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Why Should You Learn This Model? When interns begin a new field placement, they are eager to serve, to learn, and to make a change in the world. After all, you are supposed to be “change agents,” right? The harsh reality begins to set in when faced with clients who are not quite ready to make changes. I am certain you are nodding your head right about now! In my decade of providing field supervision in the addictions field of social work, students have brought an array of issues to my attention. No issue has been as recurring as the anxiety, struggle, and challenge students face when they come to the realization that change comes slowly. Students completing their field placements in addictions, as well as many other fields of social work, come face to face with patients in different stages of change. When a patient in the “action” stage is assigned to you, it is usually smooth sailing. Am I right? However, when you are assigned a client in the “pre-contemplation” stage and the “contemplation” stage, it is a different story. Agree? You begin to question your abilities and even question whether you have made the right career choice. These are normal feelings and questions, but hang in there—you will get through! The best case scenario is to address these uncertainties, fears, and concerns as soon as possible when writing your process recordings and during supervision. Changes in behavior do not occur instantaneously. For example, students working in substance use fields need to understand that the disease of addiction compromises the ability for a person to make automatic behavioral changes. These changes are difficult, even for people facing the risk of losing their homes, employment, family, or children. As a student, you might find it almost incomprehensible that a person would risk these losses. The fact is that the disease of addiction is so overpowering that even if a doctor tells someone “you will die if you do not stop using alcohol,” the person will continue to consume alcohol if not ready to stop. This notion can be applied to clients struggling with all sorts of issues, such as gambling, tobacco use, and eating disorders. This reality is difficult for the most seasoned social worker to grasp. So I 8 The New Social Worker Winter 2017 can imagine what you, as a student, must go through when you come face-to-face with this fact. It is overwhelming, to say the least. The array of biopsychosocial issues your clients struggle with, coupled with the slow rate of client change, can increase your level of anxiety immensely. This becomes even more difficult to cope with when you know that you have to meet the field placement and school’s expectations. Conceptualizing Change Differently Conceptualizing change as a stage process can be helpful in many ways. First, you can begin to see change happening along a continuum. Second, becoming familiar with the Stages of Change Model will provide you with the opportunity to integrate evidencebased interventions that are compatible with each stage of change. Also, understanding your clients’ readiness and ability to change will allow them to move at their own pace—thus, honoring their autonomy. In addition, this model will provide you with a concrete and logical framework that can be used with any client, no matter what Stage of Change they are in. Finally, it will provide you with a way to track your client’s progress. Keep in Mind It is important to keep in mind that the stages of change are cyclical. In other words, clients can suffer setbacks. A client can take two steps backwards before being able to move forward again. Also, movement from stage to stage is not time-specific. Some clients can move from stage to stage much faster than others. Other clients can be stuck in the same stage of change for a long time. Do not become discouraged when this occurs. Instead, take this time to explore the discrepancies that are preventing your client from moving to the next stage of change. Also, use this time to explore with your client the pros and cons of making changes. Finally, this time can be used to educate your clients about the possible consequences that can come from not making changes in their lives. Exploring discrepancies, discussing the pros and cons of change, and educating your clients about the consequences associated with current behaviors will help your clients begin to move toward change. It is imperative to understand that clients can be in different stages of change relative to different life areas. For example, a client can be in the Pre-Contemplation Stage of Change in relation to alcohol use and in the Contemplation stage in relation to establishing mental health services. It is important to carry out a comprehensive assessment of your clients’ needs in order to be able to determine their readiness and willingness to make changes in different areas of life. Having a clear understanding of the Stages of Change model will help you explore appropriate interventions, identify possible barriers to change, and provide you with the opportunity to team up with your client to find ways to remove those barriers. Finally, and most importantly, recognizing your clients’ level of readiness to change will discourage you from personalizing their failures or triumphs. Instead, it will help you become your clients’ ally, cheering them on until they achieve CHANGE! Good luck in your field placements. Thank you so much for all the difference you are making. References Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research and Practice, 19, 276-287. Maria E. Zuluaga, LCSW-R, has worked in addictions and mental health for more than two decades. She received her bachelor’s in psychology and sociology, as well as her Master of Social Work, from Stony Brook University. In 2016, she received a Master’s in Addiction Counseling from the National Certification Commission for Addiction Professionals. She is pursuing a Ph.D. in social work research at Wurzweiler School of Social Work— Yeshiva University. Her research interests are addictions, mental health, and cultural competency. She has been a Supervisor in Field Instruction for 10 years.
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Page 1 and 2: Winter 2017 Volume 24, Number 1 FEA
Page 3 and 4: CONTENTS FEATURES Student Role Mode
Page 5 and 6: Student Role Model Tanisha Bowman b
Page 7 and 8: policy require such documentation?
Page 9: can be learned by students at all l
Page 13 and 14: and perceived pathways to achieve t
Page 15 and 16: • 10 Essential Tips for Your Amaz
Page 17 and 18: Kennedy-Hendricks, & Chisolm, 2015)
Page 19 and 20: The A-to-Z Self-Care Handbook for S
Page 21 and 22: minutes, we hear the door open. Fro
Page 23 and 24: scenario in which the student must
Page 25 and 26: Social Work Students in Action With
Page 27 and 28: I see a lot of movies. I just wrote
Page 29 and 30: saying their illness out loud and c
Page 31 and 32: scale your action to something you
Page 33 and 34: Are You Covered if Your Client Data
Page 35 and 36: Reviews Overcoming Destructive Ange
Page 37 and 38: youth who navigate a world of racis
Page 39 and 40: Read Dr. Bodenheimer’s blog at so

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