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Introduction
Motivational Interviewing(MI) is considered a conversation focusing on the client and their ambivalence for change.  Survivors of domestic violence shows behaviors that want to be changed, but due to the situation experienced might be ambivalent to change. Some of the behaviors they might have:
Worthlessness
Low self-esteem
Deprivation of their roles/responsibilities
Fear
Occupational therapists can work with survivors of domestic violence through motivational interviewing in order to assist them in the changing process for a better life.

Theory
The transtheoretical model assists in the behavioral change process which is divided in categories of pre-contemplation, contemplation, planning, action, and maintenance (Hughes & Rasmussen, 2010). It is important to understand the steps these individuals must take in order to make a change in their lives and incorporate themselves back in society. Through the appropriate interventions, the end goal of occupational therapists is for the client to take the next step in changing their behavior or situation.

Evidence
Evidence indicates that MI is effective for survivors of domestic abuse in “increasing their self-efficacy about ending violence and avoiding violent relationships” (Hughes & Rasmussen, 2008). MI has been effective for survivors of domestic violence in increasing their confidence that they can make changes for better outcomes (Miller & Rollnick, 2002; Wahab, 2005).  Participants expressed increased self-confidence and readiness to take control of their lives.

Case Study
Leslie is a 22 year old Harvard graduate with a degree in journalism. She was in a 2 year abusive marriage in which she suffered multiple head injuries causing a mild cognitive impairment. She arrived at the women’s shelter two days ago after experiencing a near death experience causing her to leave her husband. She is currently employed at the New York Post but is having difficulties fulfill work responsibilities.

Intervention Plan

Problem Statement
Client demonstrates difficulties maintaining deadlines for work due to reduced processing, problem solving, and sequencing skills.

Outcomes – Increase work participation.

Long term goals
Client will move from contemplation to maintenance in relation to completing tasks at work in a timely manner by discharge.
Client will independently implement 3 strategies for meeting work deadlines.

Short term goals
Client will identify 3 barriers preventing her from being successful at work in 2 weeks for work participation.
Client will independently identify 3 strategies for meeting deadlines in 2 weeks for work participation.
Client will move from contemplation to action in relation to completing work tasks in 2 weeks for work participation.

Intervention format:
Individual 45 min
Shelter for women and children who have been impacted by domestic abuse
Client would be seen at the shelter twice a week at 4:00 pm.

Supplies (if any): No supplies needed.

Agenda & description
Meet Lesley at the shelter for women and children and engage in one on one conversation (10 min)
Discover current barriers to independence (work tasks) (5 min)
Motivational Interviewing session (30 min)
What are some things that would make you successful at your job? (journalist)
What are some things preventing you from being successful?
How do you think you could manage those difficulties?
On a scale of 1-10, how confident are you that you will be able to make these changes?
It sounds like you have a plan for being successful at your job.
It seems like you really enjoy your career and you have what it takes to meet deadlines.
Provide a summary
Is it okay if I give you some evidence based strategies that may help you stay on task?

Documentation
S:Client stated that she is “having trouble meeting deadlines because I am easily distracted, and I can’t seem to follow through with a plan.”
O: Client participated in a 45 minute one on one interview with the occupational therapist where she actively identified one barrier preventing her from being successful at work. She also identified a possible solution to reducing distractions, however she initially feels that on a scale of 1-10, her confidence towards making this change is at a 4.
A: Client demonstrates that she has insight of what is preventing her to be successful at work, but her confidence rating to make the change is very low. This indicates that she is currently in the contemplation stage. However, due to being able to  identify possible solutions that will assist her in being more successful at meeting deadlines at work she is approaching the preparation stage.

P: Client will continue one on one therapy sessions 2 times a week to continue to increase change talk and create a plan as to which strategies she would like to use and how she will implement these strategies.

References

Miller, W. R., & Rollnick, S. (2002).Motivational interviewing: Preparing people for change (2nd ed.). New York, NY: Guilford.

Rasmussen, L. A., Hughes, M. J., & Murray, C. A. (2008). Applying motivational interviewing in a domestic violence shelter: A pilot study evaluating the training of shelter staff. Journal of Aggression, Maltreatment & Trauma, 17(3), 296-317.

Wahab, S. (2005). Motivational interviewing and social work practice.Journal of Social Work,5, 45–60.