BRIEF INTERVENTION IN PRIMARY CARE

BRIEF INTERVENTION IN PRIMARY CARE
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THIS IS THE PAPER SUBMITTED BY SARA TO BE RESPONDED OR REACTED TO.

Our client for this week is a fictional client. Marcos is a Hispanic male, 60 years-old and divorced. He recently retired due to a medical condition. A year ago he was diagnosed with diabetes and he has not been able to control his sugar levels since his initial diagnosis. Marcos lives alone and tends to forget to take his medication, he also does not follow his diet as he hates cooking for himself.

Marcos came to see his primary care physician as he has been noticing changes in his sight. He had an optometrist appointment more than a month ago and they have told him that he is loosing his sight due to his uncontrolled diabetes.

While attending his PCP appointment, his doctor provided a warm-hand-off to the newly hired BHC. After assessing the patient, the BHC used motivational interviewing to assess the patient and to learn more about his motivation or lack of to control his diabetes and the reasons for not regularly taking his medication.

As this was the initial meeting with Marcos, the BHC started with the following stage to find out what motivates Marcos and to learn a little about his story and see his life through his eyes, (Rollnick et al., 2008, p. 14). After listening to Marcos for a little while, the BHC changed from following to the inform and guide stage to educate Marcos about his diagnosis. Apart from using motivational interviewing skills and informing and guiding, the BHC used acceptance and commitment therapy to assist Marcos to agree to live a meaningful life, (Robinson & Reiter, 2015, p. 127).

Together, Marcos and the BHC, drafted some goals for the next month. Marcos will purchase a medication dispenser that will help him remember what and when he has to take his pills. Marcos will take his medication as indicated by the physician every day for the next four weeks. Additionally, Marcos will go grocery shopping every Sunday for fresh fruits and vegetables. Every Monday, Wednesday and Friday, Marcos will cook chicken avoiding frying it. Tuesday and Thursday, Marcos will choose to cook from beef or pork. Marcos will have free days during the weekend to eat what he chooses. Apart from trying to cook meals at home during the week, Marcos will walk 15 min. after dinner every night around his neighborhood.

The main challenge that the BHC faces with Marcos is that he does not have a good support system that can assist him to keep motivated to make the dietary changes he needs. Since he has not taken care of himself from the time he was diagnosed with diabetes, his condition is very advanced and he is at high risk of loosing his sight.

Reference:

Rollnick, S., Miller, W. R., & Butler, C. (2008). Motivational interviewing in health care: Helping patients change behavior. New York: Guilford Press.

Robinson, P. J., & Reiter, J. T. (2015). Behavioral consultation and primary care: A guide to integrating services. New York, NY: Springer.

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