3.14 Imaginethatyouworkatacommunityhealthcentre.Karina,20yearsold,hasbeenreferredto you in relation to her concern with weight loss. She has recently started overeating andher meals are based around high calorie diets causing her to gain weight. Her partner, Zachisveryconcernedandwanted hertoget somehelp.

A- In your first session with Karina, she seemed distracted and not keen to talk aboutherself. You asked her what brought her to counselling, and she responded, "I have noclue what I am doing here. Zach seems to think I have a eating and weight problem, buthe is just being paranoid. It's all good." In the space below, write down how you woulddocumentKarina'sstageofchangeinyournotes.

B- After you have worked with Karina for a few sessions and made a range of changes, youwanttoinitiateadiscussiononoutcomesfromtheintervention.Inthespacebelow,writeone statement that you could say to Karina in order to begin this discussion.

C- During the review process Karina tells you that she feels as though she is not gettingenough support to get over her unhealthy eating habits. List two (2) resources that youcould suggest to Karina for her to feel more supported in changing her behaviour.

D You realise that a brief intervention will not be enough to solve Karina's issues as she hasconsistentlybeenunabletosticktohergoalsduetoherphysicaldependenceonunhealthyfood.Whatdoyouthinkwouldbethebeststeptotake?(

3.15 Imaginethatyouhavejuststartedworkingwithanewclient,LisaCarr.Shehasbeendrinking

alcoholsinceshewasateenagerandisnow46yearsold.Overthepast5yearsshehasstarteddrinking excessively since her husband passed away. In these 5 years she had a period of 1monthwhenshe didn'ttouchalcoholbutwasunable tosustainthechange.During the session, Lisa tells you that she is drinking up to half a bottle everyday now. Shereportsthatshehasdecidedtogiveupdrinkingbutis cluelesshowtogoaboutit.Shesharesthe reason for her wanting to quit is a man she has been dating and is very interested in.However,hehasbeenalittlewaryofherdrinkingandshedoesn'twanttolosehim.Shealsotellsyouthatherchildrenarealsofedupwithherdrinkingandshedoesn'twanttobeaselfishpersonanymore.Whenyouaskherwhatshegainsbydrinking,shetellsyouthatithelpshertodullthepainoflosing her husband in an accident. But now that she has this new friend, she is hopeful ofstaying clean. You praise and encourage Lisa for making this decision and also provide Lisawith brochures on the 'ills of alcohol' and also provide her details of the support group shecan join. Lisa's goal is to drink only when she is with her friend and be accountable to hereldestdaughterbykeepingherinformed of herdrinkingroutine.

Complete the following assessment form to record Lisa's client details and stage of changebasedontheaboveinformation.

STAGEOFCHANGEASSESSMENT NewLightInterventions
Session Number:1Date: Counsellor:	Clientname:LisaCarr Age:46 Gender:Female
Issuesofconcern Drug UseAlcoholUse NutritionalConcerns Other.Specify _
Explanationoftheconcernraisedabove:
Datewhentheproblemstarted
Historyoftheissues(expressanytimewhenthiswasnotaconcernandhowthesituationhas progressed) :
Currentsituation:
Current stage of change:Pre-contemplative

ContemplativePreparationAction

Maintenance

Evidenceforstageofchange:

CostsandBenefitsofcurrentbehaviour:

Supportprovided:

Clientplan

Followup