involved with Mary and Kylie since her birth, culminating in Kylie being looked after by the local authority as a result of Mary arriving to collect Kylie from the local nursery while significantly under the influence of alcohol. Mary has demonstrated ambivalence regarding her ability to control her alcohol use. Mary has referred herself to a local counseling agency as suggested by the social worker and her PCP.  When Mary explained her history to the group leader, the psychiatric NP said, “You want to change.  Great!  But, how do you think you got this way?  Let’s explore the past.”  

What techniques or pitfalls were used by the nurse practitioner?
Discuss how you might use the principles of motivational interviewing to facilitate change with Mary.   
Describe how a provider would recognize this patient is ready to change.  Use principles of motivational interviewing to support your answer.
SCIENCE
HEALTH SCIENCE
NURSING
NUR 650